Method and apparatus for surgical navigation of a multiple piece construct for implantation

• US 8,706,185 B2
• Filed: 11/15/2010
• Issued: 04/22/2014
• Est. Priority Date: 10/16/2003
• Status: Expired due to Term

• Current Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Inventors: Foley, Kevin T., Sprouse, Stacy, Mire, David A., Clayton, John B., Hunter, Mark W.
• Primary Examiner(s): KISH, JAMES M
• Application Number:
  US12/946,288
• Publication Number:
  US 20110060216A1
• Time in Patent Office: 1,254 Days
• Field of Search: 600/424, 606/61, 606/130, 606/53, 606/54, 606/59, 606/60, 606250-258, 606/260, 606/261, 606/277, 606/278, 606/279
• US Class Current: 600/407
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/1735 for rasps or chisels
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/7089 wherein insertion is along an arcuate path
• CPC Class Codes: A61B 17/8872 Instruments for putting said fixation devices against or away from the bone A61B17/7074, A61B17/808 take precedence
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• 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 2034/2072 Reference field transducer attached to an instrument or patient
• 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 2090/3983 Reference marker arrangements for use with image guided surgery
• 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: A61B 90/10 for stereotaxic surgery, e.g. frame-based stereotaxis
• 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

Abstract

A method and apparatus for percutaneous and/or minimally invasive implantation of a construct. The construct may be implanted using a navigation system for planning and execution of a procedure. A plurality of portions of the construct may be interconnected using locations and paths determined and navigated with the navigation system.

Claims

1. A system for use in navigating an implantation of a selected construct, comprising:

a first member having an open passage to receive a second member, wherein the second member is configured to be received and connected within the open passage of the first member after implantation;

a first localization element selectively connectable and fixed to said first member by at least partially encompassing a portion of the first member and engaging at least the encompassed portion of the first member with an internal mechanism during a navigation of the second member relative to the first member;

a second localization element simultaneously selectively connected to said second member when said first localization element is selectively connected and fixed to said first member;

a detector to detect said first localization element and said second localization element while both said first localization element is connected to said first member and said second localization element is selectively connected to said second member;

a display device; and

a processor configured to navigate said second member relative to said first member;

wherein said processor is operable to receive position information for both of said first member and said second member from said detector both while said first localization element is connected to said first member and while said second localization element is selectively connected to said second member and further operable to determine a relative position of said first member to said second member;

wherein said processor is configured to distinguish the location of said first localization element that is different from said second localization element;

wherein said relative position is operable to allow a navigated movement of said second member to said first member to connect said first member and said second member substantially only by detecting positions of said first localization element and said second localization element and the display device illustrates only icons representing the first member and the second member.

2. The system of claim 1, wherein said first member is configured to be positioned beneath a tissue and said second member is configured to move beneath the tissue to be connected with said first member.

3. The system of claim 2, wherein said first localization element is configured to remain fixed to said first member during the navigation.

4. The system of claim 3, wherein said second member is configured to be moved in a volume between said first localization element and said first member.

5. The system of claim 3, further comprising:

an extending member that is configured to extend through the tissue and include the internal mechanism, wherein said first localization element is coupled to said extending member to be exposed to said detector when associated with said first member.

6. The system of claim 5,

wherein the first member is a screw and the extending member is keyed to engage the screw in substantially a single position to determine six degree of freedom position information of said screw;

wherein said six degree of freedom information is displayed with said display device.

7. The system of claim 6, further comprising:

a third member that is a screw configured to be interconnected to the first member and the second member to form the construct; and

a third localization element configured to be connected to the third member during navigation of the second member relative to the first member and the third member where the third localization element extends through the tissue when the third member is covered by the tissue;

wherein said second member is configured to be fixedly connected to said first member and said third member in a selected connected configuration;

wherein said connected configuration is based on an alignment in at least one plane defined relative to an anatomy;

wherein said display device is configured to display an alignment icon based on the alignment in at least one plane relative to a display of relative positions of at least the first member and the third member.

