Method and apparatus for preplanning a surgical procedure

• US 7,542,791 B2
• Filed: 03/05/2004
• Issued: 06/02/2009
• Est. Priority Date: 01/30/2003
• Status: Active Grant

• Current Assignee: Surgical Navigation Technologies, Inc. (Medtronic Plc)
• Original Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Inventors: Mire, David A, Hunter, Mark W, Trieu, Hai H, Dugger, Janice
• Primary Examiner(s): Le; Long V
• Assistant Examiner(s): Rozanski; Michael T
• Application Number:
  US10/794,716
• Publication Number:
  US 20040171924A1
• Time in Patent Office: 1,915 Days
• Field of Search: 600/407, 600/427, 378/42, 700/245, 703/11
• US Class Current: 600/407
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2034/252 indicating steps of a surgical procedure
• CPC Class Codes: A61B 2034/254 being adapted depending on the stage of the surgical procedure
• CPC Class Codes: A61B 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• 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: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders

Abstract

A method and system to assist in a selection and planning of procedure and assist in selecting a prosthetic for the procedure. Generally, the system allows for image acquisition of a selected area of the anatomy. A model may be formed of the anatomy from the acquired images. The system may also allow for navigational tracking of the procedure to ensure that the procedure is substantially carried out relative to the selected plan.

Claims

1. A method of performing a procedure to position a prosthesis in a selected portion of an anatomy, the method comprising:

acquiring an image of the selected portion of the anatomy;

forming an image based model of the selected portion of the anatomy;

displaying on a human viewable display the image based model;

measuring a dimension of the image based model;

defining a complete area of the anatomy to be removed;

displaying the complete area of the anatomy to be removed relative to the image based model on the human viewable display; and

selecting the prosthesis based upon the defined complete area to be removed and the measurement to substantially mimic the measured dimension.

2. The method of claim 1, wherein acquiring an image of the selected portion of the anatomy includes obtaining an image from at least one of a magnetic resonance imaging apparatus, a computed tomography apparatus, an X-ray apparatus, a fluoroscopic system, an ultrasound, or combinations thereof.

3. The method of claim 1, wherein acquiring an image includes acquiring a plurality of images of the selected portion of the anatomy.

4. The method of claim 1, wherein forming a model includes forming a multidimensional model of the selected portion of the anatomy based upon the acquired images;

and

wherein the model is placed in a coordinate space to substantially accurately measure the selected portion of the anatomy on the model.

5. The method of claim 1, wherein measuring a dimension of the model further includes measuring at least one of a volume, a geometry, or combinations thereof.

6. The method of claim 1, wherein selecting the prosthesis includes selecting a prosthetic for at least one of a femoral head, an intramedullary stem, a vertebral disc, a vertebral nucleus, a humeral head, a glenoid, a distal femoral implant, a proximal tibial implant, or combinations thereof.

7. The method of claim 1, further comprising:

determining an abnormality of the selected portion of the anatomy from said formed model; and

determining a procedure to perform relative to the selected portion of the anatomy to alleviate the determined abnormality.

8. The method of claim 7, wherein selecting the prosthesis includes selecting a procedure to substantially alleviate the abnormality;

and

wherein the prosthesis is operable to interact with the selected portion of the anatomy to alleviate at least a portion of the abnormality.

9. The method of claim 1, further comprising:

planning a procedure; and

performing a procedure relative to the selected portion of the anatomy including;

navigating an instrument moved by a user relative to the selected portion of the anatomy to remove a portion of the anatomy per the planned procedure; and

performing the removal while navigating the instrument to substantially achieve the planned procedure.

10. The method of claim 9, wherein planning the procedure includes modeling dynamic motion of the anatomy on a human viewable display to confirm a selected implant will achieve a selected motion in the anatomy.

11. The method of claim 1, further comprising:

implanting the prosthesis; and

confirming the selected placement of the prosthesis.

12. The method of claim 1, further comprising:

positioning a tracking sensor relative to the prosthesis to allow tracking of the prosthesis to achieve a selected characteristic of the prosthesis during at least one of implantation and post-implantation of the prosthesis.

13. The method of claim 1, further comprising:

displaying an icon with the human viewable display relative to the displayed complete area to be removed; and

displaying on the human viewable display a remaining anatomy to be removed.

14. The method of claim 1, further comprising:

determining a volume based on measuring at least three dimensions, where measuring a dimension includes the measuring at least three dimensions; and

selecting a volume of a spinal nucleolus implant based on the determined volume;

wherein the at least three dimensions are a height, a width, and a depth of an anatomical spinal nucleolus.

