Image guided spinal surgery guide, system and method for use thereof

• US 7,763,035 B2
• Filed: 09/13/2004
• Issued: 07/27/2010
• Est. Priority Date: 12/12/1997
• Status: Expired due to Fees

• Current Assignee: Sofamor Danek Holdings, Inc
• Original Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Inventors: Estes, Bradley T, Melkent, Tony, Chaudoin, Joseph, Foley, Kevin T
• Primary Examiner(s): Milano; Michael J
• Assistant Examiner(s): Nguyen; Victor X
• Application Number:
  US10/939,953
• Publication Number:
  US 20050059885A1
• Time in Patent Office: 2,143 Days
• Field of Search: 606/61, 606 96- 97, 606/130, 600/426, 600/427, 600/429, 600/424, 600/414
• US Class Current: 606/130
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2034/254 being adapted depending on the stage of the surgical procedure
• 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: A61F 2/442 Intervertebral or spinal discs, e.g. resilient non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455
• CPC Class Codes: A61F 2/4455 for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages intervertebral discs A61F2/442
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/2839 Bone plugs or bone graft dowels
• CPC Class Codes: A61F 2002/4627 with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
• CPC Class Codes: A61F 2002/4632 using computer-controlled surgery, e.g. robotic surgery
• CPC Class Codes: Y10S 606/907 Composed of particular material or coated
• CPC Class Codes: Y10S 606/909 Bone
• CPC Class Codes: Y10S 606/912 Radiolucent material
• CPC Class Codes: Y10S 606/914 Toolkit for installing or removing spinal positioner or stabilizer

Abstract

A guide is disclosed for use in performing spinal surgery to prepare across a spinal disc and adjacent vertebrae an implantation space. The guide is associated with a computer controlled surgical navigation system employing an energy-detecting array to track positions of the guide in three dimensional space relative to a known reference point. The guide comprises a body for providing protected access to prepare across the spinal disc and into the adjacent vertebrae the implantation space. The body has a passage adapted to receive a bone removal device for forming the implantation space through the body. At least one electrically energizable energy emitter array is attached to the body for use in identifying the location of the guide relative to the adjacent vertebrae. A system and method for using the guide in spinal surgery are also disclosed.

Claims

1. A surgical instrument for use in performing spinal surgery to prepare an implantation space across adjacent vertebrae, said surgical instrument for use with a computer controlled surgical navigation system employing a position tracking device to track positions of said surgical instrument in three-dimensional space, said surgical instrument comprising:

a tool operable to be positioned through a guide defining a passage and positioned near adjacent vertebrae to prepare the implantation space;

a first tracking device attached to said tool for use in identifying a location of said tool relative to said adjacent vertebrae; and

a second tracking device attached to a first end of said guide;

wherein said guide includes a plurality of penetrating projections extending from a second end of said guide operable to engage and penetrate the adjacent vertebrae;

wherein said tool is operable to be tracked with said first tracking device separately from said guide being tracked with said second tracking device to allow a guide location of said guide and a tool location of said tool to be known respectively;

wherein said first tracking device is operable to identify a position of said tool relative to said guide, wherein an orientation of said guide and a depth of said tool are determined upon tracking said first tracking device on said tool and said second tracking device on said guide.

2. The surgical instrument of claim 1 wherein at least one of said first tracking device and said second tracking device is an active tracking device selected from a group comprising acoustic, magnetic, electromagnetic, radiologic, light emitting devices and micropulsed radar systems.

3. The surgical instrument of claim 1 wherein at least one of said first tracking device and said second tracking device is a passive tracking device having reflective surfaces.

4. The surgical instrument of claim 1 wherein said guide is operable to be impacted to engage and penetrate the adjacent vertebrae with the plurality of penetrating projections for use in preparing the implantation space.

5. The surgical instrument of claim 4

wherein said guide having said second tracking device is operable as a reference array during the surgery at least by tracking the second tracking device during the surgery.

6. The surgical instrument of claim 1 wherein said tool is selected from a group comprising:

a distractor, a tap, an inserter and a reamer.

