Fluoroscopic locator and registration device

• US 7,063,705 B2
• Filed: 06/26/2002
• Issued: 06/20/2006
• Est. Priority Date: 06/29/2001
• Status: Expired due to Term

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: SDGI Holdings Incorporated (Medtronic Plc)
• Inventors: Melkent, Tony, Johnson, Chris, Carls, Thomas A., Young, John Stewart, Taylor, Harold S.
• Primary Examiner(s): Robert, Eduardo C.
• Assistant Examiner(s): COMSTOCK, DAVID C
• Application Number:
  US10/180,045
• Publication Number:
  US 20030009169A1
• Time in Patent Office: 1,455 Days
• Field of Search: 606/60, 606/61, 606/86, 606/90, 606/96, 606/97, 606/99, 606/102, 606/105, 606/130, 606/206, 606/207, 600/196, 600/201, 600/209, 600/210, 600/215, 600/219, 600/222, 600/225, 600/235, 600/407, 600/414, 600/417, 600/426, 600/427, 600/429
• US Class Current: 606/86.00R
• CPC Class Codes: A61B 2090/363 Use of fiducial points
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms

Abstract

A registration device is used to couple an identification superstructure of a surgical navigation system to the spinal column. The registration device includes a pair of vertebral engaging members positionable in a spinal disc space. At least one of the vertebrae engaging members moves outwardly from a collapsed position to engage the registration device to the endplates of the adjacent vertebrae.

Claims

1. A vertebral registration device, comprising:

a connector adapted to connect to an identification superstructure that is used for location identification during surgery; and

a vertebral engagement portion coupled to the connector, the vertebral engagement portion being adapted to expand from a compact configuration to an expanded configuration to secure the vertebral engagement portion in a disc space between adjacent vertebrae, the vertebral engagement portion when in the compact configuration being able to fit into the disc space, the vertebral engagement portion when in the expanded configuration inside the disc space engages the adjacent vertebrae;

wherein the connector includes

an enlarged end portion having a plurality of radially oriented ridges,

a coupling member defining a first hole extending along a first axis, the coupling member having a first set of ridges radially oriented around the first hole,

a fastener received in the first hole to mate the first set of ridges of the coupling member with the ridges on the enlarged end portion in an interdigiting fashion and to allow rotational repositioning the coupling member relative to the enlarged end portion, and

the coupling member defining a second hole extending along a second axis that is orthogonal to the first axis, the coupling member having a second set of ridges radially oriented around the second hole, the second set of ridges being constructed and arranged to mate in an interdigiting fashion with ridges on the identification superstructure.

2. The device of claim 1, wherein the vertebral engagement portion includes:

a first member;

a second member, the first member being pivotally connected to the second member; and

a drive member positioned proximal the first member to pivot the first member to the expanded configuration.

3. The device of claim 2, wherein:

the second member defines a receptacle sized to receive the first member;

the first member is at least partially received within the receptacle when the vertebral engagement portion is in the compact configuration.

4. The device of claim 3, wherein the first member has a tapered leading edge.

5. The device of claim 2, wherein both the first member and the second member have spikes adapted to engage the vertebrae.

6. The device of claim 1, further comprising a shaft connecting the vertebral engagement portion to the connector.

7. The device of claim 6, wherein the shaft includes a bend portion proximal the connector.

8. The device of claim 1, wherein the vertebral engagement portion includes:

a drive member;

a first member having a first drive engaging portion engaging the drive member;

a second member oriented in an opposing relationship with the first member, the second member having a second drive engaging portion engaging the drive member; and

wherein the drive member is adapted to drive the first member and the second member apart from one another to the expanded configuration.

9. The device of claim 8, wherein:

the first member has a first vertebrae engagement surface and a first support rib extending from the first vertebrae engagement surface towards the second member;

the second member has a second vertebrae engagement surface and a second support rib extending from the second vertebrae engagement surface towards the first member; and

the first support rib of the first member and the second support rib of the second member are offset with respect to one another to nest together in the compact configuration.

10. The device of claim 8, wherein:

the first drive engaging portion of the first member defines a first pair of angled slots;

the second drive engaging portion of the second member defines a second pair of angled slots; and

the drive member has a driving end portion received between the first drive engaging portion and the second drive engaging portion, the driving end portion having a slot engagement rods engaging the first pair of angled slots and the second pair of angled slots.

11. The device of claim 8, wherein the vertebral engagement portion defines a receptacle in which at least a portion of the first member and the second member are received in the compact configuration.

12. The device of claim 11, wherein:

the vertebral engagement portion defines a pair of oppositely disposed channels;

the first member has a first pair of opposing alignment tabs received in the oppositely disposed channels in the vertebral engagement portion; and

the second member has a second pair of opposing alignment tabs received in the oppositely disposed channels in the vertebral engagement portion.

13. The device of claim 8, further comprising an actuator coupled to the drive member to move the drive member.

14. The device of claim 13, wherein:

the vertebral engagement portion defines a bore in which the actuator is received;

the drive member has a threaded portion;

the actuator defines a tool receiving cavity adapted to receive a driving tool; and

the actuator has a smooth exterior surface to rotate in the bore and a threaded interior cavity engaged with the threaded portion of the drive member.

15. The device of claim 13, further comprising a shaft connecting the vertebral engagement portion to the connector, the shaft being offset with respect to a longitudinal axis of the vertebral engagement portion, wherein the shaft defines a recess portion proximal the actuator to facilitate access of the driving tool.

