Method and apparatus for positioning a reference frame

• US 20070066887A1
• Filed: 09/21/2005
• Published: 03/22/2007
• Est. Priority Date: 09/21/2005
• Status: Active Grant

• Current Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Inventors: Mire, David, Clayton, John
• Granted Patent: US 7,835,784 B2
• Time in Patent Office: Days
• US Class Current: 600/424
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2068 using pointers, e.g. pointers having reference marks for determining coordinates of body points
• 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 2090/363 Use of fiducial points
• CPC Class Codes: A61B 2090/3916 Bone tissue
• CPC Class Codes: A61B 2090/3925 ultrasonic
• CPC Class Codes: A61B 2090/3937 Visible markers
• CPC Class Codes: A61B 2090/3954 magnetic, e.g. NMR or MRI
• 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 90/39 Markers, e.g. radio-opaque or breast lesions markers

Abstract

A method and apparatus to perform a procedure that can include a processor assisted surgical procedure. During the procedure patient space and image space can be registered to allow for tracking of various tracking sensors. A dynamic reference frame can be used to maintain localization of the patient space with the image space. The dynamic reference frame can be fixedly interconnected with a bone portion of the anatomy.

Claims

1. A surgical navigation system for use in a surgical procedure on an anatomy including a bone, comprising:

a tracking system operable to track a tracking sensor;

a dynamic reference frame having the tracking sensor and a dynamic reference frame position member

wherein the tracking sensor is tracked by the tracking system; and

wherein the dynamic reference frame positioning member is operable to engage a bone in the anatomy in a selectively fixed manner;

wherein said dynamic reference frame positioning member is impacted into the bone to hold said dynamic reference frame in a selected position.

2. The surgical navigation system of claim 1, wherein said dynamic reference frame positioning member includes a first end and a second end;

and

wherein a bone engaging portion extends from said first end.

3. The surgical navigation system of claim 2, wherein said bone engaging portion includes a first member and a second member extending at an angle relative to one another.

4. The surgical navigation system of claim 1, wherein said dynamic reference frame positioning member positions said dynamic reference frame substantially immobile in rotational movement, axial movement, translational movement, yaw movement, pitch movement, and roll movement, or combinations thereof relative to the anatomy.

5. The surgical navigation system of claim 1, wherein said tracking system includes an electromagnetic tracking system, an optical tracking system, an infrared tracking system, an acoustic tracking system, or combinations thereof.

6. The surgical navigation system of claim 1, further comprising:

an imaging system operable to obtain patient image data.

7. The surgical navigation system of claim 6, wherein said imaging system is selected from a group consisting of a C-arm, a fluoroscope, an MRI, a PET scanner, a computer tomography system, an x-ray system, an ultrasound system, and accommodations thereof.

8. The surgical navigational system of claim 6, further comprising:

a monitor;

wherein the image data is displayed on the monitor and said dynamic reference frame is tracked relative to said image data.

9. The surgical navigation system of claim 1, further comprising:

at least one of a cannula, a dilator, a slap hammer, an impactor, a tap cap or combinations thereof.

10. The surgical navigation system of claim 1, further comprising a cannula operable to be passed through a selected portion of the anatomy relative to the bone in the anatomy:

wherein said dynamic reference frame positioning member is operable to be positioned relative to the bone with said cannula.

11. The surgical navigation system of claim 10, further comprising:

a dilator;

wherein said dilator is operable with said cannula to move the cannula through a selected portion of the anatomy.

12. The surgical navigation system of claim 1, further comprising a surgical instrument operable to be tracked by said tracking system.

13. The surgical navigation system of claim 12, wherein said surgical instrument is at least one of an impactor, a stylet, a reamer, a reamer driver, a probe, an implant positioning instrument, a tap, a drill, a drill bit, or combinations thereof.

14. The surgical navigation system of claim 1, wherein said dynamic reference frame further includes a fiducial marker.

15. The surgical navigation system of claim 14, wherein said fiducial marker is integral with said dynamic reference frame.

