Fluoroscopic image guided orthopaedic surgery system with intraoperative registration

• US 7,130,676 B2
• Filed: 08/29/2002
• Issued: 10/31/2006
• Est. Priority Date: 08/20/1998
• Status: Expired due to Term

• Current Assignee: Sofamor Danek Holdings, Inc
• Original Assignee: Sofamor Danek Holdings, Inc
• Inventors: Barrick, Earl F
• Primary Examiner(s): Smith, Ruth S.
• Application Number:
  US10/230,958
• Publication Number:
  US 20030060703A1
• Time in Patent Office: 1,524 Days
• Field of Search: 600/407, 600426-427, 600/429, 606/130, 606/97, 378205-207
• US Class Current: 600/426
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/1721 for applying pins along or parallel to the axis of the femoral neck
• CPC Class Codes: A61B 17/1742 for the hip
• 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 2090/363 Use of fiducial points
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• 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 5/064 using markers A61B5/062 takes precedence
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/4441 the rigid structure being a C-arm or U-arm
• CPC Class Codes: A61B 6/547 involving tracking of position of the device or parts of the device
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for

Abstract

A fluoroscopic image guided surgery system, comprising a C-arm fluoroscope for obtaining fluoroscopic images of an object bone, the C-arm fluoroscope including at least one set of emitters; a reference bar capable of attaching to an object bone, the reference bar including emitters; a surgical instrument for performing an operation, the instrument including emitters; a digitizer system in communication with the at least one set of emitters of the C-arm fluoroscope, the emitters of the reference bar, and the emitters of the surgical instrument so that the digitizer system can determine a position of each of the C-arm fluoroscope, the reference bar, and the surgical instrument; and a single fiducial marker for attachment to an object bone, the single fiducial marker being visible in the fluoroscopic images for determining a position of an object bone relative to the digitizer system.

Claims

1. An image guided surgery system comprising:

an imaging device operable to obtain images of a region of a patient;

a reference device operable to be positioned in the region of the patient, said reference device including at least one localization sensor being positioned on said reference device;

a surgical instrument operable for use in performing an operation, said surgical instrument including at least one localization sensor positioned on said surgical instrument;

a localization system operable to determine a position of said surgical instrument with respect to said reference device by use of said at least one localization sensor associated with said surgical instrument and said at least one localization sensor associated with said reference device; and

only one fiducial marker for attachment to the region, said only one fiducial marker being visible in the image of the region of the patient, wherein said only one fiducial marker is used for determining the position of the region relative to the localization system.

2. The image guided surgery system as defined in claim 1 wherein said imaging device is a fluoroscopic imaging device.

3. The image guided surgery system as defined in claim 2 wherein said fluoroscopic imaging device is a C-arm fluoroscopic imaging device.

4. The image guided surgery system as defined in claim 3 wherein said C-arm fluoroscopic imaging device includes an x-ray generator and an x-ray receiver operable to obtain fluoroscopic images of the region of the patient.

5. The image guided surgery system as defined in claim 1 wherein said localizing sensors are emitters.

6. The image guided surgery system as defined in claim 5 wherein said emitters are optical emitters.

7. The image guided surgery system as defined in claim 6 wherein said optical emitters are LED optical emitters.

8. The image guided surgery system as defined in claim 1 wherein said localization system is an optical localization system.

9. The image guided surgery system as defined in claim 8 wherein said optical localization system includes an optical digitizer camera.

10. The image guided surgery system as defined in claim 1 wherein the region of the patient is an object bone in the patient.

11. The image guided surgery system as defined in claim 10 wherein said only one fiducial marker and a shape of the object bone is used for determining position of the object bone relative to the localization system.

12. The image guided surgery system as defined in claim 1 further comprising a computer programmed to match images from said imaging device to effect a two-dimensional image registration.

13. The image guided surgery system as defined in claim 1 further comprising a computer programmed for determining a plane in which a patient body lies in relation to said reference device.

14. The image guided surgery system as defined in claim 1 wherein said imaging device further includes at least one localization sensor being positioned on said imaging device and wherein said localization system is operable to determine a position of said imaging device.

15. The image guided surgery system as defined in claim 1 further comprising a monitor operable to display the images of the region of the patient and the position of said surgical instrument overlying the images in near real-time for continually monitoring a position of said surgical instrument.

