System and method for navigated drill guide

• US 9,265,589 B2
• Filed: 11/06/2007
• Issued: 02/23/2016
• Est. Priority Date: 11/06/2007
• Status: Active Grant

• Current Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Inventors: Hartmann, Steven L., Hughes, Joel S., Moctezuma, Joseph, Verard, Laurent
• Primary Examiner(s): COOK, CHRISTOPHER L
• Application Number:
  US11/935,793
• Publication Number:
  US 20090118742A1
• Time in Patent Office: 3,031 Days
• Field of Search: 600/424, 600/425, 600/426, 600/429, 606/80
• US Class Current: 1/1
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/1707 using electromagnetic effects, e.g. with magnet and external sensors
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2090/034 abutting on parts of the device itself
• CPC Class Codes: A61B 2090/062 penetration depth
• 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 90/36 Image-producing devices or illumination devices not otherwise provided for

Abstract

A system for tracking a navigated instrument. The system can include a first elongated instrument and a second elongated instrument. The first elongated instrument can have a first proximal end and a first distal end. The first elongated instrument can be adapted to be positioned relative to an anatomy. The second elongated instrument can move adjacent to the first elongated instrument. The second elongated instrument can have a second proximal end and a second distal end. The system can also include at least one tracking device coupled to the second elongated instrument. When the second elongated instrument is in a first position, the at least one tracking device tracks the first distal end of the first elongated instrument, and when the second elongated instrument is in a second position, the at least one tracking device tracks the second distal end of the second elongated instrument.

Claims

1. A system comprising:

a guide instrument that has a first proximal end, a first distal end and defines a first bore, the guide instrument positionable with a handle adjacent to an anatomy;

a sleeve having a second proximal end, a second distal end and a second bore, the sleeve slideably received within the first bore;

a drill bit slideably received within the second bore and moveable relative to the sleeve, having a third distal end and an axially extending body composed of a first non-ferrous metal material, the body including at least two distinct segments that are axially separated, wherein the at least two distinct segments composed of a second non-ferrous metal material, the first non-ferrous metal material having a first magnetic permeability different from a second magnetic permeability of the second non-ferrous metal material and the at least two distinct segments include a segment length less than a total length of the body;

at least one tracking device fixedly coupled about the sleeve; and

a controller configured to receive a varying signal from the at least one tracking device based at least on the first magnetic permeability different from the second magnetic permeability;

wherein when the sleeve is in a first position, the at least one tracking device indicates a position of the first distal end of the guide instrument, and when the sleeve is in a second position, the at least one tracking device indicates a position of the third distal end of the drill bit;

wherein movement of the drill bit relative to and within the second bore of the sleeve and relative to the at least one tracking device acts to change a current induced in the at least one tracking device due to movement of a first distinct segment and a second distinct segment of the at least two distinct segments through the at least one tracking device and to determine a depth of the third distal end;

wherein the controller receives the varying signal based on the current induced in the at least one tracking device to at least assist in determining at least one of a position or a trajectory of the drill bit.

2. The system of claim 1, further comprising:

a drill configured to operably engage the drill bit to move the drill bit within the second bore;

wherein the at least one distinct segment of the body of the drill bit further comprises three distinct segments, wherein each of the three distinct segments is spaced apart at the third distal end of the drill bit, each of the three distinct segments having a different permeability to change the current induced by the at least one tracking device and each of the three distinct segments have segments lengths less than the total length of the body.

3. The system of claim 1, further comprising:

a tracking system that tracks the at least one tracking device; and

an imaging device selected from a fluoroscopy device, an O-arm device, a bi-plane fluoroscopy device, an ultrasound device, a computed tomography (CT) device, a multi-slice computed tomography (MSCT) device, a magnetic resonance imaging (MRI) device, a high frequency ultrasound (HFU) device, a positron emission tomography (PET) device, an optical coherence tomography (OCT) device, an intra-vascular ultrasound (IVUS) device, an intra-operative CT device, an intra-operative MRI device and combinations thereof.

4. A method comprising:

positioning a first elongated instrument relative to a second elongated instrument, the first elongated instrument having a first proximal end, a first distal end and a first bore with at least one tracking device positioned around the first bore of the first elongated instrument, the second elongated instrument having a second proximal end and a second distal end;

moving the second elongated instrument within the first bore of the first elongated instrument to vary a signal induced in the at least one tracking device due to a plurality of distinct and separated segments spaced along the length of the second elongated instrument, wherein each distinct and separated segment is formed of a first material that differs from a second material forming the remaining portions of the second elongated instrument, wherein the first material has different magnetic permeability than the second material forming the second elongated instrument;

tracking the at least one tracking device; and

determining, based on the tracking of the at least one tracking device, a location of the first distal end of the first elongated instrument or the second distal end of the second elongated instrument.

5. The method of claim 4, further comprising:

determining, based on the varying of the signal induced in the at least one tracking device, a depth of the second elongated instrument at least relative to the at least one tracking device;

wherein the signal is varied based on the plurality of distinct and separated segments formed of the first material and separated a distance from the second distal end of the second elongated instrument.