16. The surgical navigation system of claim 1, wherein said tracking sensor of said dynamic reference frame is formed as a single member with said dynamic reference frame positioning member.

17. The surgical navigation system of claim 1, wherein said tracking sensor of said dynamic reference frame is selectively coupled to said dynamic reference frame positioning member.

18. The surgical navigation system of claim 1, wherein said tracking sensor is at least one of an electromagnetic tracking sensor, an optical tracking sensor, an infrared tracking sensor, an acoustic tracking sensor, a reflective tracking sensor, or combinations thereof.

19. The surgical navigation system of claim 1, wherein said tracking sensor transmits a signal to be tracked by said tracking system.

20. A dynamic reference frame system operable to be fixed in a selected position relative to a bone, comprising:

a positioning member extending between a first end and a second end;

a tracking sensor engaging portion defined nearer said first end than said second end;

a bone engaging portion extending from near said second end;

wherein said bone engaging portion comprises a first member and a second member extending at an angle relative to one another;

wherein said bone engaging portion is operable to be driven into the bone.

21. The dynamic reference frame system of claim 20, further comprising:

a tracking sensor interconnectable with said tracking sensor engaging portion.

22. The dynamic reference frame system of claim 21, wherein said tracking sensor is formed within said tracking sensor engaging portion so that said member and said tracking sensor are formed as a single piece.

23. The dynamic reference frame of claim 21, wherein said tracking sensor is removable from said positioning member.

24. The dynamic reference frame system of claim 20, wherein said bone engaging portion further includes a third member and a fourth member;

wherein each of said first member, second member, third member, and fourth member are positioned at an angle of about 90°

relative to one another.

25. The dynamic reference frame system of claim 20, wherein said bone engaging portion further includes a central member.

26. The dynamic reference frame system of claim 25, wherein said first member and said second member extend from said central member.

27. The dynamic reference frame system of claim 20, wherein said bone engaging portion is driven into the bone with an impactor.

28. The dynamic reference frame system of claim 20, further comprising:

a cannula;

wherein said member is operable to be moved through said cannula to engage the bone.

29. The dynamic reference frame system of claim 28, further comprising:

a dilator;

wherein said cannula is positioned relative to the bone initially with the dilator positioned through the cannula.

30. The dynamic reference frame system of claim 21, wherein said tracking sensor is at least one of an electromagnetic dynamic reference frame, an acoustic dynamic reference frame, a optical dynamic reference frame, a nuclear dynamic reference frame, or combinations thereof.

31. The dynamic reference frame system of claim 20, further comprising:

a slap hammer;

wherein said slap hammer is operable to remove said member from the bone.

32. The dynamic reference frame system of claim 20, further comprising an imaging system operable to obtain an image data of a patient.

33. The dynamic reference frame system of claim 32, wherein the imaging system is at least one of a C-arm, a fluoroscope, an x-ray system, a magnetic resonance imaging system, an ultrasound system, a PET scanner, a computer tomography scanner, or combinations thereof.

34. The dynamic reference frame system of claim 32, further comprising:

a monitor.

35. The dynamic reference frame system of claim 34, further comprising a surgical instrument.

36. The surgical dynamic reference frame system of claim 35, further comprising a tracking system.

37. The dynamic reference frame system of claim 36, wherein said surgical instrument is tracked relative to the image data by maintaining a registration of the image data with the patient by tracking said tracking sensor.

38. The dynamic reference frame system of claim 21, wherein said positioning member fixes said tracking sensor relative to the bone.

39. A method of using a dynamic reference frame system to position a dynamic reference frame relative to a selected portion of an anatomy including a bone, comprising:

positioning a cannula through a soft tissue portion of the anatomy relative to the bone portion;

passing the dynamic reference frame positioning member through said positioned cannula;

impacting the dynamic reference frame positioning member into engagement with the bone to fix the dynamic reference frame positioning member relative to the bone in at least one of a rotational motion, axial motion, translation motion, pitch movement, yaw movement, roll movement, or combination thereof.