16. The image guided surgery system as defined in claim 1 wherein said surgical instrument is a drill operable to drive a guide pin into the region of the patient.

17. The image guided surgery system as defined in claim 1 further comprising a computer programmed to reduce distortion in the images.

18. The image guided surgery system as defined in claim 1 further comprising a monitor to display the image of the region of the patient and a graphic representation of the position of said surgical instrument overlying the image, wherein the graphical representation includes an extended projection of said surgical instrument to determine correct trajectory of said surgical instrument.

19. The image guided surgery system as defined in claim 1 wherein said fiducial marker is a surgical implant.

20. The image guided surgery system as defined in claim 19 wherein the surgical implant is an intramedullary nail.

21. The image guided surgery system as defined in claim 1 further comprising a computer programmed to perform two-dimensional image registration by matching an outline of bone in two planes.

22. An image guided surgery system comprising:

an imaging device operable to obtain images of an object bone of a patient, said imaging device including at least one localization sensor positioned on said imaging device;

a reference device operable to be attached to the object bone, said reference device including at least one localization sensor positioned on said reference device;

a surgical instrument operable for use in performing an operation, said surgical instrument including at least one localization sensor positioned on said surgical instrument;

a localization system operable to determine a position of said imaging device, said surgical instrument and said reference device;

a computer programmed to determine a real-time trajectory of said surgical instrument;

a monitor operable to display the images of the object bone from said imaging device and the real-time position of said surgical instrument overlying the images for continually monitoring a position of said surgical instrument; and

only one fiducial marker for attachment to the object bone, said one fiducial marker being visible in the image of the object bone, wherein said only one fiducial marker is used for determining the position of the object bone relative to the localization system.

23. The image guided surgery system as defined in claim 22 wherein said computer is programmed to overlay a graphic display of an implant having a predetermined length on the image of the object bone in near real-time.

24. The image guided surgery system as defined in claim 23 wherein said implant is a fixation device.

25. The image guided surgery system as defined in claim 22 wherein said imaging device is a fluoroscopic imaging device.

26. The image guided surgery system as defined in claim 25 wherein said fluoroscopic imaging device is a C-arm fluoroscopic imaging device.

27. The image guided surgery system as defined in claim 26 wherein said C-arm fluoroscopic imaging device includes an x-ray generator and an x-ray receiver operable to obtain fluoroscopic images of the region of the patient.

28. The image guided surgery system as defined in claim 22 wherein said localizing sensors are emitters.

29. The image guided surgery system as defined in claim 28 wherein said emitters are optical emitters.

30. The image guided surgery system as defined in claim 29 wherein said optical emitters are LED optical emitters.

31. The image guided surgery system as defined in claim 22 wherein said localization system is an optical localization system.

32. The image guided surgery system as defined in claim 31 wherein said optical localization system includes an optical digitizer camera.

33. The image guided surgery system as defined in claim 22 wherein said only one fiducial marker and a shape of the object bone is used for determining position of the object bone relative to the localization system.

34. The image guided surgery system as defined in claim 22 wherein said computer is programmed to match images from said imaging device to affect a two-dimensional image registration.

35. The image guided surgery system as defined in claim 22 wherein said computer is programmed to determine a plane in which a patient body lies in relation to said reference device.

36. The image guided surgery system as defined in claim 22 wherein said surgical instrument is a drill operable to drive a guide pin into the object bone of the patient.

37. The image guided surgery system as defined in claim 22 wherein said computer is programmed to reduce distortion in the images.

38. The image guided surgery system as defined in claim 22 wherein said fiducial marker is a surgical implant.

39. The image guided surgery system as defined in claim 38 wherein the surgical implant is an intramedullary nail.

40. The image guided surgery system as defined in claim 22 wherein said computer is programmed to perform two-dimensional image registration by matching an outline of the object bone in two planes.

