Computer-aided orthopedic surgery

• US 6,711,432 B1
• Filed: 10/23/2000
• Issued: 03/23/2004
• Est. Priority Date: 10/23/2000
• Status: Expired due to Term

• Current Assignee: Carnegie Mellon University
• Original Assignee: Carnegie Mellon University
• Inventors: Kanade, Takeo, Shimada, Kenji, Weiss, Lee E., Krause, Norman M.
• Primary Examiner(s): Leung, Philip H.
• Application Number:
  US09/694,665
• Time in Patent Office: 1,247 Days
• Field of Search: 128/898, 128/920, 128/923, 128/924, 600/427, 600/424, 600/411, 600/416, 600/425, 600/426, 606/53, 606/60, 623/16, 623/18, 395/924, 382/128, 382/131
• US Class Current: 600/427
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/151 for corrective osteotomy
• CPC Class Codes: A61B 17/152 for removing a wedge-shaped piece of bone
• CPC Class Codes: A61B 2034/101 Computer-aided simulation of surgical operations
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: Y10S 128/922 including image analysis

Abstract

Devices and methods for implementing computer-aided surgical procedures and more specifically devices and methods for implementing a computer-aided orthopedic surgery utilizing intra-operative feedback. A three-dimensional model of an area of a patient upon which a surgical procedure is to be performed is modeled using software techniques. The software model is used to generate a surgical plan, including placement of multifunctional markers, for performing the surgical procedure. After the markers are placed on the patient, an updated image of the patient is taken and used to calculate a final surgical plan for performing the remainder of the surgical procedure. The three-dimensional modeling, surgical planning, and surgery may all take place remote from each other. The various entities may communicate via an electronic communications network such as the Internet.

Claims

1. A method of generating an updated surgical plan, the method comprising:

generating a three dimensional (3D) model of a bone;

based on the 3D model, generating a surgical plan including;

one or more locations on the bone upon which to dispose one or more markers for receiving one or more guides for guiding one or more surgical tools, and

one or more settings of the one or more guides;

based on the surgical plan, disposing the one or more markers on the bone; and

,

based on data associated with the placement of the one or more markers disposed on the bone, generating an updated surgical plan including updated settings for the one or more guides.

2. The method of claim 1, wherein the one or more guides comprise an adjustable cutting guide.

3. The method of claim 2, wherein the adjustable cutting guide includes settings for one or more of an angle in a plane parallel to the bone and an angle in a plane perpendicular to the bone.

4. The method of claim 1, wherein the one or more guides comprise an adjustable fixation guide.

5. The method of claim 4, wherein the adjustable fixation guide includes settings for one or more of an angle in a plane parallel to the bone and an angle in a plane perpendicular to the bone.

6. The method of claim 1, wherein the one or more guides comprise an adjustable combined cutting-fixation guide.

7. The method of claim 1, wherein the data comprise one or more images of the bone.

8. The method of claim 7, wherein the one or more images include one or more X-ray images.

9. The method of claim 7, wherein the one or more images include one or more fluoroscopic images.

10. The method of claim 9, wherein the one or more fluoroscopic images include one or more calibration grid points used to unwarp the fluoroscopic images.

11. The method of claim 1, wherein the one or more surgical tools are attached to an area of the bone designated for a surgical procedure.

12. The method of claim 1, wherein the one or more markers are radio-opaque.

13. The method of claim 1, wherein the one or more markers are capable of anchoring the one or more surgical tools to an area of the bone designated for a surgical procedure.

14. The method of claim 1, wherein the one or more locations of the one or more markers includes a range of acceptable marker locations.

15. The method of claim 1, wherein the one or more locations include one or more locations for an osteotomy.

16. The method of claim 1, wherein the one or more surgical tools include one or more calibration grids.

17. The method of claim 1, wherein generating the surgical plan comprises:

receiving at a server images of the bone from a client;

generating the surgical plan at the server; and

,

providing the surgical plan from the server to the client; and

,

wherein generating the updated surgical plan includes;

receiving at the server the data associated with the placement of the one or more markers from the client;

generating the updated surgical plan at the server, and

providing the updated surgical plan from the server to the client.

