Method and apparatus for positioning a reference frame

• US 8,467,851 B2
• Filed: 11/15/2010
• Issued: 06/18/2013
• Est. Priority Date: 09/21/2005
• Status: Active Grant

• Current Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Inventors: Mire, David A., Clayton, John B.
• Primary Examiner(s): Le, Long V.
• Assistant Examiner(s): FERNANDEZ, KATHERINE L
• Application Number:
  US12/946,309
• Publication Number:
  US 20110060213A1
• Time in Patent Office: 946 Days
• Field of Search: 600/407, 600/424, 600/429, 600/595, 606/53
• US Class Current: 600/424
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• 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 2090/363 Use of fiducial points
• CPC Class Codes: A61B 2090/3916 Bone tissue
• CPC Class Codes: A61B 2090/3925 ultrasonic
• CPC Class Codes: A61B 2090/3937 Visible markers
• CPC Class Codes: A61B 2090/3954 magnetic, e.g. NMR or MRI
• 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 90/39 Markers, e.g. radio-opaque or breast lesions markers

Abstract

A method and apparatus to perform a procedure that can include a processor assisted surgical procedure. During the procedure patient space and image space can be registered to allow for tracking of various tracking sensors. A dynamic reference frame can be used to maintain localization of the patient space with the image space. The dynamic reference frame can be fixedly interconnected with a bone portion of the anatomy.

Claims

1. A surgical navigation system for use in a surgical procedure on an anatomy including a bone, comprising:

a tracking system;

a dynamic reference frame tracking sensor operable to be tracked by the tracking system as a dynamic reference frame;

a dynamic reference frame positioning member having a substantially non-cylindrical bone engaging portion including at least one arm extending from a central region that is configured to be axially driven into the bone to at least resist rotation of the dynamic reference frame positioning member about a long axis of the dynamic reference frame positioning member;

wherein the dynamic reference frame tracking sensor is attached to the dynamic reference frame positioning member;

wherein the dynamic reference frame positioning member is operable to engage a bone in the anatomy in a selectively fixed manner at least by being impacted into the bone in the axial direction to hold the dynamic reference frame tracking sensor in a selected position relative to the bone.

2. The system of claim 1, wherein the at least one arm includes at least four arms extending radially from the central region.

3. The system of claim 2, wherein the substantially non-cylindrical bone engaging portion has a cruciform cross-section when taken substantially perpendicular to the long axis of the dynamic reference frame positioning member defined by the at least four arms extending radially from the central region.

4. The system of claim 1, wherein the dynamic reference frame positioning member further comprises:

a sensor holding portion that is at a fixed position relative to the substantially non-cylindrical bone engaging portion.

5. The system claim 1, wherein the dynamic reference frame positioning member further comprises:

a pin extending transverse to the long axis of the dynamic reference frame positioning member; and

a resilient member to bias the dynamic reference frame tracking sensor to engage the pin.

6. The system of claim 1, wherein the dynamic reference frame positioning member includes incorporated therein the dynamic reference frame tracking sensor such that the dynamic reference frame tracking sensor is at a fixed position relative to the substantially non-cylindrical bone engaging portion.

7. The system of claim 1, further comprising:

a cannula adapted to pass through soft tissue relative to the bone adapted to assist in passage of the dynamic reference frame positioning member towards and into the bone;

a dilator configured to initially pass through the cannula prior to passing the dynamic reference frame positioning member passing towards and into the bone through the cannula; and

an impaction instrument adapted to impact the dynamic reference frame positioning member into the bone through the cannula;

wherein the cannula and the dilator are adapted to prepare the soft tissue for passage of the dynamic reference frame positioning member towards and into the bone;

wherein the dynamic reference frame positioning member includes indicia to assist in determining an amount of movement of the dynamic reference frame positioning member relative to at least one of the cannula or the bone.

8. A surgical navigation system for use in a surgical procedure on an anatomy including a bone, comprising:

a tracking system;

a dynamic reference frame tracking sensor operable to be tracked by the tracking system as a dynamic reference frame; and

a dynamic reference frame positioning member having;

a bone engaging portion, wherein the bone engaging portion has at least a first section that has at least a first arm and a second arm that extend transverse to a long axis of the dynamic reference frame positioning member and that is configured to be axially driven into the bone to at least resist rotation of the dynamic reference frame positioning member about the long axis, and

a sensor holding section, wherein the dynamic reference frame tracking sensor is configured to removably engage the sensor holding section in a fixed position relative to the bone engaging portion;

wherein the dynamic reference frame positioning member is operable to engage a bone in the anatomy in a selectively fixed manner at least by being impacted into the bone in the axial direction to hold said dynamic reference frame tracking sensor in a selected position relative to the bone.

9. The system of claim 8, wherein the dynamic reference frame tracking sensor includes a locking screw to engage the sensor holding section.

