Radio-transparent system for stereotactic radiosurgery and fractionated radiation therapy

• US 5,728,106 A
• Filed: 03/03/1995
• Issued: 03/17/1998
• Est. Priority Date: 04/16/1993
• Status: Expired due to Fees

• Current Assignee: Oregon Neuro-Medical Technology Incorporated
• Original Assignee: Oregon Neuro-Medical Technology Incorporated
• Inventors: Miller, Robert J., Heard, Stan, Misko, John
• Primary Examiner(s): Dawson, Glenn K.
• Application Number:
  US08/397,886
• Time in Patent Office: 1,110 Days
• Field of Search: 606/1, 606/130, 604/116, 128/653.1-653.5
• US Class Current: 606/130
• CPC Class Codes: A61B 2090/101 for stereotaxic radiosurgery
• CPC Class Codes: A61B 90/14 Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
• CPC Class Codes: A61N 2005/1097 Means for immobilizing the patient
• CPC Class Codes: A61N 5/1049 for verifying the position of the patient with respect to the radiation beam

Abstract

A rigid frame that is positioned around the skull to define a multi-dimensional coordinate system. Multiple arms are coupled together with a support ring to increase the overall stiffness of the frame. The arms and the support ring are made from a plastic material that makes the frame appear transparent in CT and MRI images. Receptors provide a mounting base upon which the frame is repeatedly attached and detached from the skull at the same reproducible reference location. Each receptor is mounted to the skull with a screw that inserts through a rear end. A drill assembly and attachment assembly are used to secure the receptors in the skull.

Claims

1. Apparatus for performing stereotactic radiosurgery upon a lesion within a skull, comprising:

a frame extending about a central axis for positioning around the skull, the frame defining a multi-dimensional coordinate system for localizing surgical procedures;

multiple vertically elongated arms each made from a plastic radio-transparent material and including a bottom end attached to the frame and a top end, each arm including an associated receptacle;

multiple assemblies insertable into the arm receptacles; and

a support frame made from a plastic radio-transparent material extending about the central axis and attached to the top end of each arm thereby holding each arm in a rigid lateral alignment.

2. An apparatus according to claim 1 wherein the frame and support frame are coaxially aligned about the central axis.

3. An apparatus according to claim 1 wherein the assemblies include a mounting pin for attaching the frame to an outside surface of the skull at a predetermined reference location, the mounting pin having a flat front face.

4. An apparatus according to claim 1 wherein the assemblies include a drill bit assembly for boring holes in the skull.

5. An apparatus for performing stereotactic radiosurgery upon a lesion within a skull, comprising:

a frame extending about a central axis for positioning around the skull, the frame defining a multi-dimensional coordinate system for localizing surgical procedures;

multiple vertically elongated arms each including a bottom end attached to the frame and a top end, each arm including an associated receptacle;

multiple assemblies insertable into the arm receptacles the assemblies including a mounting pin having a flat front face for attaching the frame to the skull at a predetermined reference location;

a support frame extending about the central axis and attached to the top end of each arm thereby holding each arm in a rigid lateral alignment; and

multiple receptors each for attaching to the skull and receiving an associated mounting pin, the receptors providing a mounting base upon which the frame can be repeatedly attached to and detached from the skull at the same reproducible reference location.

6. An apparatus according to claim 5, wherein each receptor includes a cylindrical hole extending partially through the receptor from a front face to a rear end.

7. An apparatus according to claim 6, including a screw hole extending through the rear end of the receptor from a rear end of the cylindrical hole to a rear face of the receptor.

8. An apparatus according to claim 7, including a receptor screw for inserting through the screw hole, the front face of the mounting pin including a concave indentation for seating over a head of the receptor screw.

9. An apparatus for performing stereotactic radiosurgery upon a lesion within a skull, comprising:

a frame extending about a central axis for positioning around the skull, the frame defining a multi-dimensional coordinate system for localizing surgical procedures;

multiple vertically elongated arms each including a bottom end attached to the frame and a top end, each arm including an associated receptacle;

multiple assemblies insertable into the arm receptacles;

a support frame extending about the central axis and attached to the top end of each arm thereby holding each arm in a rigid lateral alignment; and

means for selectively varying height of the support frame above the frame.

10. An apparatus for performing stereotactic radiosurgery upon a lesion within a skull, comprising:

a frame extending about a central axis for positioning around the skull, the frame defining a multi-dimensional coordinate system for localizing surgical procedures;

multiple vertically elongated arms each including a bottom end attached to the frame and a top end, each arm including an associated receptacle;

multiple assemblies insertable into the arm receptacles, assemblies including a drill bit assembly for boring holes in the skull, the drill bit assembly having a drill guide body insertable into any of the arm receptacles, a drill guide spindle for selectively inserting at various distances into the drill guide body and a depth gauge attached at a front end of the drill guide spindle for gauging the distance a drill bit is inserted into the skull; and

a support frame extending about the central axis and attached to the top end of each arm thereby holding each arm in a rigid lateral alignment.

