Simulated bone or tissue manipulation

• US 8,565,853 B2
• Filed: 08/13/2007
• Issued: 10/22/2013
• Est. Priority Date: 08/11/2006
• Status: Active Grant

• Current Assignee: DePuy Synthes Products LLC (Johnson & Johnson)
• Original Assignee: DePuy Synthes Products LLC (Johnson & Johnson)
• Inventors: Frigg, Robert, Weikel, Stuart, Schwer, Stefan, Flexner, Geoffrey, Hamel, Ross Jonathan
• Primary Examiner(s): Le, Long V.
• Assistant Examiner(s): BOR, HELENE CATHERINE
• Application Number:
  US11/838,093
• Publication Number:
  US 20080039717A1
• Time in Patent Office: 2,262 Days
• Field of Search: 600/411, 600/426, 600/421
• US Class Current: 600/407
• CPC Class Codes: A61B 17/88 Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices A61B17/7074 takes precedence
• CPC Class Codes: A61B 2034/2063 Acoustic tracking systems, e.g. using ultrasound
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 2090/3762 using computed tomography systems [CT]
• CPC Class Codes: A61B 2090/3912 Body cavities
• CPC Class Codes: A61B 2090/3929 Active markers
• CPC Class Codes: A61B 2090/3958 emitting a signal
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 2090/3987 Applicators for implanting markers
• 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 5/0036 including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/7405 using sound
• CPC Class Codes: A61B 6/032 Transmission computed tomography [CT]
• CPC Class Codes: A61B 6/52 Devices using data or image processing specially adapted for radiation diagnosis
• CPC Class Codes: A61B 8/0841 for locating instruments
• CPC Class Codes: A61B 8/52 Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves image processing per se G06T
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61C 19/04 : Measuring instruments specially adapted for dentistry A61C5/44 takes precedence; testing vitality of teeth A61B5/0534; radiation diagnosis specially adapted for dentistry A61B6/51
• CPC Class Codes: G01R 33/285 : Invasive instruments, e.g. catheters or biopsy needles, specially adapted for tracking, guiding or visualization by NMR
• CPC Class Codes: G01R 33/5608 : Data processing and visualization specially adapted for MR, e.g. for feature analysis and pattern recognition on the basis of measured MR data, segmentation of measured MR data, edge contour detection on the basis of measured MR data, for enhancing measured MR data in terms of signal-to-noise ratio by means of noise filtering or apodization, for enhancing measured MR data in terms of resolution by means for deblurring, windowing, zero filling, or generation of gray-scaled images, colour-coded images or images displaying vectors instead of pixels image data processing or generation, in general G06T
• CPC Class Codes: G16H 50/50 : for simulation or modelling of medical disorders

Abstract

The present invention is directed to a system and method for performing tissue, preferably bone tissue manipulation. The system and method may include implanting markers on opposite sides of a bone, fractured bone or tissue to facilitate bone or tissue manipulation, preferably in-situ closed fracture reduction. The markers are preferably configured to be detected by one or more devices, such as, for example, a detection device so that the detection device can determine the relative relationship of the markers. The markers may also be capable of transmitting and receiving signals. An image may be captured of the bone or tissue and the attached markers. From the captured image, the orientation of each marker relative to the bone fragment may be determined. Next, the captured image may be manipulated in a virtual or simulated environment until a desired restored orientation has been achieved. The orientation of the markers in the desired restored orientation may then be determined. The desired relationship between markers may then be programmed into, for example, the detection device. Next, actual physical reduction and/or manipulation of the bone may begin. During the manipulation procedure, the orientation of the markers may be continuously monitored and when the markers substantially align with the virtual or simulated orientation of the markers in the desired restored orientation, an indicator signal is transmitted.

Claims

1. A method of performing bone or tissue manipulation comprising the steps of:

implanting programmable markers on opposite sides of one or more fragments of one of bone and tissue within a patient'"'"'s body, the markers communicating with one another to enable a determination of their relative positions, wherein the markers transmit to and receive from an external device signals containing information as to the markers'"'"' positions;

capturing an image of the fragments with the markers attached thereto;

manipulating the image of the fragments in one of a virtual environment and a simulated environment to a desired restored orientation;

determining desired positions the markers will have when the fragments are in the desired restored orientation;

programming the implanted markers with the desired orientations and instructing the markers to communicate with an external device, the external device being capable of generating an indicator signal upon the markers being manipulate into the desired orientations; and

manipulating the fragments, after the markers have been programmed, until an indicator signal is generated indicating that the desired restored orientation has been substantially achieved.

2. The method according to claim 1, wherein the markers are passive markers.

3. The method according to claim 1, wherein the communication during the procedure between the markers is continuously performed.

4. The method according to claim 1, wherein the positions of the markers are monitored by a detection device.

5. The method according to claim 4, wherein the detection device is capable of determining when the markers have arrived at the desired restored orientation.

6. The method according to claim 4, wherein the detection device is capable of transmitting the indicator signal.

7. The method according to claim 1, further comprising the step of implanting a fracture fixation device to the fragments after the desired restored orientation has been achieved.

8. The method according to claim 1, wherein the indicator signal is auditory.

9. The method according to claim 1, wherein the image is captured using a method selected from the group consisting of x-ray, three dimensional x-ray, computed tomography, magnetic resonance imaging and ultrasound.

10. The method according to claim 1, wherein the step of implanting the markers occurs outside of an operating room setting.

11. The method according to claim 10, wherein the steps of capturing and manipulating the image of the fragments occurs outside of the operating room setting.

12. The method according to claim 11, wherein the step of determining the positions of the markers relative to one another occurs outside of the operating room setting.

13. The method according to claim 12, wherein the step of manipulating the fragments until the indicator signal indicates that the desired restored orientation has been substantially achieved occurs outside of the operating room setting.

14. A method of performing bone or tissue manipulation comprising the steps of:

implanting first and second programmable markers on opposite sides of a fragment of one of bone and tissue within a patient'"'"'s body, the first and second markers being capable of communicating with one another to determine their position relative to one another, wherein the first and seconds markers transmit to and receive from an external device signals containing information as to the positions to the first and second markers;

capturing an image of the fragments with the first and second markers attached thereto;

manipulating the image of the fragments in one of a virtual environment and a simulated environment to a desired restored orientation;

determining desired positions the first and second markers will have when the fragments are in the desired restored orientation; and

providing an indicator signal when the fragments have been manipulated such that the positions of the first and second markers on the fragments substantially corresponds to the desired positions of the first and second markers.

15. A method of performing bone or tissue manipulation comprising the steps of:

implanting and associating first and second programmable markers on opposite sides of a fragment of one of bone and tissue within a patient'"'"'s body, wherein the markers communicate with one another to determine their positions relative to one another, and wherein the first and second markers communicate signals with an external device, the signals containing information as to the positions of the first and second markers;

acquiring an image of the fragments;

manipulating the image of the fragments in one of a virtual environment and a simulated environment until the fragments have achieved a desired restored orientation;

determining desired positions the orientation of the first and second markers will have when the fragments are in the desired restored orientation;

programming the external device with the desired positions of the first and second markers and instructing the external device to generate an indicator signal when the external device determines that the orientation of the first and second markers substantially corresponds with the desired positions of the first and second markers; and

manipulating the fragments until the indicator signal is generated.