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.
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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
73 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)
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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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21. A method of positioning an implant in an anatomy, including a first implant portion and a second implant portion with a surgical navigation system, comprising:
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positioning the first implant portion through an opening in a soft tissue of the anatomy;
tracking a position of the first implant portion;
interconnecting an implant inserter with the second implant portion;
determining a location of the second implant portion; and
moving the second implant portion relative to the first implant portion via determining a location of the second implant portion. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38)
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39. A method of performing a spinal procedure in an anatomy with a surgical navigation system, comprising:
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positioning a first screw implant in a vertebrae percutaneously through an opening in a soft tissue of the anatomy;
tracking a position of the first screw implant with a screw tracking apparatus;
orientating the first screw implant in a selected orientation at least in part via tracking the position of the first screw implant;
interconnecting an implant inserter with a rod;
determining a position of a portion of the rod; and
moving the rod relative to the first screw implant via determining a location of the rod to interconnect the screw with rod. - View Dependent Claims (40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73)
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Specification