41. An imaged guided surgery system comprising:

an imaging device operable to obtain images of an object bone of a patient;

a reference device operable to be attached to the object bone, said reference device including at least one localization sensor being positioned on said reference device;

a surgical instrument operable for use in performing an operation, said surgical instrument including at least one localization sensor positioned on said surgical instrument;

a localization system operable to determine a position of said surgical instrument with respect to said reference device by use of said at least one localization sensor associated with the surgical instrument and said at least one localization sensor associated with said reference device;

a computer programmed to perform two-dimensional image registration by matching an outline of the object bone in two planes from at least two images; and

only one fiducial marker for attachment to the object bone, said one fiducial marker being visible in the image of the object bone, wherein said only one fiducial marker is used for determining the position of the object bone relative to the localization system.

42. The image guided surgery system as defined in claim 41 wherein said computer is programmed to overlay a graphic display of an implant having a predetermined length on the image of the object bone in near real-time.

43. The image guided surgery system as defined in claim 42 wherein said implant is a fixation device.

44. The image guided surgery system as defined in claim 41 wherein said imaging device is a fluoroscopic imaging device.

45. The image guided surgery system as defined in claim 44 wherein said fluoroscopic imaging device is a C-arm fluoroscopic imaging device.

46. The image guided surgery system as defined in claim 45 wherein said C-arm fluoroscopic imaging device includes an x-ray generator and an x-ray receiver operable to obtain fluoroscopic images of the region of the patient.

47. The image guided surgery system as defined in claim 41 wherein said localizing sensors are emitters.

48. The image guided surgery system as defined in claim 47 wherein said emitters are optical emitters.

49. The image guided surgery system as defined in claim 48 wherein said optical emitters are LED optical emitters.

50. The image guided surgery system as defined in claim 41 wherein said localization system is an optical localization system.

51. The image guided surgery system as defined in claim 50 wherein said optical localization system includes an optical digitizer camera.

52. The image guided surgery system as defined in claim 41 wherein said only one fiducial marker and a shape of the object bone is used for determining position of the object bone relative to the localization system.

53. The image guided surgery system as defined in claim 41 wherein said computer is programmed to match images from said imaging device to affect the two-dimensional image registration.

54. The image guided surgery system as defined in claim 41 wherein said computer is programmed to determine a plane in which a patient body lies in relation to said reference device.

55. The image guided surgery system as defined in claim 41 wherein said imaging device further includes at least one localization sensor being positioned on said imaging device and wherein said localization system is operable to determine a position of said imaging device.

56. The image guided surgery system as defined in claim 41 further comprising a monitor operable to display the images of the region of the patient and the position of said surgical instrument overlying the images in near real-time for continually monitoring a position of said surgical instrument.

57. The image guided surgery system as defined in claim 41 wherein said surgical instrument is a drill operable to drive a guide pin into the object bone of the patient.

58. The image guided surgery system as defined in claim 41 wherein said computer is programmed to reduce distortion in the images.

59. The image guided surgery system as defined in claim 41 further comprising a monitor operable to display the image of the region of the patient and a graphic representation of the position of said surgical instrument overlying the image, wherein the graphical representation includes an extended projection of said surgical instrument to determine correct trajectory of said surgical instrument.

60. The image guided surgery system as defined in claim 41 wherein said only one fiducial marker is a surgical implant.

61. The image guided surgery system as defined in claim 60 wherein the surgical implant is an intramedullary nail.

62. The image guided surgery system as defined in claim 41 wherein said computer is programmed to determine a real-time trajectory of said surgical instrument.

63. An image guided system comprising:

an imaging device operable to obtain images of an object bone of a patient, said imaging device including at least one localization sensor positioned on said imaging device;

a reference device operable to be attached to the object bone, said reference device including at least one localization sensor positioned on said reference device;

a localization system operable to determine a position of said imaging device, a surgical instrument and said reference device;

a computer programmed to determine a real-time trajectory of said surgical instrument; and

only one fiducial marker for attachment to the object bone, said one fiducial marker being visible in the image of the object bone, wherein said only one fiducial marker is used for determining the position of the object bone relative to the localization system.

64. The image guided system of claim 63, further comprising:

a surgical instrument operable for use in performing an operation, said surgical instrument including at least one localization sensor positioned on said surgical instrument.

65. The image guided surgery system of claim 64, further comprising:

a monitor operable to display the images of the object bone from said imaging device and the real-time position of said surgical instrument overlying the images for continually monitoring a position of said surgical instrument.