11. An apparatus for attaching a stereotactic frame to a skull, comprising:

a frame;

a plurality of attachment assemblies each detachably joined to frame receptacles in the frame and configured to be extendably directed toward the skull;

multiple receptors each having a back end for attaching to the skull and a front end for receiving the attachment assemblies, the receptors providing a mounting base upon which the frame can be repeatedly attached to and detached from the skull at the same reproducible reference location;

multiple receptor screws each configured to extend through the back end of an associated receptor into the skull; and

a detachable drill guide body insertable inside the frame receptacles, a drill guide spindle adjustably insertable at selectable longitudinal positions inside the drill guide body and a depth gauge attached at a front side of the drill guide spindle.

12. A system for attaching a stereotactic frame to a skull, comprising:

a frame;

a plurality of attachment assemblies each detachably joined to frame receptacles in the frame and configured to be and extendably directed toward the skull;

multiple receptors each having a back end for attaching to the skull and a front end for receiving the attachment assemblies, the receptors providing a mounting base upon which the frame can be repeatedly attached to and detached from the skull at the same reproducible reference location;

multiple receptor screws each configured to extend through the back end of an associated receptor into the skull; and

an installation tool and a screw driver, the installation tool insertable inside the frame receptacles and having a front end insertable inside any of the multiple receptors, the installation tool for further aligning the receptor screws into pilot holes previously drilled in the skull.

13. A method for attaching a stereotactic frame to a skull, comprising:

spot facing the skull at locations where receptors are to be mounted to the skull, each spot face having a flat circular surface with a center pilot hole;

drilling screw holes into the skull at the spot face locations;

inserting receptor screws into receptors;

screwing the receptor screws into the screw holes thereby attaching the receptors to the skull;

inserting pins through receptacles provided in the frame and into the receptors; and

locking the pins to the frame thereby holding the fame in a given reference position in relation to the skull.

14. A method for attaching a stereotactic frame to a skull, comprising:

providing a stereotactic frame with receptacles in the stereotactic frame;

inserting a drill guide into one of the receptacles;

inserting a drill guide spindle into the drill guide;

inserting a drill bit attached to a drill chuck into the drill guide through the drill guide spindle until the drill bit contacts the skull;

attaching a depth gauge on the drill bit between the drill guide spindle and the drill chuck, the depth gauge having a given thickness;

moving the drill guide spindle longitudinally inside the drill guide until the depth gauge is snugly fit between the drill guide spindle and the drill chuck;

removing the depth gauge from the drill bit;

drilling the drill bit into the skull until the drill chuck comes in contact with the drill guide spindle thereby forming a screw hole in the skull a distance substantially equal to the given thickness of the depth gauge;

inserting a receptor screw into a receptor;

screwing the receptor screw into the screw hole thereby attaching the receptor to the skull;

inserting a pin through one of the receptacles and into the receptors; and

locking the pins to the stereotactic frame thereby holding the stereotactic frame in a given reference position in relation to the skull.

15. A method for attaching a stereotactic frame to a skull, comprising:

inserting a receptor screw into a receptor hole in a back end of a receptor;

inserting a front end of an installation tool into the receptor;

inserting a screw driver into the installation tool, the screw driver engaging with the receptor screw;

inserting the installation tool, receptor and receptor screw through a receptacle provided in the stereotactic frame;

driving the receptor screw into a screw hole in the skull with the screwdriver until the receptor screw is tight against a back end of the receptor;

inserting a pin through the receptacle and into the receptor; and

locking the pin to the frame thereby holding the fame in a given reference position in relation to the skull.

16. Apparatus for attaching a stereotactic frame to a skull comprising;

a plurality of attachment assemblies each detachably joined to an associated one of multiple receptacles in a stereotactic frame and extendably directed toward a central location in the frame;

multiple receptors for attaching to the skull and providing a mounting base and reproducible reference location for slidingly receiving a front end of an associated one of the plurality of attachment assemblies whereby the stereotactic frame can be repeatedly attached to and detached from the multiple receptors;

a detachable drill guide body insertable inside the stereotactic frame receptacles;

a drill guide spindle adjustably insertable at selectable longitudinal positions inside the drill guide body; and

a depth gauge attached at a front side of the drill guide spindle.