15. A method of performing a procedure to position a prosthesis in a selected portion of an anatomy, the method comprising:

acquiring an image of the selected portion of the anatomy;

forming an image based model of the selected portion of the anatomy;

measuring a dimension of the image based model;

selecting the prosthesis based upon the measurement to substantially mimic the measured dimension;

planning the procedure to achieve a selected characteristic of the prosthesis at least in part based upon the step of measuring a dimension;

displaying an area of the anatomy to be completely removed;

displaying an area of the anatomy yet to be removed; and

implanting the prosthesis in the area of the anatomy removed with navigation to substantially ensure that the selected characteristic is achieved.

16. The method of claim 15, wherein the characteristic includes at least one of a size, a geometry, a material characteristic, a curing time period, a dynamic movement of the anatomy, or combinations thereof.

17. The method of claim 15, further comprising:

planning a final configuration of the prosthesis;

navigating a curing element relative to the prosthesis to cure the prosthesis according to the planned procedure to achieve the selected characteristic including the planned configuration of the prosthesis after implantation that is different than a configuration of the prosthesis prior to implantation.

18. The method of claim 17, wherein navigating the curing element includes navigating a radiating probe, a curing material dispenser probe, and combinations thereof.

19. The method of claim 15, further comprising displaying an instrument in the model and displaying an area of the anatomy removed.

20. The method of claim 19, further comprising displaying an area of the anatomy yet to be removed.

21. A method of planning a procedure to implant a prosthesis into a portion of an anatomy, the method comprising:

selecting the portion of the anatomy;

forming a model of the selected portion of the anatomy operable to be manipulated with a workstation;

forming the model in a coordinate system;

measuring said model with the coordinate system to obtain at least three measurements of the selected portion of the anatomy with the model placed in the coordinate system;

determining a volume of the selected portion of the anatomy based on the at least three measurements;

selecting a procedure to be performed on the selected portion of the anatomy;

displaying a portion of the anatomy to be removed in the model;

selecting the prosthesis to be implanted during the procedure based on the determined volume; and

displaying an instrument in the model.

22. The method of claim 21, further comprising:

acquiring an image of the selected portion of the anatomy,

wherein said model is formed with said acquired image.

23. The method of claim 21, wherein said at least three measurements include a height, width, volume, depth, or combinations thereof.

24. The method of claim 21, wherein forming a model includes:

acquiring an image of the selected area of the anatomy with at least one of a MRI, an ultrasound, a fluoroscope, and X-ray device, a CT scanner, or combinations thereof;

processing the image to form a multi-dimensional digital image of the selected portion of the anatomy; and

providing the multi-dimensional digital image of the area of the anatomy to be removed.

25. The method of claim 24, further comprising;

determining a preliminary procedure;

wherein selecting a procedure includes;

analyzing said multi-dimensional digital image;

verifying the determined preliminary procedure; and

planning a procedure substantially with said multi-dimensional digital image.

26. The method of claim 24, further comprising:

saving the planned procedure;

providing the saved planned procedure to a work station;

displaying a complete area of the anatomy to be removed; and

navigating an instrument by a user based on said plan to perform the selected procedure.

27. The method of claim 24, further comprising:

implanting the selected prosthesis including navigating the prosthesis to the planned location.

28. A method of performing a procedure to position a prosthesis in a selected portion of an anatomy, the method comprising:

acquiring image data of the selected portion of the anatomy;

measuring an anatomical dimension of the selected portion of the anatomy;

selecting the prosthesis based upon the measurement;

displaying an area of the anatomy removed;

positioning the prosthesis in a selected portion of the anatomy;

altering a characteristic of the prosthesis during or after positioning the prosthesis; and

confirming the characteristic of the prosthesis after implanting the prosthesis,

wherein the characteristic includes a configuration of the prosthesis that has an implanted configuration different than an unimplanted configuration; and

wherein said confirming the characteristic is performed with at least one of a tracking sensor, an imaging device, a radio-opaque portions in the prosthesis, or combinations thereof.

29. The method of claim 28, further comprising:

determining a prosthesis dimension of the prosthesis;

substantially matching the prosthesis dimension with the anatomical dimension; and

selecting the prosthesis.

30. The method of claim 28, wherein the substantially matching of the prosthesis dimension with the anatomical dimension is performed with a processor.

31. The method of claim 30, further comprising:

storing a plurality of matching the prosthesis dimension with the anatomical dimension;

forming a correlation between the anatomical dimension and the prosthesis dimension; and

selecting the prosthesis by at least referring to the correlation of the anatomical dimension and the prosthesis dimension.

32. The method of claim 28, wherein acquiring image data of the selected portion of the anatomy includes obtaining image data from at least one of a magnetic resonance imaging apparatus, a computed tomography apparatus, an X-ray apparatus, a fluoroscopic system, an ultrasound, or combinations thereof.

33. The method of claim 28, further comprising forming a model of the selected portion of the anatomy based upon the acquired image data,

wherein the model is placed in a coordinate space to substantially accurately measure the selected portion of the anatomy on the model.

