Integrated surgical navigational and neuromonitoring system having automated surgical assistance and control
First Claim
Patent Images
1. An apparatus comprising:
- a hand-held surgical instrument configured to apply an electrostimulation to induce a neurological response for a neural monitoring system wherein the electrostimulation is automatically adjusted based on the real-time positioning of the hand-held surgical instrument;
an integrated system comprising;
an instrument tracking system configured to track a real-time positioning of the hand-held surgical instrument, and the neural monitoring system configured to conduct real-time neuromonitoring during a surgical procedure;
a database containing pre-acquired images of an anatomical structure and technical information regarding the surgical procedure and patient anatomy;
a graphical user interface (GUI);
a computer operatively linked with the instrument tracking system, the neural monitoring system, the surgical instrument, the database, and a display terminal, the computer programmed to;
determine an anticipated trajectory of the hand-held instrument and display the anticipated trajectory on the GUI;
display on the display terminal the pre-acquired images of the anatomical structure, the pre-acquired images of the anatomical structure including an image of a nerve structure;
receive data relating to a measured neurological response of a portion of the nerve structure of the anatomical structure;
determine a predicted structure of the nerve structure based on a measured neurological response of a portion of the nerve structure;
display on the display terminal the predicted structure over the pre-acquired images such that the predicted structure supplements the image of the pre-acquired nerve structure to provide a real-time structural view of the nerve structure in its entirety;
automatically identify and determine based on the positioning of the instrument with respect to the anatomical structure, a portion of the technical information contained on the database that relates to the anatomical structure; and
generate and display identifiers for the portion of the technical information in a user-selectable manner to allow a user to selectively obtain technical information relating to the surgical procedure and the anatomical structure.
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Accused Products
Abstract
The invention relates to an integrated surgical navigational and neuromonitoring system having automated surgical assistance and control. The integrated system provides real-time introperative assistance to a surgeon or other user. The integrated system can also automatically control neuromonitoring based on a position of a neuromonitoring probe.
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Citations
17 Claims
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1. An apparatus comprising:
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a hand-held surgical instrument configured to apply an electrostimulation to induce a neurological response for a neural monitoring system wherein the electrostimulation is automatically adjusted based on the real-time positioning of the hand-held surgical instrument; an integrated system comprising;
an instrument tracking system configured to track a real-time positioning of the hand-held surgical instrument, and the neural monitoring system configured to conduct real-time neuromonitoring during a surgical procedure;a database containing pre-acquired images of an anatomical structure and technical information regarding the surgical procedure and patient anatomy; a graphical user interface (GUI); a computer operatively linked with the instrument tracking system, the neural monitoring system, the surgical instrument, the database, and a display terminal, the computer programmed to; determine an anticipated trajectory of the hand-held instrument and display the anticipated trajectory on the GUI; display on the display terminal the pre-acquired images of the anatomical structure, the pre-acquired images of the anatomical structure including an image of a nerve structure; receive data relating to a measured neurological response of a portion of the nerve structure of the anatomical structure; determine a predicted structure of the nerve structure based on a measured neurological response of a portion of the nerve structure; display on the display terminal the predicted structure over the pre-acquired images such that the predicted structure supplements the image of the pre-acquired nerve structure to provide a real-time structural view of the nerve structure in its entirety; automatically identify and determine based on the positioning of the instrument with respect to the anatomical structure, a portion of the technical information contained on the database that relates to the anatomical structure; and generate and display identifiers for the portion of the technical information in a user-selectable manner to allow a user to selectively obtain technical information relating to the surgical procedure and the anatomical structure. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. A method comprising:
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displaying a pre-acquired image of an anatomical structure; applying electrostimulation at a given surgical instrument position within the patient using a hand-held surgical instrument; determining a location of a portion of the neural structure relative to the surgical instrument position from a neurological response of the portion of the neural structure to the electrostimulation; determining a predicted structure of the neural structure in its entirety based on the neurological response of the portion of the neural structure; displaying the predicated structure over the pre-acquired image such that the predicted structure supplements the image of the pre-acquired neural structure to provide a structural view of the nerve structure in its entirety; determining a trajectory of a movement of the hand-held surgical instrument and generating a neural structure map along the trajectory by applying electrostimulation to and measuring the neurological response of neural structures along the trajectory; developing a visualization of patient anatomy containing the neural structure from a coronal image, a sagittal image, and an axial image of the patient anatomy, each of the images contained in a separate image pane; displaying the trajectory superimposed on the visualization of patient anatomy containing the neural structure; varying a direction of electrostimulation based on a movement of the hand-held surgical instrument; and automatically setting one of the electrostimulation intensity and electrostimulation pattern based on the surgical instrument position. - View Dependent Claims (9, 10, 11, 12)
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13. An apparatus including an integrated neuromonitoring and surgical navigational system comprising a computer, the computer programmed to:
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display a pre-acquired image of an anatomical structure; determine a real-time location of a hand-held neuromonitoring bone-screwdriver positioned within a patient using the pre-acquired image, the neuromonitoring bone-screwdriver configured to drive a bone screw and to apply an electrostimulation to the patient during a pedicle hole preparation; compare the determined location to an anatomical framework of the patient, the anatomical framework providing a general localization of a neural structure; automatically determine one of electrostimulation intensity and electrostimulation pattern for electrostimulating the neural structure based on the position of the neuromonitoring bone-screwdriver and the neural structure; apply electrostimulation to a portion of the neural structure by the neuromonitoring bone-screwdriver positioned within the patient during the pedicle hole preparatoin; determine a predicted structure of the neural structure in its entirety based on a neurological response of the portion of the neural structure to the electrostimulation; and display the predicted structure over the pre-acquired image such that the predicted structure supplements the pre-acquired image of the neural structure to provide a real-time structural view of the nerve structure in its entirety, wherein the integrated neuromonitoring and surgical navigational system includes a display configured as a graphical user interface (GUI) showing a visualization of the anatomical framework through a plurality of image panes including a coronal image, a sagittal image, and an axial image, and wherein the computer causes a superimposition of a position marker on the visualization of the anatomical framework indicating the location of the neuromonitoring bone-screwdriver in image panes, and wherein the computer is further programmed to indicate, on the GUI, an anticipated trajectory of a movement of the bone-screwdriver. - View Dependent Claims (14)
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15. A computer programmable to execute non-transitory computer readable storage medium having instructions thereon that when executed by a computer causes the computer to:
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access an anatomical visualization of a patient, the visualization of the patient including a pre-acquired image of an anatomical structure; access real-time neurological information acquired from applying electrostimulation to a portion of the neural structure of the patient a hand-held surgical instrument configured to apply electrostimulation; instantaneously track a position of the hand-held surgical instrument in the patient using an optical tracking system; automatically identify an determine a class of neural structure of the patient by accessing the neurological information of the patient and a predicted structure of the neural structure in its entirety based on the neurological information acquired from applying the electrostimulation to a portion of the neural structure; automatically update the anatomical visualization obtained by movement of the surgical instrument to incorporate the neurological information, and the predicted structure; integrate the optical tracking system and the pre-acquired image to produce a display; display the integrated optical tracking system and the predicted structure over the pre-acquired image by automatically refreshing an image pane such that the predicted structure supplements the pre-acquired portion image of the neural structure to provide a real-time structural view of the nerve structure in its entirety and a trajectory of the hand-held surgical instrument; and automatically adjusts the electrostimulation based on the tracked instantaneous position of the surgical instrument. - View Dependent Claims (16, 17)
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Specification