Method and apparatus for performing a navigated procedure

• US 8,301,226 B2
• Filed: 04/28/2008
• Issued: 10/30/2012
• Est. Priority Date: 04/24/2007
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Csavoy, Andrew N., Solar, Matthew S., Waynik, Jeffrey M., Freas, Mark S., Miller, Thomas I., Sootsman, Keith
• Primary Examiner(s): Le, Long V.
• Assistant Examiner(s): PENG, BO JOSEPH
• Application Number:
  US12/110,666
• Publication Number:
  US 20080269602A1
• Time in Patent Office: 1,646 Days
• Field of Search: None
• US Class Current: 600/424
• CPC Class Codes: A61B 2017/3407 including a base for support on the body
• 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 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2068 using pointers, e.g. pointers having reference marks for determining coordinates of body points
• 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 2090/101 for stereotaxic radiosurgery
• CPC Class Codes: A61B 2090/103 Cranial plugs for access to brain
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• 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 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/18 Retaining sheets, e.g. immobilising masks made from a thermoplastic material

Abstract

A system can be used to navigate or guide an instrument or device into an anatomy of a patient. The navigation can occur with the use of image data acquired of the patient. The image data can be registered to the patient space for navigation. Also, one or more coils can be used for tracking or localization.

Claims

1. A method of tracking an instrument with a navigation system, comprising:

generating a first navigation field relative to a patient;

navigating an alignment device with the first navigation field before fixing the alignment device to the patient;

fixing the alignment device to the patient;

generating a second navigation field independent of the first navigation field relative to the patient; and

navigating the instrument relative to the patient only with the second navigation field after ceasing generating the first navigation field.

2. The method of claim 1, further comprising:

providing the alignment device including a base; and

providing a first coil integrated into the base;

wherein fixing the alignment device to the patient includes fixing the base to the patient;

wherein navigating the alignment device includes sensing the first navigation field with the first coil integrated into the base.

3. The method of claim 2, wherein generating the second navigation field includes forming the second navigation field with the first coil.

4. The method of claim 3, further comprising:

ceasing generation of the first navigation field prior to generating the second navigation field.

5. The method of claim 4, further comprising:

providing the instrument including a guide tube;

providing a second coil on the guide tube;

navigating the guide tube at least by sensing the second navigation field; and

providing the instrument further including a second moveable portion with a third coil;

wherein navigating the instrument includes tracking the location of the guide tube, the second moveable portion, the third coil or combinations thereof in the second navigation field.

6. The method of claim 2, further comprising:

forming a burr hole in the patient; and

fixing the base at the burr hole.

7. The method of claim 1, further comprising:

executing instructions with a processor to cease generating the first navigation field, generating the second navigation field, and tracking the location of the instrument; and

displaying a graphical representation of the instrument being tracked on a display device.

8. The method of claim 7, further comprising:

acquiring image data of the patient; and

superimposing the graphical representation of the instrument on the image data of the patient.

9. The method of claim 1, further comprising:

acquiring image data of the patient;

determining a location for positioning the alignment device relative to the patient;

tracking the alignment device with the first navigational field to navigate the alignment device to the location relative to the patient; and

displaying on a display a graphical representation of the alignment device to illustrate a tracked position of the alignment device relative to the location.

10. The method of claim 9, further comprising:

inputting an instruction to a processor to determine timing for forming the first navigation field, the second navigation field, or combinations thereof.

11. The method of claim 1, further comprising:

providing a localizer in a head support portion of a patient support device configured to support a body of the patient;

wherein forming a first navigation field includes forming the first navigation field with the localizer in the head support portion of the patient.

12. The method of claim 1, further comprising:

planning a location of fixation of the alignment device; and

moving the alignment device to the location of fixation;

wherein navigating the instrument includes moving the instrument into the patient at least by guiding the instrument with the alignment device at the location.

13. The method of claim 1, wherein generating the first navigation field relative to the patient includes generating a first navigation field relative to the patient in a first location;

and

wherein generating the second navigation field relative to the patient includes generating a second navigation field relative to the patient in a second location different from the first location.

14. A method of tracking an instrument with a navigation system, comprising:

generating a first navigation field relative to a patient;

navigating an alignment device with the first navigation field by sensing the first navigation field before fixing the alignment device to the patient;

fixing the alignment device directly to the patient;

ceasing generating the first navigation field;

generating a second navigation field independent of the first navigation field relative to the patient after fixing the alignment device directly to the patient and after ceasing generating the first navigation field; and

moving the instrument relative to the patient using the alignment device.