8. A method for navigating an implantation of a construct, comprising:

detecting with a detector a first localization element connected to a first member of the construct, wherein said first member is implanted into a first anatomical structure of an anatomy;

detecting with said detector a second localization element selectively connected to a second member of the construct, wherein the second member is moveable relative to the first member;

determining a first position of said first member based on position information received by a processor from said detector regarding said first localization element

and simultaneously determining a second position of said second member based on position information received by the processor from said detector regarding said second localization element;

determining an alignment of said second member relative to said first member; and

displaying the first position of said first member relative to the second position of said second member at least while the second member is positioned within a portion of the first member that is implanted into the first anatomical structure of the anatomy to achieve said determined alignment once said first member and said second member are fixedly connected;

wherein displaying the first position of said first member relative to the second position of said second member includes displaying on a display device only icons for viewing a representation of navigated portions including at least one of a selected path icon, a distal tip icon, a first icon illustrating a location of the first member, and a second icon illustrating a location of the second member.

9. The method of claim 8, further comprising:

fixedly connecting said second member to said first member.

10. The method of claim 9, further comprising:

detecting with said detector a third localization element selectively connected to a third member of the construct, wherein said third member is implanted into a second anatomical structure of the anatomy.

11. The method of claim 10, wherein determining said alignment of said second member relative to said first member includes:

detecting simultaneously all of said first localization element, said second localization element, and said third localization element; and

determining an alignment of said first member and said third member to be maintained by an interconnection of said first member and said third member with said second member.

12. The method of claim 11, wherein said alignment is one of a radius or a plane.

13. The method of claim 12, further comprising:

displaying said alignment with said display device;

wherein said processor is operable to determine said alignment.

14. The method of claim 11,

wherein the distal tip icon illustrates a present location of a distal tip of the second member relative to the selected path icon.

15. The method of claim 14, further comprising:

navigating said second member relative to said first member using a display device including moving the second member relative to the first localization element that is selectively connected with the first member.

16. A system for use in navigating an implantation of a selected construct, comprising:

a first localization element has a depressible member that operates an internal mechanism to engage and disengage a head of a first member, wherein said first member includes a slot through which a second member is configured to be placed, said depressible member and said internal mechanism allow percutaneous engagement and percutaneous disengagement from said first member while a second member is navigated and moved to said first member and fixedly connected to said first member;

a second localization element fixed to said second member while said second member is moved to connect to said first member;

a detector to detect said first localization element and said second localization element;

a processor configured to receive position information for said first member from said detector based on detecting said first localization element and position information for the second member and is further configured to determine a relative position of said second member to said first member; and

a display device configured to display said relative position of said first member relative to said second member by displaying a first icon representing said first member and a second icon representing at least a portion of said second member without registering to patient images;

wherein said first icon and said second icon alone are operable to display location of said first member and said second member;

wherein said first localization element is configured to be removed percutaneously from said first member once said second member is connected to said first member.

17. The system of claim 16, further comprising:

said first member of the construct, wherein said first member of the construct is configured to be implanted into a first anatomical structure of an anatomy;

said second member of the construct, wherein said second member is configured to be fixedly connected with said first member after implantation;

said second localization element selectively associated with said second member;

wherein said processor is operable to receive further position information for said second member from said detector based on detecting said second localization element;

wherein said processor is further operable to determine a relative position of said second member relative to said first member with said position information for said first member and said second member.

18. The system of claim 17, wherein said first localization element has a first configuration and said second localization element has a second configuration;

wherein said first configuration and said second configuration are distinct from one another such that said processor is operable to identify said first member and said second member based on said selectively associated said first localization element and said selectively associated said second localization element.

19. The system of claim 18, wherein said first member is a screw and said first localization element is keyed to engage said screw in substantially a single position to determine six degree of freedom position information of said screw;

wherein said six degree of freedom information is displayed with said display device.

20. The system of claim 19, further comprising:

a third member of the construct configured to be implanted into a second anatomical structure of the anatomy; and

a third localization element selectively associated with said third member;

wherein said detector detects said third localization element;

wherein said processor is further operable to receive position information for said third member from said detector based on detecting said third localization element and further operable to determine relative positions of said first member, said second member, and said third member;

wherein said display device is configured to display said relative positions said first member, said second member, and said third member;

wherein said second member is configured to be fixedly connected to said first member and said third member in a selected connected configuration;

wherein said connected configuration is based on an alignment in at least one plane defined relative to the anatomy;

wherein said display device is configured to display an alignment icon based on said alignment relative to a display of at least said first member and said second member.

21. The system of claim 16, wherein said first localization element includes a cannula, wherein said cannula of said first localization element is configured to be aligned with a cannula of said first member;

wherein a guide wire is operable to be positioned within the cannula of said localization element and the cannula of said first member.

22. The system of claim 16, wherein the first localization element is keyed relative to said first member such that said first localization element is configured to allow determination of six degree of freedom position information of said first member.