Systems and methods for surgical and interventional planning, support, post-operative follow-up, and functional recovery tracking

• US 10,595,844 B2
• Filed: 07/26/2018
• Issued: 03/24/2020
• Est. Priority Date: 09/17/2012
• Status: Active Grant

• Current Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Original Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Inventors: Nawana, Namal, Horton, William C., Frasier, William J., Cranson, Cody, Reinhardt, Max, Hall, Mark T., Parsons, Matthew, DiPietro, Jennifer, Lee, Kevin, LaWare, Michelle, Griffin, John P., Selover, Sean P., Bellas, Jonathan, Raymond, Douglas, Pavento, Nicholas, Fowler, Mary L., Chien, Dennis
• Primary Examiner(s): Nasri, Maryam A
• Application Number:
  US16/046,450
• Publication Number:
  US 20180344308A1
• Time in Patent Office: 607 Days
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/50 Instruments, other than pincettes or toothpicks, for removing foreign bodies from the human body locating otherwise A61B5/06; locating by radiation A61B6/00; removing calculi A61B17/22; from the eyes A61F9/00709
• CPC Class Codes: A61B 2010/009 Various features of diagnostic instruments
• CPC Class Codes: A61B 2010/0093 slide rules
• CPC Class Codes: A61B 2017/00115 with audible or visual output with imaging means A61B90/37, A61B34/20
• CPC Class Codes: A61B 2017/00119 alarm; indicating an abnormal situation
• CPC Class Codes: A61B 2017/0262 with a provision for protecting nerves
• CPC Class Codes: A61B 2034/101 Computer-aided simulation of surgical operations
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2057 Details of tracking cameras
• 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 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 2090/502 Headgear, e.g. helmet, spectacles
• 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 5/0022 : Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: A61B 5/1118 : Determining activity level
• CPC Class Codes: A61B 5/4509 : Bone density determination
• CPC Class Codes: A61B 5/4566 : Evaluating the spine A61B5/4561 takes precedence
• CPC Class Codes: A61B 5/4571 : Evaluating the hip
• CPC Class Codes: A61B 5/4824 : Touch or pain perception evaluation A61B5/4821 takes precedence
• CPC Class Codes: A61B 5/4833 : Assessment of subject's compliance to treatment
• CPC Class Codes: A61B 5/4848 : Monitoring or testing the effects of treatment, e.g. of medication
• CPC Class Codes: A61B 5/7282 : Event detection, e.g. detecting unique waveforms indicative of a medical condition A61B5/4094, A61B5/4818, A61B5/349, A61B5/0823 take precedence
• CPC Class Codes: A61B 5/742 : using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/746 : Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: A61B 5/7475 : User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: A61B 6/4494 : Means for identifying the diagnostic device
• CPC Class Codes: A61B 6/485 : involving fluorescence X-ray imaging
• CPC Class Codes: A61B 6/506 : for diagnosis of nerves
• CPC Class Codes: A61B 8/08 : Detecting organic movements or changes, e.g. tumours, cysts, swellings A61B8/02 - A61B8/06 take precedence
• CPC Class Codes: A61B 90/98 : using electromagnetic means, e.g. transponders
• CPC Class Codes: G01L 5/00 : Apparatus for, or methods of, measuring force, work, mechanical power, or torque, specially adapted for specific purposes
• CPC Class Codes: G06Q 10/00 : Administration; Management
• CPC Class Codes: G06Q 10/10 : Office automation; Time management
• CPC Class Codes: G09B 23/28 : for medicine
• CPC Class Codes: G16H 10/20 : for electronic clinical trials or questionnaires
• CPC Class Codes: G16H 20/40 : relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 30/20 : for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 40/20 : for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 40/40 : for the management of medical equipment or devices, e.g. scheduling maintenance or upgrades
• CPC Class Codes: G16H 40/63 : for local operation
• CPC Class Codes: G16H 50/20 : for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/50 : for simulation or modelling of medical disorders
• CPC Class Codes: G16H 50/70 : for mining of medical data, e.g. analysing previous cases of other patients
• CPC Class Codes: G16H 70/20 : relating to practices or guidelines
• CPC Class Codes: G16Z 99/00 : Subject matter not provided for in other main groups of this subclass

Abstract

Various systems and methods are provided for surgical and interventional planning, support, post-operative follow-up, and functional recovery tracking. In general, a patient can be tracked throughout medical treatment including through initial onset of symptoms, diagnosis, non-surgical treatment, surgical treatment, and recovery from the surgical treatment. In one embodiment, a patient and one or more medical professionals involved with treating the patient can electronically access a comprehensive treatment planning, support, and review system. The system can provide recommendations regarding diagnosis, non-surgical treatment, surgical treatment, and recovery from the surgical treatment based on data gathered from the patient and the medical professional(s). The system can manage the tracking of multiple patients, thereby allowing for data comparison between similar aspects of medical treatments and for learning over time through continual data gathering, analysis, and assimilation to decision-making algorithms.

