Method and apparatus for preplanning a surgical procedure

• US 7,974,677 B2
• Filed: 05/28/2009
• Issued: 07/05/2011
• Est. Priority Date: 01/30/2003
• Status: Expired due to Fees

• Current Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Inventors: Dugger, Janice, Trieu, Hai H., Hunter, Mark W., Mire, David A.
• Primary Examiner(s): Le; Long V
• Assistant Examiner(s): Rozanski; Michael T
• Application Number:
  US12/473,557
• Publication Number:
  US 20090234217A1
• Time in Patent Office: 768 Days
• Field of Search: 600/407, 378/42, 623/7.11, 700/245
• 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 surgical system for use in a procedure to implant a prosthesis relative to an anatomy, comprising:

an imaging device to obtain image data of a selected portion of the anatomy;

a planning system including a processor to execute operations relating to said image data;

wherein said imaging device is operable to generate image data of the selected portion of the anatomy prior to the procedure and the processor forms a model of the selected portion of the anatomy in a coordinate system based on the image data;

a display displays a portion of the anatomy to be removed in the model; and

wherein said processor determines a volume of the selected portion of the anatomy based on at least three measurements taken from the model within the coordinate system and selects a procedure to be performed on the selected portion of the anatomy and selects the prosthesis to be implanted based on the determined volume.

2. The surgical system of claim 1, further comprising a user input device such that said processor may receive an instruction from a user and execute the instruction to perform a process.

3. The surgical system of claim 2, wherein said user input device includes at least one of a keyboard, a mouse, a pointing device, a touch sensitive display, or combinations thereof.

4. The surgical system of claim 2, wherein said planning system further includes a work station including said user input device;

and

a storage system operable to store a selected dataset including said image data of the selected portion of the anatomy.

5. The surgical system of claim 1, wherein said imaging device is selected from the group consisting of a fluoroscopic C-arm, a magnetic resonance imaging system, an X-ray system, an ultrasound system, a computed tomography system, and combinations thereof.

6. The surgical system of claim 1, wherein said planning system is operable to display said model on said display, and said display displays a portion of the anatomy to be completely removed in the model along with a portion of the anatomy yet to be removed.

7. The surgical system of claim 1, further comprising a navigation system including:

a tracking system; and

a tracking sensor;

wherein said navigation system is operable with said planning system to perform the procedure according to a selected plan described with said planning system.

8. The surgical system of claim 7, wherein said tracking system is at least one of an electromagnetic tracking system, an optical tracking system, an acoustic tracking system, or combinations thereof.

9. The surgical system of claim 1, wherein said planning system is operable to determine at least one of a selection of a procedure, selection of an implant, or planning of a selected procedure.

10. The surgical system of claim 1, wherein said image data from said imaging device is displayable on said display as an image;

wherein said image on said display allows at least one of a selection of a procedure, selection of an implant, or planning of a selected procedure.

11. The surgical system of claim 1, further comprising:

a navigation system including a tracking array and a tracking sensor;

wherein said planning system is operable to plan the procedure with said image data;

wherein said navigation system is operable to navigate an instrument for substantially performing the planned procedure.

12. The surgical system of claim 1, further comprising:

a navigation system and a tracking sensor;

wherein said tracking sensor is affixed to an implant;

wherein said planning system is operable to determine an implanted characteristic of said implant;

wherein said navigation system is operable to determine a location of said tracking sensor to navigate a characteristic of said implant to allow implantation of said implant with a selected characteristic.

13. The surgical system of claim 1, further comprising:

an implant kit including a plurality of implants;

wherein said planning system is operable to select at least one of the plurality of the implants to be positioned in the selected portion of the anatomy to achieve a result.

14. The surgical system of claim 13, further comprising a memory system wherein said memory system is operable to save the model formed from said image data and a planned procedure for retrieval.

15. The surgical system of claim 13, wherein said planning system substantially autonomously selects the at least one of the plurality of the implants based on the volume of the selected portion of the anatomy measured from the model.

16. The surgical system of claim 13, wherein said planning system selects the at least one of the plurality of the implants for at least one of confirmation or selection by a user.

17. The surgical system of claim 1, further comprising a template program, wherein said template program is executable by said planning system for planning a selected procedure.

18. The surgical system of claim 17, wherein said template program allows said planning system to select at least one of a size, a geometry, a type or combinations thereof of an implant.

19. The surgical system of claim 17, wherein said template program allows a user to select at least one of a size, a shape, a type, or combinations thereof.

20. The surgical system of claim 1, wherein said planning system includes a tracking system;

wherein said planning system is operable to plan at least one of a selection of an implant, a volume to be removed, a geometry to be removed, or combinations thereof;

wherein said tracking system allows for tracking of at least one of the removal of the selected volume, a shape of the selected implant, or the selected geometry.

21. The surgical system of claim 1, further comprising an implant including at least one of a spinal implant, a knee implant, a hip implant, a shoulder implant, a wrist implant, a hand implant, an arm implant, or combinations thereof.

22. A surgical system operable to obtain image data for use in a procedure to position a prosthesis in a selected portion of an anatomy, comprising:

a planning system including a processor to execute operations relating to the image data and forming an image based model of the selected portion of the anatomy;

a display that displays the image based model;

wherein the image data relates to the selected portion of the anatomy prior to the procedure;

wherein said planning system is operable to measure a selected dimension of the selected portion of the anatomy from the image based model and to select a prosthesis based upon the measurement to substantially mimic the selected dimension and to plan the procedure to achieve a selected characteristic of the prosthesis at least in part based upon the selected dimension, and the display displays an area of the anatomy to be completely removed and an area of the anatomy yet to be removed.

