Image guided spinal surgery guide, system, and method for use thereof

• US 6,348,058 B1
• Filed: 12/10/1998
• Issued: 02/19/2002
• Est. Priority Date: 12/12/1997
• Status: Expired due to Term

• Current Assignee: Sofamor Danek Group, Inc. (Medtronic Plc)
• Original Assignee: Surgical Navigation Technologies, Inc. (Medtronic Plc)
• Inventors: Foley, Kevin T., Estes, Bradley T., Melkent, Tony, Chaudoin, Joseph
• Primary Examiner(s): Reip, David O.
• Application Number:
  US09/209,248
• Time in Patent Office: 1,167 Days
• Field of Search: 606/61, 606/60-66, 606/96-102, 606/129, 606/130, 606/11, 606/80-85, 600/426, 600/427, 600/429
• US Class Current: 606/130
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2034/254 being adapted depending on the stage of the surgical procedure
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/25 User interfaces for surgical systems
• CPC Class Codes: A61F 2/442 Intervertebral or spinal discs, e.g. resilient non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455
• CPC Class Codes: A61F 2/4455 for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages intervertebral discs A61F2/442
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/2839 Bone plugs or bone graft dowels
• CPC Class Codes: A61F 2002/4627 with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
• CPC Class Codes: A61F 2002/4632 using computer-controlled surgery, e.g. robotic surgery
• CPC Class Codes: Y10S 606/907 Composed of particular material or coated
• CPC Class Codes: Y10S 606/909 Bone
• CPC Class Codes: Y10S 606/912 Radiolucent material
• CPC Class Codes: Y10S 606/914 Toolkit for installing or removing spinal positioner or stabilizer

Abstract

A guide is disclosed for use in performing spinal surgery to prepare across a spinal disc and adjacent vertebrae an implantation space. The guide is associated with a computer controlled surgical navigation system employing an energy-detecting array to track positions of the guide in three dimensional space relative to a known reference point. The guide comprises a body for providing protected access to prepare across the spinal disc and into the adjacent vertebrae the implantation space. The body has a passage adapted to receive a bone removal device for forming the implantation space through the body. At least one electrically energizable energy emitter array is attached to the body for use in identifying the location of the guide relative to the adjacent vertebrae. A system and method for using the guide in spinal surgery are also disclosed.

Claims

1. A system for use in performing spinal surgery to prepare across a spinal disc and adjacent vertebrae an implantation space, said system comprising:

a guide for providing access to prepare the implantation space across the spinal disc and into the adjacent vertebrae, said guide having a passage adapted to receive a tool through said guide for forming the implantation space, said guide having at least one emitter array attached thereto for use in identifying the location of said guide relative to the adjacent vertebrae;

a computer controlled surgical navigation system employing an energy detecting array to track positions of said guide in three dimensional space relative to a known reference point;

an inserter sized for passage through said guide, said inserter having at least one emitter array attached thereto for use in identifying the location of said inserter relative to the adjacent vertebrae, said inserter adapted to hold one of an artificial implant and a bone dowel for insertion into the implantation space; and

wherein said computer controlled surgical navigation system tracks the position of said inserter in a three dimensional space relative to a known reference point, and said computer controlled surgical navigation system generates a display of the position of said inserter; and

wherein said computer controlled surgical navigation system displays one of an artificial implant and a bone dowel on the end of said inserter based on the geometrical configuration of said inserter and of the one of the artificial implant and a bone dowel attached to said inserter being entered into said computer controlled system.

2. The system of claim 1, wherein said emitter array includes at least one LED.

3. The system of claim 1, wherein said emitter array is an electrically energizable energy emitter array.

4. The system of claim 1, wherein said emitter array emits reflective signals.

5. The system of claim 1, wherein said emitter extends to the side of said guide to provide a line of sight from said emitter to the energy-detecting array of the navigation system.

6. The system of claim 1, wherein said guide comprises a hollow tube.

7. The system of claim 6, wherein said hollow tube has a rectangular cross-section.

8. The system of claim 6, wherein said guide further comprises spikes for engaging the adjacent vertebrae to inhibit displacement of the adjacent vertebrae during preparation of the implantation space.

9. The system of claim 1, wherein said guide has an end including extensions for penetrating the spine.

10. The system of claim 1, wherein said guide further comprises a disc penetrating extension extending from said guide for insertion into the disc space between the adjacent vertebrae and for bearing against endplates of the adjacent vertebrae.

11. The system of claim 1, further comprising said tool, wherein said tool has an energy emitter for use in identifying the depth of penetration of said tool through said guide.

12. A method for performing spinal surgery with a guide used to provide protected access across a spinal disc and into adjacent vertebrae to prepare an implantation space, said method comprising:

contacting one end of said guide having at least one emitter array attached thereto to the adjacent vertebrae;

employing a surgical navigation system with a computer controller and a digitizer array for communicating with said emitter array of said guide;

positioning said guide in three dimensional space relative to a known reference point;

forming the implantation space through said guide across the disc space and into a portion of each of the adjacent vertebrae;

implanting one of an artificial implant and a bone dowel into the implantation space;

providing an inserter sized for passage through said guide, said inserter having at least one emitter array attached thereto for use in identifying the location of said inserter relative to the adjacent vertebrae, said inserter adapted to hold one of an artificial implant and a bone dowel for insertion into the implantation space; and

generating a display of the position of said inserter relative to the adjacent vertebrae to provide a view of the axial orientation of said inserter relative to the adjacent vertebrae;

wherein the generating displays one of an artificial implant and a bone dowel on the end of said inserter.

13. The method of claim 12, wherein the contacting includes contacting one end of a tubular member having at least one emitter array attached thereto to the adjacent vertebrae.

14. The method of claim 12, wherein the positioning includes the step of positioning said guide in three dimensional space relative to a known reference point in the adjacent vertebrae.

15. The method of claim 12, further comprising positioning into the disc space between the adjacent vertebrae said guide having an extension for insertion into the disc space and for bearing against end plates of the adjacent vertebrae.

16. The method of claim 12, further comprising generating a display of the position of said guide.

17. The method of claim 16, wherein the generating displays the location of said guide relative to the adjacent vertebrae to provide a view of the axial orientation of said guide relative to each vertebra.

18. The method of claim 16, wherein the generating displays the location of said guide relative to the adjacent vertebrae to provide a view of the axial orientation of said guide relative the adjacent vertebrae.

19. The method of claim 16, wherein the generating displays the location of said guide relative to the adjacent vertebrae to provide a cross-sectional view of said guide relative to one of an anterior or posterior view of the adjacent vertebrae.

20. The method of claim 12, further comprising emitting a signal from said emitter attached to said guide which is received by an apparatus representatively indicating that signal on a visual display.

21. The method of claim 12, further comprising reflecting a signal from said emitter attached to said guide which is received by an apparatus representatively indicating that signal on a visual display.

22. The method of claim 12, wherein forming the implantation space includes passing a tool having an energy emitter through said guide.