10. The system of claim 8, wherein the sensor holding section includes a pin extending transverse to the long axis of the dynamic reference frame positioning member and a resilient member to bias the dynamic reference frame tracking sensor to engage the pin;

wherein the dynamic reference frame tracking sensor includes an opening and an engaging portion;

wherein the pin is operable to move through the opening and engage the engaging portion of the dynamic reference frame tracking sensor when the dynamic reference frame tracking sensor is biased by the resilient member.

11. The system of claim 8, wherein the first arm and the second arm are substantially thin relative to the remaining portion of the dynamic reference frame positioning member.

12. The system of claim 8, wherein the bone engaging portion further includes a third arm and a fourth arm;

wherein all of the first arm, the second arm, the third arm, and the fourth arm together form a cruciform configuration extending from an end region of the dynamic reference frame positioning member and forming a terminal end of the dynamic reference frame positioning member.

13. The system of claim 8, wherein the bone engaging portion further includes a third arm and a fourth arm, and an extending portion;

wherein all of the first arm, the second arm, the third arm, and the fourth arm extend radially from the extending portion.

14. The system of claim 13, wherein the extending portion includes a smooth portion that extends beyond all of the first arm, the second arm, the third arm, and the fourth arm along the long axis and forms a terminal end of the dynamic reference frame positioning member.

15. The system of claim 8, further comprising:

a removal tool to engage the dynamic reference frame positioning member to axially remove the bone engaging portion from the bone after it is impacted into the bone.

16. A surgical navigation system for use in a surgical procedure on an anatomy including a bone, comprising:

a tracking system;

a dynamic reference frame tracking sensor operable to be tracked by the tracking system as a dynamic reference frame; and

a dynamic reference frame positioning member having;

a bone engaging portion, wherein the bone engaging portion has at least a first section that has at least a first arm and a second arm that extend transverse to a long axis of the dynamic reference frame positioning member and that is configured to be axially driven into the bone to at least resist rotation of the dynamic reference frame positioning member about the long axis, and

a sensor holding section having a pin extending transverse to the long axis of the dynamic reference frame positioning member, wherein the dynamic reference frame tracking sensor is configured to removably engage the sensor holding section in a fixed position relative to the bone engaging portion; and

a cap having a pin passage to allow the pin to pass relative to the cap during an impaction of the dynamic reference frame positioning member;

wherein the cap is configured to be directly impacted and transfer an impaction force to the dynamic reference frame positioning member;

wherein the pin passage limits contact and an impaction force applied to the pin during impaction of the dynamic reference frame positioning member;

wherein the dynamic reference frame positioning member is operable to engage a bone in the anatomy in a selectively fixed manner at least by being impacted into the bone in the axial direction to hold said dynamic reference frame tracking sensor in a selected position relative to the bone.

17. A method for using a surgical navigation system during surgical procedure on an anatomy including a bone, comprising:

tracking a dynamic reference frame tracking sensor with a tracking system as a dynamic reference frame; and

providing a dynamic reference frame positioning member extending along a long axis and formed with;

a bone engaging portion, wherein the bone engaging portion has at least a first section that has at least a first arm and a second arm that extend transverse to the long axis and is configured to be axially driven into the bone to at least resist rotation of the dynamic reference frame positioning member about the long axis, and

a sensor holding section configured to engage the dynamic reference frame tracking sensor in a fixed position relative to the bone engaging portion;

wherein the dynamic reference frame positioning member is operable to engage a bone in the anatomy in a selectively fixed manner at least by being impacted into the bone axially in a direction along the long axis to hold said dynamic reference frame tracking sensor in a selected position relative to the bone.

18. The method of claim 17, further comprising:

axially impacting, along the long axis, at least the bone engaging portion of the provided dynamic reference frame positioning member into the bone along the long axis to penetrate the bone with at least the bone engaging portion including the first arm and the second arm to at least rotationally fix the provided dynamic reference frame positioning member relative to the bone.

19. The method of claim 18, further comprising:

connecting the dynamic reference frame tracking sensor to the driven dynamic reference frame positioning member;

performing a procedure relative to the driven dynamic reference frame positioning member; and

after performing the procedure, engaging the driven dynamic reference frame positioning member to remove at least the bone engaging portion from the bone.

20. The method of claim 17, wherein providing the dynamic reference frame positioning member with the bone engaging portion further includes at least a third arm and a fourth arm such that the first arm, the second arm, the third arm, and the fourth arm form a cruciform configuration in cross-section substantially transverse to the long axis.

21. The method of claim 17, further comprising:

forming the provided dynamic reference frame positioning member to incorporate the dynamic reference frame tracking sensor as a single member;

wherein the dynamic reference frame tracking sensor is fixed relative to the bone engaging section.