15. The method of claim 14, wherein generating the first navigation field relative to a patient is generated with a first coil;

wherein navigating the alignment device with the first navigation field by sensing the first navigation field includes sensing the first navigation field with a second coil associated with the alignment device;

wherein generating the second navigation field relative to the patient includes generating the second navigation field with the second coil; and

navigating the instrument relative to the patient by sensing the second navigation field with a third coil associated with the instrument.

16. The method of claim 15, further comprising:

executing instructions with a processor to operate the first coil to generate the first navigation field, the second coil to generate the second navigation field, and navigating the instrument;

determining a location of the instrument;

acquiring image data of the patient; and

displaying the image data of the patient on a display device and superimposing a graphical representation of a position of the instrument relative to the patient on the display device.

17. The method of claim 16, further comprising:

planning a location of a fixation position of the alignment device prior to forming the first navigation field;

and

illustrating a position of the alignment device superimposed on the image data while navigating the alignment device with the first navigation field.

18. The method of claim 17, further comprising:

forming a burr hole in a selected portion of the patient; and

mounting the alignment device to surround a vicinity of the burr hole;

wherein fixing the alignment device directly to the patient includes connecting the alignment device to the patient adjacent to the burr hole.

19. The method of claim 15, further comprising:

executing instructions with a processor operable to receive a signal regarding the first navigation field with the second coil, generating the second navigation field with the second field coil, or combinations thereof.

20. The method of claim 15, wherein moving the instrument includes moving a deep brain stimulation probe through a burr hole in a skull of a patient.

21. The method of claim 15, further comprising:

providing a patient support device configured to support a body of the patient, including a head rest portion configured to support a head of the patient;

providing the first coil within the head rest; and

supporting the patient on the patient support device.

22. The method of claim 21, wherein generating the first navigation field includes generating the first navigation field to encompass substantially only the head of the patient.

23. The method of claim 22, wherein generating the second navigation field includes generating the second navigation field to encompass substantially only a range of movement of the instrument.

24. The method of claim 15, wherein navigating the instrument includes tracking a location of a guide tube fixed relative to the alignment device, tracking an axial movement of a first instrument portion through the tube, or combinations thereof.

25. A method of tracking an instrument with a navigation system, comprising:

generating a first navigation field relative to a patient;

providing an alignment device including a base having a first coil integrated into the base;

navigating the alignment device with the first navigation field including sensing the first navigation field with the first coil that is integrated into the base before fixing the alignment device to the patient;

fixing the alignment device to the patient;

ceasing generation of the first navigation field;

generating a second navigation field different than the first navigation field relative to the patient including forming the second navigation field with the first coil after ceasing generation of the first navigation field; and

navigating the instrument relative to the patient with the second navigation field by sensing the second navigation field with at least a second coil.

26. The method of claim 25,

wherein fixing the alignment device to the patient includes fixing the base to the patient.

27. The method of claim 25,

wherein providing the instrument further includes providing a guide tube and a second moveable portion with a third coil;

wherein the second coil is on the guide tube; and

wherein navigating the instrument includes navigating the guide tube at least by sensing the second navigation field with the second coil.

28. The method of claim 27, wherein navigating the instrument includes tracking the location of the guide tube, the second moveable portion, the third coil or combinations thereof in the second navigation field.

29. The method of claim 25, wherein navigating the instrument relative to the patient with the second navigation field includes navigating the instrument only with the second navigation field after ceasing generating the first navigation field.

30. The method of claim 29, further comprising:

executing instructions with a processor to cease generating the first navigation field, generating the second navigation field, and tracking the location of the instrument; and

displaying a graphical representation of the instrument being tracked on a display device.

31. The method of claim 30, further comprising:

inputting an instruction to the processor to determine timing for generating the first navigation field, the second navigation field, or combinations thereof.

32. The method of claim 25, further comprising:

acquiring image data of the patient;

determining a location for positioning the alignment device relative to the patient;

tracking the alignment device with the first navigational field to navigate the alignment device to the location relative to the patient; and

displaying on a display a graphical representation of the alignment device to illustrate a tracked position of the alignment device relative to the location.

33. The method of claim 26, further comprising:

planning a location of fixation of the alignment device; and

moving the alignment device to the location of fixation;

wherein navigating the instrument includes moving the instrument into the patient at least by guiding the instrument with the alignment device at the location.