6. A method comprising:

positioning a first elongated instrument with a handle relative to a second elongated instrument, the first elongated instrument having a first proximal end and a first distal end and a first bore extending therebetween, the second elongated instrument including a sleeve and a drill bit, the sleeve having a second proximal end, a second distal end, and a second bore with at least one tracking device positioned around the sleeve and the second bore, the drill bit having a third proximal end and a third distal end, the drill bit provided with at least a first segment and a second segment discrete and separated by a distance from the first segment, the first segment and the second segment disposed at fixed and different positions spaced from the third distal end;

moving the drill bit within the second bore of the sleeve to vary an amount of current induced in the at least one tracking device due to positioning at least one of the first segment or the second segment within the at least one tracking device, wherein an amount of current induced is based at least on the first segment and the second segment being formed of a segment material having a first magnetic permeability different than a second magnetic permeability of a drill bit material of the remainder of the drill bit;

and

tracking of at least the third distal end of the drill bit based on varying the current induced in the at least one tracking device with the first segment or the second segment having the first magnetic permeability and second magnetic permeability.

7. The method of claim 6, further comprising:

positioning the at least one tracking device around the sleeve; and

securing the sleeve within the first bore such that the sleeve is biased into a first position, but is able to move relative to the first elongated instrument into a second position.

8. The method of claim 7, further comprising:

determining, based on tracking of the at least one tracking device, the location of the first distal end or the third distal end, comprising;

determining the location of the first distal end if the sleeve is in the first position, and

determining the location of the third distal end if the sleeve has moved relative to the first elongated instrument into the second position.

9. The method of claim 8, further comprising:

providing an image of an anatomy; and

displaying the position of the first distal end, the second distal end or combinations thereof relative to an anatomy on a display.

10. The method of claim 7, further comprising:

positioning the sleeve at a first physical position within the first bore and determining a position with the at least one tracking device of the second distal end of the first elongated instrument; and

positioning the sleeve at a second physical position within the first bore and determining with the at least one tracking device a position of the third distal end of the drill bit.

11. The method of claim 6, further comprising:

placing at least a third segment on the drill bit.

12. The method of claim 11, further comprising:

forming at least one of the first segment, the second segment, or the third segment within the drill bit.

13. The method of claim 6, further comprising:

determining at least a depth of the drill bit based at least on the varied current induced within the at least one first tracking device.

14. The method of claim 6, wherein the segment material of the first segment and the second segment are different.

15. The method of claim 6, further comprising:

determining a location of at least the third distal end based on the varied current induced due to the first segment and the second segment.

16. The method of claim 6, further comprising:

providing at least the first segment separate from the second segment with a different, distinct non-ferrous metal material, wherein at least one of the first segment and the second are adjacent to a distinct non-ferrous metal material; and

determining at least one of a position or a trajectory of the drill bit at least with the change in current induced in the at least one tracking device.

17. A system comprising:

a sleeve that has a first proximal end, a first distal end and a first bore;

a guide instrument that has a second proximal end, a second distal end and defines a second bore that is adapted to slideably receive the sleeve, the guide instrument positionable with a handle adjacent to an anatomy;

at least one electromagnetic tracking device coupled to the sleeve, the at least one electromagnetic tracking device moveable relative to the guide instrument; and

a drill bit slideably received within the first bore, the drill bit having a body composed of a first material, the body including at least two distinct segments composed of a second material that is different from the first material;

wherein when the sleeve is at a first physical position within the first bore of the guide instrument, the at least one electromagnetic tracking device indicates a position of the second distal end of the guide instrument;

wherein when the sleeve is at a second physical position within the first bore of the guide instrument, the at least one electromagnetic tracking device indicates a position of the third distal end of the drill bit.

18. The system of claim 17, wherein the second elongated instrument further comprises:

a biasing member coupled to the sleeve and retained within the first bore that applies a force to the sleeve to bias the sleeve in the first position; and

wherein in the second position, the drill bit moves the sleeve relative to the guide instrument and the relative movement between the sleeve and the guide instrument corresponds to a position of the third distal end.

19. The system of claim 17, wherein the at least one electromagnetic tracking device comprises at least one electromagnetic receiver coil positioned about the first bore and the relative movement of the drill bit within the sleeve acts as a core of the at least one electromagnetic receiver coil to vary a signal induced in the at least one electromagnetic coil, wherein a position of the drill bit is determined based on the varied signal induced based on moving the at least two distinct segments composed of the second-material that is different from the first material relative to the at least one electromagnetic receiver coil.

20. The system of claim 17, wherein the at least two distinct segments are axially spaced apart in the drill bit, wherein the at least one electromagnetic tracking device comprises at least one electromagnetic transmitter coil positioned around the first bore and the relative movement of the at least two distinct segments of the drill bit within the sleeve acts as at least two cores to the at least one electromagnetic transmitter coil to vary an electromagnetic field generated by the at least one electromagnetic coil as the first material and the second material move within the at least one electromagnetic transmitter coil, wherein a position of the drill bit is determined due to the varied electromagnetic field generated based on moving the at least two distinct segments composed of the second material that is different from the first material relative to the at least one electromagnetic receiver coil.

21. The system of claim 20, wherein each of the at least two segments is formed of a unique non-ferrous metal material, wherein the position of the drill bit is determined with use of the at least two distinct segments of the unique non-ferrous metal material to result in the change in the varied electromagnetic field generated.

22. The system of claim 17, wherein the first material has a different magnetic permeability than the second material.

23. The system of claim 17, further comprising:

a tracking system that tracks the at least one electromagnetic tracking device; and

an imaging device selected from a fluoroscopy device, an O-arm device, a bi-plane fluoroscopy device, an ultrasound device, a computed tomography (CT) device, a multi-slice computed tomography (MSCT) device, a magnetic resonance imaging (MRI) device, a high frequency ultrasound (HFU) device, a positron emission tomography (PET) device, an optical coherence tomography (OCT) device, an intra-vascular ultrasound (IVUS) device, an intra-operative CT device, an intra-operative MRI device and combinations thereof.