Percutaneous registration apparatus and method for use in computer-assisted surgical navigation
First Claim
1. An apparatus for facilitating percutaneous placement of surgical instruments into the spine, adapted for use with a surgical navigation system employing an energy-detecting array in communication with a surgical navigation computer to track positions of instruments in three dimensional space relative to a known reference point, said apparatus comprising:
- a connector adapted to be rigidly attached to a portion of the spine;
at least one central post connected to said connector;
a position identification structure rigidly and removably connected to said central post at a predetermined position on said central post and adapted to be reconnected at the same said predetermined position, said identification structure being further adapted to allow a patient to be scanned with the structure connected to the central post, said structure including an assembly for communicating positioning information with respect to said assembly to the energy detecting array and surgical navigation computer; and
a connector assembly for said reconnecting of said structure substantially to said predetermined position on said central post.
2 Assignments
0 Petitions
Accused Products
Abstract
An apparatus and procedures for percutaneous placement of surgical implants and instruments such as, for example, screws, rods, wires and plates into various body parts using image guided surgery. The invention includes an apparatus for use with a surgical navigation system, an attaching device rigidly connected to a body part, such as the spinous process of a vertebrae, with an identification superstructure rigidly but removably connected to the attaching device. This identification superstructure, for example, is a reference arc and fiducial array which accomplishes the function of identifying the location of the superstructure, and, therefore, the body part to which it is fixed, during imaging by CAT scan or MRI, and later during medical procedures.
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Citations
63 Claims
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1. An apparatus for facilitating percutaneous placement of surgical instruments into the spine, adapted for use with a surgical navigation system employing an energy-detecting array in communication with a surgical navigation computer to track positions of instruments in three dimensional space relative to a known reference point, said apparatus comprising:
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a connector adapted to be rigidly attached to a portion of the spine;
at least one central post connected to said connector;
a position identification structure rigidly and removably connected to said central post at a predetermined position on said central post and adapted to be reconnected at the same said predetermined position, said identification structure being further adapted to allow a patient to be scanned with the structure connected to the central post, said structure including an assembly for communicating positioning information with respect to said assembly to the energy detecting array and surgical navigation computer; and
a connector assembly for said reconnecting of said structure substantially to said predetermined position on said central post. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 21, 31, 32, 33)
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10. A method for monitoring the location of an instrument, surgical implant and various portions of the body, to be operated on, using a surgical navigation system with a surgical navigation computer and a digitizer array for monitoring the location of instruments in three-dimensional space relative to a known reference point, said method comprising the steps of:
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attaching a fixture having a central post to a portion of the spine;
removably attaching an identification structure including a fiducial array and a reference arc to said central post;
providing a scanned three-dimensional image of a patient including said fiducial array rigidly attached to said central post of said fixture, said fixture being rigidly attached to the patient to identify the position of said fixture and said fiducial array on the scanned image;
using an image-guided system, by touching an image guided surgical pointer to one or more fiducials on the fiducial array to register the location of a spinal element fixed to said array; and
emitting a signal from said reference arc to indicate changes in position of the spinal element during a surgical procedure. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17)
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18. A system for use in performing the percutaneous placement of surgical implants and instruments into the spine using image guided surgery and a surgical navigation computer and energy detecting array, said system comprising:
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means for attaching a fixture to a portion of the spine;
means for communicating position information to the surgical navigation computer and energy detecting array said means rigidly and removably connected to said means for attaching a fixture;
means for providing location information of said spinal portion to the surgical navigation system adapted to be connected to spinal elements;
means for indicating screw-head position said means electrically connected to the surgical navigation system and adapted to mate with the head of a screw implanted in one or more of said spinal elements. - View Dependent Claims (19, 20)
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22. An apparatus for facilitating percutaneous placement of surgical instruments into the spine, adapted for use with a surgical navigation system employing an energy-detecting array in communication with a surgical navigation computer to track positions of instruments in three dimensional space relative to a known reference point, said apparatus comprising:
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a connector adapted to be rigidly attached to a portion of the spine;
at least one post connected to said connector;
a position identification structure rigidly connected to said post at a predetermined position on said post, said identification structure being further adapted to allow a patient to be scanned with the structure connected to the post, said structure including an assembly for communicating positioning information with respect to said assembly to the energy detecting array and surgical navigation computer; and
a means for indicating a screw-head position said means electrically connected to the surgical navigation system and adapted to mate with the head of a screw implanted in the spine. - View Dependent Claims (23, 24, 25, 27, 28, 29, 30)
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26. An apparatus for facilitating percutaneous placement of surgical instruments into the spine, adapted for use with a surgical navigation system employing an energy-detecting array in communication with a surgical navigation computer to track positions of instruments in three dimensional space relative to a known reference point, said apparatus comprising:
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a connector adapted to be rigidly attached to a portion of the spine;
at least one post connected to said connector;
a position identification structure rigidly connected to said post at a predetermined position on said post, said identification structure being further adapted to allow a patient to be scanned with the structure connected to the post, said structure including an assembly for communicating positioning information with respect to said assembly to the energy detecting array and surgical navigation computer; and
wherein the connector includes an elongated fixture with a central axis and a threaded end adapted to be inserted into the spinous process and a substantially rigid wire connected to the fixture, said wire adapted to be implanted into the spinous process at an angle to prevent the fixture from rotating.
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34. A method for monitoring the location of an instrument, surgical implant and various portions of the body, to be operated on, using a surgical navigation system with a surgical navigation computer and a digitizer array for monitoring the location of instruments in three-dimensional space relative to a known reference point, said method comprising:
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attaching a fixture having a post to a portion of the body;
attaching a reference arc to said post;
providing a scanned three-dimensional image of a patient with the reference arc in place;
using an image-guided system to track instruments and implants relative to the reference arc and three-dimensional scan;
emitting a signal from said reference arc to indicate changes in position of the spinal element during a surgical procedure, inserting a threaded fixture having a substantially rigid wire into a spinal element; and
touching an image guided pointer to said threaded fixture and wire to positively register the location of said fixture and wire in a surgical navigation computer.
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35. A method for monitoring the location of an instrument, surgical implant and various portions of the body, to be operated on, using a surgical navigation system with a surgical navigation computer and a digitizer array for monitoring the location of instruments in three-dimensional space relative to a known reference point, said method comprising:
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attaching a fixture having a post to a portion of the body;
attaching a reference arc to said post;
providing a scanned three-dimensional image of a patient with the reference arc in place;
using an image-guided system to track instruments and implants relative to the reference arc and three-dimensional scan; and
emitting a signal from said reference arc to indicate changes in position of the spinal element during a surgical procedure;
implanting imageable devices into a plurality of spinal elements; and
manipulating the patient'"'"'s spine by viewing the location of the implanted devices, as communicated to the surgical navigation computer by touching an instrument with a tracking emitter to said implanted imageable devices to align the actual position of the spinal elements with the previously scanned image. - View Dependent Claims (36, 37, 38)
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39. A method for monitoring the location of an instrument, surgical implant and various portions of the body, to be operated on, using a surgical navigation system with a surgical navigation computer and a digitizer array for monitoring the location of instruments in three-dimensional space relative to a known reference point, said method comprising:
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attaching a fixture having a post to a portion of the body;
attaching a reference arc to said post;
providing a scanned three-dimensional image of a patient with the reference arc in place;
using an image-guided system to track instruments and implants relative to the reference arc and three-dimensional scan;
emitting a signal from said reference arc to indicate changes in position of the spinal element during a surgical procedure;
percutaneously implanting screws into spinal elements;
locating the position of said screws using image guided surgical navigation techniques;
manipulating the orientation of the screw heads percutaneously using a head-positioning probe for communicating location containing an emitter, said probe communicating to the surgical navigation computer the orientation of the screw heads; and