7. A surgical instrument for use in performing surgery to prepare an implantation space in at least one bone, said surgical instrument used with a computer controlled surgical navigation system employing a position tracking device to track positions of said surgical instrument in three dimensional space, said surgical instrument comprising:

a guide operable to engage the at least one bone for use in preparing the implantation space, said guide defining a passage extending through said guide for use in forming the implantation space;

a first tracking device connected to said guide, wherein said first tracking device connected to said guide is operable as a reference array once said guide engages the at least one bone; and

a tool operable to be inserted into and moved within said passage in said guide for use in performing the surgery, said tool including a second tracking device attached to said tool for use in identifying a position of said tool relative to the at least one bone, wherein at least one of an orientation or a depth of said tool are determined upon tracking said second tracking device on said tool;

wherein said guide is operable to be tracked with said first tracking device separately from said tool being tracked with said second tracking device to allow a guide location of the guide and a tool location of the tool to be known respectively.

8. The surgical instrument as defined in claim 7 wherein said first and second tracking devices are active tracking devices selected from a group comprising acoustic, magnetic, electromagnetic, radiologic, light emitting devices and micropulsed radar systems.

9. The surgical instrument as defined in claim 7 wherein said first and second tracking devices are passive tracking devices having reflective surfaces.

10. The surgical instrument as defined in claim 7 wherein said guide includes extensions extending from a first end operable to engage and penetrate the at least one bone.

11. The surgical instrument as defined in claim 7 wherein said guide includes extensions operable to engage and penetrate the at least one bone;

wherein said guide is operable to be impacted to allow said extensions to engage and penetrate the at least one bone for use in preparing the implantation space;

wherein the first tracking device is tracked during a surgery including the extensions penetrated into the at least one bone.

12. The surgical instrument as defined in claim 11 wherein said tool is an inserter operable to insert at least one of an implant or a bone dowel between the at least one bone and a second bone and wherein said first tracking device attached to said tool is used for identifying a position of said at least one of the implant or the bone dowel.

13. The surgical instrument as defined in claim 12 wherein at least one of the implant or the bone dowel may be inserted by at least one of pressing or threading the at least one of the implant or the bone dowel into the at least one bone with said inserter.

14. The surgical instrument as defined in claim 7 wherein said guide is operable to be impacted to engage and penetrate the at least one bone for use in preparing the implantation space.

15. The surgical instrument as defined in claim 7 wherein said guide is operable to engage a pair of adjacent vertebrae.

16. The surgical instrument as defined in claim 7 wherein said tool is selected from a group comprising:

a distractor, a tap, an inserter and a reamer.

17. A surgical instrument for use in performing surgery to prepare an implantation space in at least one bone, said surgical instrument used with a computer controlled surgical navigation system employing a position tracking device to track positions of said surgical instrument in three dimensional space, said surgical instrument comprising:

a guide operable to be placed in contact with the at least one bone for use in preparing the implantation space, said guide defining a passage extending through said guide for use in forming the implantation space;

a tool inserted into said passage in said guide for use in performing the surgery; and

a first tracking device attached to said tool for use in identifying a position of said tool relative to the at least one bone, wherein at least one of an orientation or a depth of said tool are determined upon tracking said first tracking device on said tool; and

a second tracking device attached to said guide;

wherein said tool is operable to be tracked with said first tracking device separately from said guide being tracked with said second tracking device to allow a guide location of said guide and a tool location of said tool to be known respectively.

18. The surgical instrument as defined in claim 17 wherein said first and second tracking devices are active tracking devices selected from a group of devices comprising:

acoustic, magnetic, electromagnetic, radiologic, light emitting, and micropulsed radar.

19. The surgical instrument as defined in claim 17 wherein said first and second tracking devices are passive tracking devices having reflective surfaces.

20. The surgical instrument as defined in claim 17 wherein said guide includes a plurality of penetrating projections operable to engage and penetrate the at least one bone.

21. The surgical instrument as defined in claim 17 wherein the penetrating projections fix said guide to the at least one bone.

22. The surgical instrument as defined in claim 17 wherein said guide is operable to be impacted to engage and penetrate the at least one bone for use in preparing the implantation space.