34. The method of claim 28, further comprising:

forming a substantially three dimensional model of the selected portion of the anatomy to be removed; and

manipulating said model formed of the selected portion of the anatomy.

35. The method of claim 28, wherein measuring the anatomical dimension includes measuring at least one of a length, a width, a depth, a volume, a geometry, or combinations thereof.

36. The method of claim 35, wherein selecting the prosthesis includes selecting a prosthesis to substantially mimic at least one of the measured anatomical dimensions.

37. The method of claim 28, wherein selecting the prosthesis includes selecting a prosthesis for at least one of a femoral head, an intramedullary stem, a vertebral disc, a vertebral nucleus, a humeral head, a glenoid, a distal femoral implant, a proximal tibial implant, or combinations thereof.

38. The method of claim 28, further comprising:

determining an abnormality of the selected portion of the anatomy; and

determining a procedure to perform relative to the selected portion of the anatomy to alleviate the determined abnormality.

39. The method of claim 38, wherein selecting the prosthesis includes selecting a procedure to substantially alleviate the abnormalities;

and

wherein the prosthesis is operable to interact with the selected portion of the anatomy to alleviate at least a portion of the abnormality.

40. The method of claim 28, further comprising:

planning a procedure; and

performing a procedure relative to the selected portion of the anatomy including;

navigating an instrument relative to the selected portion of the anatomy to remove a portion of the anatomy per the planned procedure; and

performing the removal with a navigation system to substantially achieve the planned procedure.

41. The method of claim 28, further comprising:

selecting a characteristic of the prosthesis;

implanting the prosthesis into the anatomy; and

manipulating the prosthesis to achieve the selected characteristic.

42. The method of claim 41, wherein the characteristic includes at least one of a specific location of a dimension, a specific location of a rigidity, a specific location of a curing time, or combinations thereof.

43. The method of claim 42, further comprising:

confirming the presence of the selected characteristic.

44. The method of claim 42, further comprising:

navigating the implant relative to the anatomy to position the selected characteristic in a selected area of the anatomy.

45. The method of claim 42, further comprising:

navigating a curing probe relative to the implant to cure a selected portion of the implant to allow the positioning of the selected characteristic at a selected position relative to the anatomy.

46. The method of claim 28, wherein the characteristic includes at least one of a size, a geometry, a position, a viscosity, or a malleability.

47. A method of performing a procedure to position a prosthesis in a selected portion of a spinal region, the method comprising:

acquiring image data of the selected portion of the spinal region;

measuring an anatomical dimension of the selected portion of the anatomy with said acquired image data;

providing a template program to be executed by a processor;

generating a first prosthetic model with the template program;

modeling the first prosthetic model with an anatomical model formed with the acquired image data;

determining whether the first prosthetic model achieves a selected result;

generating a second prosthetic model with the template program if the first prosthetic model is determined to not achieve the selected result; and

selecting the prosthesis based upon the first prosthetic model or the second prosthetic model.

48. The method of claim 47, further comprising:

aligning the prosthesis relative to the selected portion of the spinal region with said acquired image data.

49. The method of claim 48, wherein aligning the prosthesis includes aligning the prosthesis in at least one of a sagittal plane, a coronal plane, an axial plane, or combinations thereof.

50. The method of claim 48, wherein aligning the prosthesis includes:

navigating the prosthesis relative to the spinal region with said image data by tracking the prosthesis with a tracking sensor.

51. The method of claim 50, wherein said tracking sensor includes at least one of an optical sensor, an electromagnetic sensor, an acoustic sensor, or combinations thereof.

52. The method of claim 50, wherein tracking the prosthesis with a tracking sensor includes providing a plurality of the tracking sensors near a surface of the prosthesis to determine a surface contour of the prosthesis.

53. The method of claim 48, further comprising:

confirming a characteristic of the prosthesis after implanting the prosthesis.

54. The method of claim 53, wherein said confirming the position may be performed with a tracking sensor, and imaging device, radio-opaque portions in the prosthesis, and combinations thereof

55. The method of claim 47, wherein said template program includes a computer aided drafting program operable to create a shape according to instructions from a user and determine dimensions of the shape.

56. The method of claim 47, further comprising:

confirming that the prosthesis includes a selected shape, size, viscosity, geometry, or malleability relative to a selected portion of the anatomy.

57. The method of claim 47, wherein the template program is operable to display an icon created by forming a real time model of the prosthesis at least by one of:

imaging the prosthesis;

moving a tracked probe relative to the prosthesis;

performing a 2D scan of the prosthesis;

performing a 3D scan of the prosthesis;

or combinations thereof.

58. The method of claim 47, further comprising displaying an area of the spinal region yet to be removed.

59. The method of claim 58, further comprising preselecting a volume of tissue to be removed from the spinal region and tracking that the tissue has been removed.