Systems and methods for performing spine surgery

• US 9,510,771 B1
• Filed: 10/29/2012
• Issued: 12/06/2016
• Est. Priority Date: 10/28/2011
• Status: Expired

• Current Assignee: Nuvasive Incorporated
• Original Assignee: Nuvasive Incorporated
• Inventors: Nesbitt, Bryce, Finley, Eric, Kim, Albert, Scholl, Thomas, Barnes, Jeffrey
• Primary Examiner(s): ROZANSKI, MICHAEL T
• Application Number:
  US13/663,459
• Time in Patent Office: 1,499 Days
• Field of Search: 378/21, 600/407, 600/424, 600/427, 700/264, 606/99, 606/104, 606/130
• US Class Current: 1/1
• CPC Class Codes: A61B 2034/2048 using an accelerometer or inertia sensor
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/252 indicating steps of a surgical procedure
• CPC Class Codes: A61B 2034/254 being adapted depending on the stage of the surgical procedure
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• 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 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 5/064 using markers A61B5/062 takes precedence
• CPC Class Codes: A61B 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/4893 Nerves
• CPC Class Codes: A61B 5/743 Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots

Abstract

The present application includes a position tracking system for tracking the location of surgical objects within the surgical field, a neuromonitoring system for detecting the existence of (and optionally the distance and/or direction to) neural structures during a surgical procedure, and a processing system communicatively linked to both the position tracking system and the neuromonitoring system.

Claims

1. A method for tracking a position of an instrument relative to a surgical target site, said method comprising the steps of:

using an imaging device to take a first image of a patient'"'"'s body in a first anatomical view, wherein said imaging device displays a virtual center location when taking said first image and said first image has a user defined first point location at said virtual center location, and wherein said imaging device is in a first position;

obtaining three-dimensional positional data of the location of said imaging device in said first position while taking said first image;

using said imaging device to take a second image of said patient'"'"'s body in said first anatomical view, wherein said imaging device displays a second virtual center location when taking said second image and said second image has a user defined second point location at said second virtual center location, and wherein said imaging device is in a second position, and wherein movement between said first and second positions of said imaging device is constrained to one axis;

obtaining three-dimensional positional data of the location of said imaging device in said second position while taking said second image;

scaling the first and second images to create a virtual backdrop image in said first anatomical view for viewing on a display unit, wherein said scaling comprises selecting the user defined first and second point locations to calculate a physical distance between said user defined first and second point locations and selecting at least one said user defined first and second point locations from at least one of said first and second images to correlate said physical distance between said user defined first and second point locations on said patient'"'"'s body and a number of pixels between said user defined first and second point locations as represented on said display unit; and

monitoring three-dimensional position data of at least one surgical instrument via said display unit as said surgical instrument is moved within said patient'"'"'s body by tracking a virtual representation of said surgical instrument overlaid onto said virtual backdrop image.

2. The method of claim 1, wherein said imaging device is a c-arm fluoroscope.

3. The method of claim 1, wherein said user defined first point location is on the spine of said patient.

4. The method of claim 1, wherein said first anatomical view is at least one of a lateral view and an anterior-posterior view.

5. The method of claim 1, wherein said three-dimensional positional data of the first and second positions of the imaging device is registered using an infrared position tracking system.

6. The method of claim 1, wherein said user defined second point location is on the spine of said patient.

7. The method of claim 1, wherein the scaling is accomplished manually.

8. The method of claim 1, wherein the at least one surgical instrument comprises at least one of a cannula, a dilator, a retractor blade, a k-wire, a cobb, a rasp, a drill, a tap, and a screw driver.

9. The method of claim 1, wherein the position of said at least one surgical instrument is monitored during a spine surgery procedure.

10. The method of claim 9, wherein the spinal surgery procedure is a lateral lumbar spinal surgery procedure.

11. A method for tracking a position of a surgical instrument during a surgical procedure, said method comprising the steps of:

using an intraoperative imaging device in a first position to generate a first radiographic image of a patient'"'"'s body in a first anatomical view, wherein said first radiographic image displays a first user defined point location in the center of the first image;

using said intraoperative imaging device in a second position to generate a second radiographic image of the patient'"'"'s body in said first anatomical view, wherein said second radiographic image displays a second user defined point location in the center of the second image;

obtaining three-dimensional positional data of said first position of said imaging device during generation of said first image and said second position of said imaging device during generation of said second image;

scaling the first and second images to create a first virtual backdrop image in said first anatomical view for viewing on a display unit, said scaling step comprising correlating a physical distance between the first and second user defined point locations on said patient'"'"'s body and a number of pixels between said first and second user defined point locations as represented on said display unit;

using said imaging device in a third position to generate a third radiographic image of the patient'"'"'s body in a second anatomical view, wherein said third radiographic image displays a third user defined point location in the center of the third image;

using said imaging device in a fourth position to generate a fourth radiographic image of the patient'"'"'s body in said second anatomical view, wherein said fourth radiographic image displays a fourth user defined point location in the center of the fourth image;

obtaining three-dimensional positional data of said third position of said imaging device during generation of said third image and said fourth position of said imaging device during generation of said fourth image;

scaling the third and fourth images to create a second virtual backdrop image in said second anatomical view for viewing on said display unit, said scaling the third and fourth images step comprising correlating a physical distance between the third and fourth user defined point locations on said patient'"'"'s body and a number of pixels between said third and fourth user defined point locations as represented on said display unit; and

tracking a virtual representation of a surgical instrument against said first and second virtual backdrop images as the actual surgical instrument is moved within said patient'"'"'s body.

12. The method of claim 11, wherein said imaging device is a c-arm fluoroscope.

13. The method of claim 11, wherein said three-dimensional positional data of the first, second, third, and fourth positions of the imaging device is registered using an infrared position tracking system.

14. The method of claim 11, wherein said first and second anatomical views are anterior-posterior and lateral views.

15. The method of claim 11, wherein the surgical instrument is at least one of an intervertebral implant, an intervertebral trial, a rasp, a cobb, a retractor, a dilator, a cannula, a k-wire, a drill, a tap, and a screw driver.

16. The method of claim 11, wherein each said scaling step is accomplished manually.

17. The method of claim 11, wherein the position of said surgical instrument is monitored during a spine surgery procedure.

18. The method of claim 17, wherein the spinal surgery procedure is a lateral lumbar spinal surgery procedure.