23. The surgical instrument as defined in claim 17 wherein said guide is operable to engage a pair of adjacent vertebrae.

24. The surgical instrument as defined in claim 17 wherein said tool is selected from a group comprising:

a distractor, a tap, an inserter and a reamer.

25. The surgical instrument as defined in claim 17 wherein said tool is an inserter operable to insert at least one of an implant or a bone dowel in the at least one bone and wherein said first tracking device is used for identifying a position of at least one of the implant or the bone dowel.

26. The surgical instrument as defined in claim 25 wherein at least one of the implant or the bone dowel may be inserted by at least one of pressing or threading the at least one of the implant or the bone dowel into the at least one bone with said inserter.

27. The surgical instrument as defined in claim 26 wherein said second tracking device attached to said guide is used as a reference array during the surgery.

28. The surgical instrument as defined in claim 27 wherein said guide is operable to be impacted to a pair of adjacent vertebrae and said tool includes at least one of said inserter, a tap, and a reamer;

wherein said reamer, said tap, and said inserter are operable to be passed sequentially and separately through said guide and tracked sequentially and separately with said first tracking device relative to said guide that is tracked with said second tracking device.

29. A surgical instrument for use in performing spinal surgery to prepare an implantation space across adjacent vertebrae, said surgical instrument for use with a computer controlled surgical navigation system employing a position tracking device to track positions of said surgical instrument in three-dimensional space, said surgical instrument comprising:

a guide having a first end and a second end and defining a passage through said first and second end and operable to be positioned near the adjacent vertebrae, wherein said guide includes a plurality of penetrating projections extending from said first end of said guide operable to engage and penetrate the adjacent vertebrae;

a first tracking device attached to said second end of said guide;

a tool operable to be positioned through said passage to prepare the implantation space near the adjacent vertebrae;

a second tracking device attached to said tool for use in identifying a location of said tool relative to the adjacent vertebrae; and

wherein said first tracking device connected to said guide is operable as a reference array once said plurality of penetrating projections of said guide engage and penetrate the adjacent vertebrae;

wherein said tool is operable to be tracked with said second tracking device separately from said guide being tracked with said first tracking device to allow a guide location of said guide and a tool location of said tool to be known respectively;

wherein said second tracking device is operable to identify a position of said tool relative to said guide, wherein an orientation of said guide and a depth of said tool are determined upon tracking said second tracking device on said tool and said first tracking device on said guide.

30. A surgical instrument for use in performing spinal surgery to prepare an implantation space across adjacent vertebrae, said surgical instrument for use with a computer controlled surgical navigation system employing a position tracking device to track positions of said surgical instrument in three-dimensional space, said surgical instrument comprising:

a guide having a first end and a second end and defining a passage through said first and second end and operable to be positioned near the adjacent vertebrae, wherein said guide includes a plurality of penetrating projections extending from said first end of said guide operable to engage and penetrate the adjacent vertebrae;

a first tracking device attached to said second end of said guide;

a tool selected from a group consisting of a distractor, a tap, an inserter and a reamer operable to be positioned through said passage to prepare the implantation space near the adjacent vertebrae;

a second tracking device attached to said tool for use in identifying a location of said tool relative to the adjacent vertebrae; and

wherein said first tracking device connected to said guide is operable as a reference array once said plurality of penetrating projections of said guide engage and penetrate the adjacent vertebrae;

wherein said tool is operable to be tracked with said second tracking device separately from said guide being tracked with said first tracking device to allow a guide location of said guide and a tool location of said tool to be known respectively;

wherein said second tracking device is operable to identify a position of said tool relative to said guide, wherein an orientation of said guide and a depth of said tool are determined upon tracking said second tracking device on said tool and said first tracking device on said guide;

wherein said first tracking device and said second tracking device are selected from a group consisting of a passive tracking device and an active tracking device;

wherein the computer controlled surgical navigation system employing the position tracking is operable to determine the locations of said tool and said guide to generate a display of a position of at least one of said tool, an implant, or a bone dowel, relative to an axis of the adjacent vertebrae to provide a view along the adjacent vertebrae, said tool, said implant, or said bone dowel.