23. The surgical system of claim 22, further comprising:

an implant including at least one of an implant dimension, type, geometry, or combinations thereof;

wherein said planning system is operable to select the implant including the at least one of an implant dimension, type, geometry, or combinations thereof, and placement to substantially fit the selected dimension of the selected portion of the anatomy.

24. The surgical system of claim 23, further comprising:

a tracking system to track the implant during placement of the implant to confirm placement of the implant.

25. The surgical system of claim 22, further comprising a user input device such that said processor may receive an instruction from a user and execute the instruction to perform a process.

26. The surgical system of claim 25, wherein said planning system further includes a work station including said user input device;

and

a storage system operable to store a selected dataset including the image data of the selected portion of the anatomy.

27. The surgical system of claim 26, wherein said planning system further includes an implant storage system, wherein said implant storage system includes a data set of a plurality of implants;

wherein said planning system is operable to compare said data set of the plurality of implants to said image data from the selected portion of the anatomy to select at least one of the plurality of the implants for implantation.

28. The surgical system of claim 22, further comprising:

an imaging system operable to collect image data regarding the selected portion of the anatomy;

wherein said processor is operable to form a model of the selected portion of the anatomy with the image data obtained by the imaging system.

29. The surgical system of claim 28, wherein the imaging system is selected from the group consisting of a fluoroscopic C-arm, a magnetic resonance imaging system, an X-ray system, an ultrasound system, a computed tomography system, and combinations thereof.

30. The surgical system of claim 29:

wherein said planning system is operable to display said model on said display.

31. The surgical system of claim 22, further comprising a navigation system including:

a tracking system; and

a tracking sensor;

wherein said navigation system is operable with said planning system to perform the procedure according to a selected plan described with said planning system.

32. The surgical system of claim 31, wherein said tracking system is at least one of an electromagnetic tracking system, an optical tracking system, an acoustic tracking system, or combinations thereof.

33. The surgical system of claim 22, wherein said planning system is operable to determine at least one of a selection of a procedure, selection of an implant, planning of a selected procedure, or combinations thereof.

34. The surgical system of claim 22,

wherein the image based model on said display allows at least one of a selection of a procedure, selection of an implant, planning of a selected procedure, or combinations thereof.

35. The surgical system of claim 22, further comprising:

a navigation system including a tracking array and a tracking sensor;

wherein said planning system is operable to plan the procedure with the image data;

wherein said navigation system is operable to navigate an instrument for substantially performing the planned procedure.

36. The surgical system of claim 22, further comprising:

a navigation system and a tracking sensor;

wherein said tracking sensor is affixed to an implant;

wherein said navigation system is operable to determine a location of said tracking sensor to navigate a characteristic of said implant to allow implantation of said implant with a selected implanted characteristic.

37. The surgical system of claim 22, further comprising:

an implant kit including a plurality of implants;

wherein said planning system is operable to select at least one of the plurality of the implants to be positioned in the selected portion of the anatomy to achieve a result.

38. The surgical system of claim 37, wherein said plurality of implants include a plurality of implants of a hip implant, a knee implant, a shoulder implant, a spinal implant, and combinations thereof.

39. The surgical system of claim 37, further comprising a memory system wherein said memory systems operable to save a modeled portion formed from said image data and a planned procedure for retrieval.

40. A surgical system for use in a procedure to position an implant relative to an anatomy, comprising:

an imaging device to obtain image data of a selected portion of a spine of the anatomy;

a planning system including a processor to execute operations relating to said image data;

a display for displaying an area of the anatomy to be removed;

wherein said imaging device is operable to generate image data of the selected portion of the anatomy prior to the procedure; and

wherein said processor determines a selected dimension in said image data from said imaging device and selects an implant based upon the determined selected dimension; and

an implant configured to be positionable relative to the selected portion of the spine based on the selected dimension, the implant having a characteristic that is adjustable during or after being positioned relative to the selected portion of the anatomy,

wherein the characteristic includes a configuration of the implant that has an implanted configuration different than an unimplanted configuration.

41. The surgical system of claim 40 further comprising:

a confirmation system to compare at least one of an implanted status and position of said implant to a selected planned status or position determined with said planning system.

42. The surgical system of claim 41, wherein said confirmation system includes a virtual digital subtraction system;

wherein said imaging device is operable to obtain image data of the selected portion of the spine after said implant is positioned relative to said selected portion of the spine and compare the after image data to the image data used by said planning system to plan the procedure.

43. The surgical system of claim 41, wherein said confirmation system is operable to compare image data of the selected portion of the spine in at least one of two dimensions, three dimensions, a coronal plane, an axial plane, a sagittal plane, or combinations thereof.

44. The surgical system of claim 41, further comprising:

a tracking system operable to track a position of said implant with at least one of an electromagnetic sensor, an acoustic sensor, an optical sensor or combinations thereof.

45. The system of claim 41, wherein the confirmation system confirms the characteristic of the implant after the implant is implanted.

46. The surgical system of claim 40, wherein said planning system is operable to plan an alignment of said implant relative to the selected portion of the spine during an operative procedure.

47. The surgical system of claim 46, wherein said alignment is along at least one of a coronal plane, a sagittal plane, an axial plane or combinations thereof.

48. The surgical system of claim 40, wherein said implant includes a radio-opaque portion operable to be imaged with said image device.