Claims

1. A surgical method, comprising:

wearing a stereoscopic viewing device during performance of a surgical procedure on a patient;

receiving from the stereoscopic viewing device a visualization overlaid on the patient indicating a recommended trajectory for a pedicle screw into a vertebra of the patient, the recommended trajectory being part of a pre-operative plan for the surgical procedure developed before the performance of the surgical procedure; and

receiving an alert indicating a deviation between the recommended trajectory and an actual trajectory of the pedicle screw into the vertebra of the patient.

2. The method of claim 1, wherein the visualization automatically changes during the performance of the surgical procedure based on a position of a wearer of the stereoscopic viewing device relative to the patient.

3. The method of claim 2, wherein a processor of a surgical planning, support, and management system causes the automatic changing of the visualization using a pre-stored scanned image of the patient.

4. The method of claim 1, wherein the visualization is three-dimensional.

5. The method of claim 1, wherein the visualization overlaid on the patient also shows nerves of the patient.

6. The method of claim 1, wherein the visualization also indicates at least one of a dimension of the vertebra of the patient, a distance between the vertebra and a second vertebra of the patient, and an estimated position and orientation of an implant implanted in the patient.

7. The method of claim 1, wherein a reference marker is positioned on the patient having the surgical procedure performed thereon, and a location of the visualization overlaid on the patient is based on a position of a wearer of the stereoscopic viewing device relative to the reference marker.

8. The method of claim 1, wherein the alert includes at least one of a visual signal, an auditory signal, and a motion signal.

9. The method of claim 1, wherein the deviation includes an angular difference between a recommended line of approach to the vertebra and an actual line of approach to the vertebra during the surgical procedure.

10. The method of claim 1, wherein the stereoscopic viewing device receives the recommended trajectory over a network from a processor of a surgical planning, support, and management system, the processor is in communication with a memory of the surgical planning, support, and management system, the memory has the recommended trajectory stored therein as part of the pre-operative plan.

11. The method of claim 10, wherein the processor determines the deviation and provides the deviation to the stereoscopic viewing device over the network.

12. A surgical system, comprising:

a stereoscopic viewing device configured to be worn by a user during performance of a surgical procedure on a patient and configured to provide to the user a three-dimensional visualization overlaid on the patient indicating a recommended trajectory for a pedicle screw into a vertebra of the patient; and

a surgical planning, support, and management system including a memory and a processor, the memory having stored therein a pre-operative plan that includes the recommended trajectory for the pedicle screw into the vertebra of the patient, the memory having stored therein a pre-operative scanned image of the patient, the processor being configured to cause the user during performance of the surgical procedure to receive an alert indicating a deviation between the recommended trajectory and an actual trajectory of the pedicle screw into the vertebra of the patient, and the processor being configured to cause the visualization to automatically change during the performance of the surgical procedure using the stored pre-operative scanned image of the patient.

13. The system of claim 12, wherein the processor is configured to cause the visualization to automatically change during the performance of the surgical procedure based on a position of the user relative to the patient.

14. The system of claim 12, wherein the visualization also indicates at least one of nerves of the patient, a dimension of the vertebra of the patient, a distance between the vertebra and a second vertebra of the patient, and an estimated position and orientation of an implant implanted in the patient.

15. The system of claim 12, further comprising a reference marker configured to positioned on the patient having the surgical procedure performed thereon, and the processor is configured to use a position of the user relative to the reference marker in determining a location of the visualization overlaid on the patient on.

16. The system of claim 12, wherein the alert includes at least one of a visual signal, an auditory signal, and a motion signal.

17. The system of claim 12, wherein the deviation includes an angular difference between a recommended line of approach to the vertebra and an actual line of approach to the vertebra during the surgical procedure.

18. The system of claim 12, wherein the stereoscopic viewing device is configured to receive the recommended trajectory and the deviation over a network from the processor.