18. The method of claim 17, wherein the one or more images include one or more X-ray images of the bone.

19. The method of claim 17, wherein the one or more images are orthogonal to each other.

20. The method of claim 17, wherein the data associated with the placement of the one or more markers include one or more fluoroscopic images of the bone.

21. The method of claim 1, wherein generating a surgical plan includes performing a numerical analysis on the 3D model of the bone.

22. The method of claim 21, wherein the numerical analysis is an iterative analysis.

23. The method of claim 21, wherein performing a numerical analysis comprises:

virtually cutting the 3D model of the bone at one or more first locations along an axis of the bone;

repositioning the 3D model along a selected mechanical axis; and

determining a first deviation between the positions of the 3D model before and after repositioning the 3D model.

24. The method of claim 23, wherein performing a numerical analysis further comprises:

for each of the one or more first locations, virtually cutting the 3D model at one or more second locations along the axis of the bone;

performing a second repositioning of the 3D model along the selected mechanical axis;

determining a second deviation between the positions of the 3D model before and after performing the second repositioning of the 3D model ; and

identifying the first and second locations corresponding to a minimum value of the combined first and second deviations.

25. The method of claim 1, wherein generating a 3D model includes:

generating a 3D model based on one or more two dimensional (2D) images of the bone and one or more 3D bone templates.

26. The method of claim 1, further comprising:

generating one or more 2D images of the bone with the one or more markers disposed on the bone, and

wherein generating an updated surgical plan includes;

generating the updated surgical plan based on the 2D images.

27. The method of claim 26, further comprising:

calibrating the 2D images, and

wherein generating an updated surgical plan includes;

generating an updated surgical plan based on the calibrated 2D images.

28. The method of claim 26, wherein the 2D images include one or more of X-ray images and fluoroscopic images.

29. A method for generating an updated surgical plan, the method comprising:

generating a three dimensional (3D) model of a bone,

based on the 3D model, generating a surgical plan including;

one or more locations on the bone upon which to dispose one or more guides for guiding one or more surgical tools, and

one or more settings of the one or more guides,

based on the surgical plan, disposing the one or more guides on the bone, and

based on data associated with the placement of the one or more guides disposed on the bone, generating an updated surgical plan including updated settings for the guides.

30. The method of claim 29, wherein generating a 3D model includes:

generating a 3D model based on one or more two dimensional (2D) images of the bone and one or more 3D bone templates.

31. The method of claim 30, wherein the 2D images include one or more of X-ray images and fluoroscopic images.

32. The method of claim 30, wherein the 2D images are orthogonal to each other.

33. The method of claim 29, wherein the one or more guides include one or more of an adjustable cutting guide, an adjustable fixation guide, and an adjustable cutting-fixation guide.

34. The method of claim 29, wherein the one or more guides include settings for one or more of an angle in a plane parallel to the bone and an angle in a plane perpendicular to the bone.

35. The method of claim 29, wherein the data associated with the placement of the one or more guides on the bone include one or more of X-ray images and fluoroscopic images.

36. The method of claim 35, wherein the images are orthogonal to each other.

37. A method for generating an updated surgical plan, the method comprising:

generating a three dimensional (3D) model of a bone,

based on the 3D model, generating a surgical plan including;

one or more locations on the bone upon which to dispose one or more surgical tools, and

one or more instructions for using the one or more surgical tools,

based on the surgical plan, disposing the one or more surgical tools on the bone, and

based on data associated with the placement of the one or more surgical tools disposed on the bone, generating an updated surgical plan including updated instructions for the one or more surgical tools.

38. The method of claim 37, wherein generating a 3D model includes:

generating a 3D model based on one or more two dimensional (2D) images of the bone and one or more 3D bone templates.

39. The method of claim 38, wherein the 2D images include one or more of X-ray images and fluoroscopic images.

40. The method of claim 38, wherein the 2D images are orthogonal to each other.

41. The method of claim 37, wherein the one or more guides include one or more of an adjustable cutting guide, an adjustable fixation guide, and an adjustable cutting-fixation guide.

42. The method of claim 37, wherein the one or more guides include settings for one or more of an angle in a plane parallel to the bone and an angle in a plane perpendicular to the bone.

43. The method of claim 37, wherein the data associated with the placement of the one or more surgical tools on the bone include one or more of X-ray images and fluoroscopic images.

44. The method of claim 43, wherein the images are orthogonal to each other.