using a head positioning tool for manipulating implants having an end portion that mates with the heads of the screws and rotating the screws to receive a connecting implant. - View Dependent Claims (40)
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41. A system for use in performing the percutaneous placement of surgical implants and instruments into the spine using image guided surgery and a surgical navigation computer and energy detecting array, said system comprising:
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means for attaching a fixture to a portion of the spine;
means for communicating position information to the surgical navigation computer and energy detecting array said means rigidly connected to said means for attaching a fixture;
means for providing location information of said spinal portion to the surgical navigation system adapted to be connected to spinal elements; and
a means for indicating screw-head position said means electrically connected to the surgical navigation system and adapted to mate with the head of a screw implanted in one or more of said spinal elements. - View Dependent Claims (42, 43)
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44. A system for use in performing the percutaneous placement of surgical implants and instruments into the spine using image guided surgery and a surgical navigation computer and energy detecting array, said system comprising:
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means for attaching a fixture to a portion of the spine;
means for communicating position information to the surgical navigation computer and energy detecting array said means rigidly connected to said means for attaching a fixture;
means for providing location information of said spinal portion to the surgical navigation system adapted to be connected to spinal elements; and
wherein a screw has a head and the elongated implant is a rod adapted to be guided through holes in said implanted screw head.
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45. An apparatus for use with a surgical navigation system to track a position of at least one object in three-dimensional space relative to a patient'"'"'s body, said apparatus comprising:
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an anchor operable to be attached to a portion of the body;
a position identification structure rigidly and removably connected to said anchor at a pre-determined position and adapted to be reconnected at said same pre-determined position, said position identification structure being further adapted to allow the patient to be scanned with said position identification structure connected to said anchor, said position identification structure including an assembly for providing position information to the surgical navigation system;
a connector assembly associated with said position identification structure operable to reconnect said position identification structure substantially to said pre-determined position; and
a means for indicating a member position said means electrically connected to the surgical navigation system and adapted to mate with said member implanted in the body. - View Dependent Claims (46, 47, 48, 49, 50, 51, 52, 53, 54)
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55. A method for monitoring the location of an object relative to a patient'"'"'s body using a surgical navigation system, said method comprising:
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attaching an anchor to a portion of the body;
movably attaching an identification structure having a fiducial array and a reference arc to said anchor;
providing a three-dimensional image of a patient, including said fiducial array attached to said anchor, said anchor being attached to the body to identify the position of said fiducial array on the three-dimensional image;
using the fiducial array to register a location of the body fixed to said fiducial array; and
using the reference arc to identify changes in position of the body during a surgical procedure;
inserting a threaded anchor into a spinal element; and
touching an image guided pointer to said threaded anchor to positively register a location of said fixture with the surgical navigation system. - View Dependent Claims (56, 57, 58, 59, 60, 61, 62)
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63. A method for monitoring the location of an object relative to a patient'"'"'s body using a surgical navigation system, said method comprising:
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attaching an anchor to a portion of the body;
movably attaching an identification structure having a fiducial array and a reference arc to said anchor;
providing a three-dimensional image of a patient, including said fiducial array attached to said anchor, said anchor being attached to the body to identify the position of said fiducial array on the three-dimensional image;
using the fiducial array to register a location of the body fixed to said fiducial array;
using the reference arc to identify changes in position of the body during a surgical procedure;
performing a surgical procedure percutaneously on a spine of the patient;
locating an implant relative to the spine and an instrument associated with the implant;
comprising percutaneously implanting screws into spinal elements;
locating the position of the screws;
manipulating an orientation of screw heads associated with the screws percutaneously using a head-positioning probe, which is adapted to communicate with the surgical navigation system to orient the screw head;
tracking a location and position of a connecting implant by use of an instrument attached to the connecting implant that include emitters capable of communicating orientational location to the surgical navigation system; and
attaching the connecting implant to the screw heads percutaneously.
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Specification