40. The method of claim 39, wherein positioning a cannula through a soft tissue portion of the anatomy includes:

operatively associating a dilator with a cannula;

passing the interconnected cannula and dilator through the soft tissue; and

removing the dilator from the cannula to leave the cannula substantially free of obstruction.

41. The method of claim 39, further comprising:

positioning a first portion of the dynamic reference frame positioning member relative to a second portion of a dynamic reference frame positioning member to substantially eliminate rotation of the dynamic reference frame positioning member once fixed to the bone.

42. The method of claim 39, further comprising:

interconnecting a tracking sensor with the dynamic reference frame positioning member.

43. The method of claim 42, wherein fixing the tracking sensor to the dynamic reference frame positioning member includes:

affixing a tracking sensor selected from at least one of an acoustic dynamic reference frame, an electromagnetic dynamic reference frame, an optical dynamic reference frame, or combinations thereof.

44. The method of claim 39, further comprising:

removing the cannula;

wherein removing the cannula occurs after impacting the dynamic reference frame positioning member relative to the bone.

45. The method of claim 39, further comprising:

removing the dynamic reference frame positioning member from the bone.

46. The method of claim 45, wherein removing the dynamic reference frame positioning member from the bone includes interconnecting a slap hammer with the dynamic reference frame positioning member.

47. The method of claim 39, further comprising:

providing the dynamic reference frame positioning member with a bone engaging portion, including a first member and a second member extending at an angle relative to one another.

48. The method of claim 42, further comprising:

tracking said tracking sensor with a tracking system.

49. The method of claim 48, wherein the tracking system is selected from at least one of an acoustic tracking system, an electromagnetic tracking system, a radiation tracking system, an optical tracking system, or combinations thereof.

50. The method of claim 39, further comprising obtaining image data of the anatomy.

51. The method of claim 50, wherein obtaining image data of the anatomy includes obtaining at least one of a two dimensional image data, three dimensional image data, four dimensional image data, or combinations thereof.

52. The method of claim 50, further comprising:

displaying the image data on a display viewable by a user.

54. A method of using a surgical navigation system in a surgical procedure on an anatomy including a bone, comprising:

positioning a cannula through a soft tissue portion of the anatomy relative to the bone portion;

passing the dynamic reference frame positioning member through said positioned cannula; and

impacting the dynamic reference frame positioning member into engagement with the bone to fix the dynamic reference frame positioning member relative to the bone in at least one of a rotational motion, axial motion, translation motion, pitch motion, yaw motion, roll motion, or combination thereof.

53. The method of claim 62, further comprising:

tracking an instrument relative to the anatomy; and

displaying a representation of the position of the instrument relative to the anatomy on the display.

55. The method of claim 54, further comprising:

providing image data of the anatomy;

displaying the provided image data of the anatomy;

maintaining a registration of the image data with the anatomy.

56. The method of claim 55, further comprising:

interconnecting a tracking sensor with said dynamic reference frame positioning member.

57. The method of claim 56, wherein said tracking sensor is at least one of an electromagnetic tracking sensor, an acoustic tracking sensor, an optical tracking sensor, an infrared tracking sensor, or combinations thereof.

58. The method of claim 56, wherein the tracking sensor is resiliently interconnected with the dynamic reference frame positioning member.

59. The method of claim 58, further comprising:

providing a resiliently deformable member extending from the dynamic reference frame positioning member;

providing an engaging member extending from the dynamic reference frame positioning member;

deforming the resiliently deformable member with the tracking sensor with an applied force; and

removing the applied force to allow the engaging member to engage the tracking sensor.

60. The method of claim 59, wherein the resiliently deformable member moves the tracking sensor from an unengaged position to an engaged position when the applied force is removed.

61. The method of claim 54, further comprising:

tracking a surgical instrument.

62. The method of claim 61, further comprising:

providing image data of the anatomy; and

displaying a representation of the surgical instrument relative to the provided image data.

63. The method of claim 54, further comprising:

removing the cannula.