Instrumentation and method for mounting a surgical navigation reference device to a patient

• US 6,993,374 B2
• Filed: 04/17/2002
• Issued: 01/31/2006
• Est. Priority Date: 04/17/2002
• Status: Active Grant

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Inventors: Sasso, Ricardo
• Primary Examiner(s): Casler, Brian L.
• Assistant Examiner(s): JUNG, WILLIAM C
• Application Number:
  US10/124,291
• Publication Number:
  US 20030196671A1
• Time in Patent Office: 1,385 Days
• Field of Search: 600/407, 600/420, 600/408, 600/410, 600/411, 600/419, 600/423, 600/433, 600/414, 600/424, 600/426, 604 4- 52, 604/164.01, 604/164.11, 606/130, 378/20, 378/42
• US Class Current: 600/426
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 2090/3987 Applicators for implanting markers
• 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 90/39 Markers, e.g. radio-opaque or breast lesions markers

Abstract

Instrumentation and methods are provided for mounting a surgical navigation reference frame to a patient for performing an image-guided surgical procedure on an anatomical component. In one embodiment of the invention, a trocar is positioned within a cannula to form an insertion device adapted for percutaneous introduction into the patient. A bone anchor having a bone engaging portion is inserted through the cannula and is anchored to bone. The bone anchor cooperates with the cannula to form a mounting device adapted for coupling with the surgical navigation reference frame. In one embodiment of the invention, an image-guided surgical procedure is performed at a location remote from the anchoring location. In a specific embodiment, an image-guided surgical procedure is performed adjacent the spinal column, with the bone engaging portion of the bone anchor anchored to the iliac region of the pelvic bone, and more specifically to the iliac crest of the pelvic bone.

Claims

1. A method of mounting a surgical navigation reference device to a patient for performing an image-guided surgical procedure said surgical procedure being performed on the patient'"'"'s spinal column, comprising:

providing a bone anchor having a bone engaging portion;

anchoring the bone engaging portion of the bone anchor to bane at a location remote from the patient'"'"'s spinal column; and

coupling the reference device to the bone anchor to mount the reference device in a substantially fixed position relative to the patient'"'"'s spinal column.

2. The method of claim 1, wherein the anchoring comprises anchoring the bone engaging portion of the bone anchor to a portion of the patient'"'"'s pelvic bone.

3. The method of claim 2, wherein the portion of the pelvic bone is the iliac region of the pelvic bone.

4. The method of claim 3, wherein the portion of the pelvic bone is the iliac crest.

5. The method of claim 1, further comprising percutaneously inserting the bone engaging portion of the bone anchor into the patient.

6. The method of claim 5, wherein the percutaneously inserting comprises:

providing a cannula having a proximal end and a distal end;

providing a trocar having a distal end portion;

positioning the trocar within the cannula with the distal end portion of the trocar extending beyond the distal end of the cannula;

percutaneously introducing the cannula into the patient;

removing the trocar from the cannula; and

inserting the bone engaging portion of the bone anchor through the cannula and into engagement with the bone.

7. The method of claim 1, further comprising:

forming a surgical incision at a location remote from the anchoring location; and

performing an image-guided surgical procedure on the patient through the surgical incision.

8. The method of claim 7, wherein the surgical incision is formed subsequent to the anchoring.

9. The method of claim 1, further comprising performing a percutaneous image-guided surgical procedure at a location remote from the anchoring location.

10. The method of claim 1 wherein said bone engaging portion of the bone anchor includes treads and the anchoring is accomplished by use of said threads.

11. A method of mounting a surgical navigation reference device to a patient for performing an image-guided surgical procedure, comprising:

providing a cannula having a proximal end and a distal end, a trocar having a distal end portion, and a bone anchor having a bone engaging portion, said cannula and bone anchor being separate elements not connected to one another;

positioning the trocar within the cannula with the distal end portion of the trocar extending beyond the distal end of the cannula;

percutaneously introducing the cannula into the patient;

removing the trocar from the cannula;

inserting the bone engaging portion of the bone anchor through the cannula;

anchoring the bone engaging portion of the bone anchor to bone; and

coupling the surgical navigation reference device to the bone anchor.

12. The method of claim 11, further comprising securely engaging the distal end of the cannula against the bone to substantially prevent displacement of the cannula relative to the bone.

13. The method of claim 12, wherein the coupling comprises securely engaging the bone anchor with the cannula and connecting the surgical navigation reference device to the cannula.

14. The method of claim 11, wherein the bone engaging portion of the bone anchor is threaded and wherein the anchoring comprises threading the bone engaging portion of the bone anchor into the bone.

15. The method of claim 14, wherein the bone engaging portion of the bone anchor is self-tapping, and wherein the threading comprises cutting threads along an opening in the bone.

16. The method of claim 14, wherein the bone engaging portion of the bone anchor is self-drilling and self-tapping, and wherein the threading comprises forming a threaded opening in the bone.

17. The method of claim 11, wherein the anchoring comprises anchoring the bone engaging portion of the bone anchor to the bone at a location remote from the patient'"'"'s spinal column;

and

further comprising performing an image-guided surgical procedure adjacent the patient'"'"'s spinal column.

18. The method of claim 17, wherein the anchoring comprises anchoring the bone engaging portion of the bone anchor to a portion of the patient'"'"'s pelvic bone.

19. The method of claim 18, wherein the portion of the patient'"'"'s pelvic bone is the iliac crest.

20. The method of claim 11, further comprising;

forming a surgical incision at a location remote from the anchoring location; and

performing an image-guided surgical procedure on the patient through the surgical incision.

21. The method of claim 20, wherein the surgical incision is formed subsequent to the anchoring.

22. The method of claim 11, further comprising performing a percutaneous image-guided surgical procedure on the patient at a location remote from the anchoring location.

26. The instrumentation of claim 22, wherein said distal end portion of said trocar is pointed to facilitate percutaneous introduction of said insertion device into the patient.

23. Instrumentation for performing an image-guided surgical procedure on a patient, comprising:

a cannula having a proximal end and a distal end;

a trocar positioned within said cannula with a distal end portion of said trocar extending beyond said distal end of said cannula to form an insertion device adapted for percutaneous introduction into the patient;

a bone anchor having a bone engaging portion insertable through said cannula and adapted for anchoring to bone, said bone anchor being a separate element from said cannula but cooperating with said cannula to form a mounting device; and

a surgical navigation reference device adapted for coupling to said mounting device to percutaneously mount the reference device to the patient.

24. The instrumentation of claim 23, wherein said distal end of said cannula includes at least one anchoring element adapted to securely engage said cannula against the bone to substantially prevent displacement of said cannula relative to the bone.

25. The instrumentation of claim 23, wherein said surgical navigation reference device is a reference frame assembly.

27. The instrumentation of claim 23, wherein said trocar includes a stop member engagable against said proximal end of said cannula to position said distal end portion of said trocar relative to said distal end of said cannula.

28. The instrumentation of claim 23, wherein said bone anchor includes a stop member engagable against said proximal end of said cannula to limit displacement of said bone engaging portion beyond said distal end of said cannula.

29. The instrumentation of claim 28, wherein said stop member is adjustably positionable relative to said bone anchor to selectively limit displacement of said bone engaging portion beyond said distal end of said cannula.

30. The instrumentation of claim 23, wherein said bone engaging portion of said bone anchor is self-tapping.

31. The instrumentation of claim 30, wherein said bone engaging portion of said bone anchor is self-drilling.