16. The device of claim 8, wherein the first member and the second member each have vertebrae engagement spikes.

17. The device of claim 16, further comprising:

an actuator coupled to the drive member to move the drive member;

the vertebral engagement portion defining a bore in which the actuator is received;

the drive member having a threaded portion;

the actuator defining a tool receiving cavity adapted to receive a driving tool;

the actuator having a smooth exterior surface to rotate in the bore and a threaded interior cavity engaged with the threaded portion of the drive member;

a shaft connecting the vertebral engagement portion to the connector, the shaft being offset with respect to a longitudinal axis of the vertebral engagement portion, wherein the shaft defines a recess portion proximal the actuator to facilitate access of the driving tool;

the first member having a first vertebrae engagement surface and a first support rib extending from the first vertebrae engagement surface towards the second member;

the second member having a second vertebrae engagement surface and a second support rib extending from the second vertebrae engagement surface towards the first member;

the first support rib of the first member and the second support rib of the second member being offset with respect to one another to nest together in the compact configuration;

the first drive engaging portion of the first member defining a first pair of angled slots;

the second drive engaging portion of the second member defining a second pair of angled slots;

the drive member having driving end portion received between the first device engaging portion and the second drive engaging portion, the driving end portion having a slot engagement rods engaging the first pair of angled slots and the second pair of angled slots;

the vertebral engagement portion defining a receptacle in which at least a portion of the first member and the second member are received in the compact configuration;

the vertebral engagement portion defining a pair of oppositely disposed channels;

the first member having a first pair of opposing alignment tabs received in the oppositely disposed channels in the vertebral engagement portion; and

the second member having a second pair of opposing alignment tabs received in the oppositely disposed channels in the vertebral engagement portion.

18. The device of claim 1, wherein:

the vertebral engagement portion includes a first member, a second member, a drive member, and linkages pivotally connecting the first member and the second member to the drive member;

the vertebral engagement portion defines an alignment slot and a drive slot;

the vertebral engagement portion has a rail;

the first member has an alignment tab slidably received in the alignment slot;

the second member defines a channel in which the rail is received; and

the drive member is slidably received in the drive slot to drive the first member and the second member apart to the expanded configuration through the linkages.

19. The device of claim 18, wherein:

the drive member defines a first receptacle configured to receive the first member when the vertebral engagement portion is in the compact configuration; and

the second member defines a second receptacle configured to receive the drive member and the first member when the vertebral engagement portion is in the compact configuration.

20. The device of claim 1, wherein:

the vertebral engagement portion defines slots;

the vertebral engagement portion includes a moveable first member having flanges slidably received in the slots;

a fixed second member defining a drive cavity; and

a drive member slidably received in the drive cavity, the drive member having a ramp shaped surface contacting the first member to drive first member away from the second member to the expanded configuration.

21. The device of claim 20, wherein the second member defines a receptacle configured to slidably receive the first member.

22. The device of claim 1, further comprising the identification superstructure connected to the connector.

23. A method of securing a registration device for fluoroscopic registration of a spinal column, comprising:

inserting a vertebral engagement portion of the registration device between endplates of adjacent vertebrae in the spinal column;

expanding the vertebral engagement portion between the adjacent vertebrae to engage the vertebral engagement portion with the endplates;

wherein said expanding includes sliding a moveable first member in the registration device away from a fixed second member in the registration device; and

coupling a location identification superstructure to a connector on the registration device.

24. The method of claim 23 wherein the first member is pivotally coupled to the second member.

25. The method of claim 24, wherein the first member is pivotally coupled to the second member at a location adjacent the connector and the first and second members extend from the location away from the connector.

26. A vertebral registration device, comprising:

a connector adapted to connect to an identification superstructure that is used for location identification during surgery; and

a vertebral engagement portion coupled to the connector, the vertebral engagement portion being adapted to expand from a compact configuration to an expanded configuration to secure the vertebral engagement portion in a disc space between adjacent vertebrae, the vertebral engagement portion when in the compact configuration being able to fit into the disc space, the vertebral engagement portion when in the expanded configuration inside the disc space engages the adjacent vertebrae, wherein the vertebral engagement portion comprises;

a first member;

a second member, the first member being pivotally connected to the second member;

a drive member positioned proximal the first member to pivot the first member to the expanded configuration,

wherein the second member defines a receptacle sized to receive the first member; and

wherein the first member is at least partially received within the receptacle when the vertebral engagement portion is in the compact configuration.

27. The device of claim 26, wherein the first member has a tapered leading edge.

28. A vertebral registration device, comprising:

a connector adapted to connect to an identification superstructure that is used for location identification during surgery;

a vertebral engagement portion coupled to the connector, the vertebral engagement portion being adapted to expand from a compact configuration to an expanded configuration to secure the vertebral engagement portion in a disc space between adjacent vertebrae, the vertebral engagement portion when in the compact configuration being able to fit into the disc space, the vertebral engagement portion when in the expanded configuration inside the disc space engages the adjacent vertebrae; and

a shaft connecting the vertebral engagement portion to the connector, wherein the shaft includes a bend portion proximal the connector.

29. A vertebral registration device, comprising:

a connector adapted to connect to an identification superstructure that is used for location identification during surgery;

a vertebral engagement portion coupled to the connector, the vertebral engagement portion being adapted to expand from a compact configuration to an expanded configuration to secure the vertebral engagement portion in a disc space between adjacent vertebrae, the vertebral engagement portion when in the compact configuration being able to fit into the disc space, the vertebral engagement portion when in the expanded configuration inside the disc space engages the adjacent vertebrae;

wherein the vertebral engagement portion defines slots;

wherein the vertebral engagement portion includes a moveable first member having flanges slidably received in the slots;

a fixed second member defining a drive cavity; and

a drive member slidably received in the drive cavity, the drive member having a ramp shaped surface contacting the first member to drive first member away from the second member to the expanded configuration.

30. The device of claim 29, wherein the second member defines a receptacle configured to slidably receive the first member.