Method and apparatus for positioning a reference frame

• US 7,835,784 B2
• Filed: 09/21/2005
• Issued: 11/16/2010
• Est. Priority Date: 09/21/2005
• Status: Active Grant

• Current Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Inventors: Clayton, John B., Mire, David A.
• Primary Examiner(s): Winakur; Eric F
• Assistant Examiner(s): Fernandez; Katherine L
• Application Number:
  US11/232,445
• Publication Number:
  US 20070066887A1
• Time in Patent Office: 1,882 Days
• Field of Search: 600/407, 600/424, 600/595, 600/429, 606/53
• 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 surgical instrument operable to be tracked by said tracking system;

a dynamic reference frame having the tracking sensor; and

a dynamic reference frame positioning member extending along an axis from a first end to a second end;

wherein said first end forms a one piece bone engaging portion having a first portion and a second portion extending at a fixed angle relative to one another;

wherein the tracking sensor is tracked by the tracking system;

wherein the dynamic reference frame positioning member is operable and configured to engage a bone in the anatomy and be axially impacted along the axis of the dynamic reference frame positioning member into the bone in a selectively fixed manner to hold said dynamic reference frame at a selected position; and

wherein the tracking system is configured to correlate the surgical instrument relative to the dynamic reference frame.

2. 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.

3. 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.

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

an imaging system operable to obtain patient image data.

5. The surgical navigation system of claim 4, 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.

6. The surgical navigational system of claim 4, 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.

7. The surgical navigation system of claim 1, further comprise:

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

8. 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.

9. The surgical navigation system of claim 8, further comprising:

a dilator;

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

10. The surgical navigation system of claim 1, 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.

11. The surgical navigation system of claim 1, wherein said dynamic reference frame further:

includes a fiducial marker.

12. The surgical navigation system of claim 11, wherein said fiducial marker is integral with said dynamic reference frame.

13. 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.

14. 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.

15. 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.

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

17. The surgical navigation system of claim 1, wherein said first portion and said second portion extending at a fixed angle relative to one another define a substantially cruciform cross-section.

18. The surgical navigation system of claim 1, wherein said first end further includes at least one of an extending portion with a smooth surface, said first portion and said second portion that terminate in sharpened ends, and said first portion and said second portion terminate in a substantially planar region.

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

a positioning member extending along an axis between a first end and a second end;

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

a resilient portion extending from said first end of said positioning member;

a catch member extending transverse to said axis and outwardly from said positioning member;

a tracking sensor defining a void in a connection portion and a finger extending into said void, wherein said finger selectively engages said catch member;

a bone engaging portion extending from near said second end;

wherein said resilient portion biases said finger towards said catch member;

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.

20. The dynamic reference frame system of claim 19,

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 degrees relative to one another.

21. The dynamic reference frame system of claim 19, wherein said bone engaging portion further includes a central member.

22. The dynamic reference frame system of claim 21, wherein said first member and said second member extend from said central member.

23. The dynamic reference frame system of claim 19, further comprising:

an impactor;

wherein said bone engaging portion is driven into the bone with said impactor.

24. The dynamic reference frame system of claim 19, 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.

25. The dynamic reference frame system of claim 19, further comprising:

a slap hammer;

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

26. The dynamic reference frame system of claim 19, further comprising an imaging system operable to obtain an image data of a patient.

27. The dynamic reference frame system of claim 26, 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.

28. The dynamic reference frame system of claim 26, further comprising:

a monitor.

29. The dynamic reference frame system of claim 28, further comprising a surgical instrument.

30. The surgical dynamic reference frame system of claim 29, further comprising a tracking system.

31. The dynamic reference frame system of claim 30, 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.

32. The dynamic reference frame system of claim 19,

wherein said bone engaging portion comprises a unitary member of the first member and the second member;

wherein the unitary member defines a substantially cruciform cross-section.

33. 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 formed by said second end;

a cannula; and

a dilator;

wherein said bone engaging portion comprises a first portion and a second portion extending at a fixed angle relative to one another and operable to be driven axially into the bone;

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

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

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

34. The dynamic reference frame system of claim 33, further comprising:

a tracking sensor interconnectable with said tracking sensor engaging portion.

35. The dynamic reference frame system of claim 34, wherein said tracking sensor is removable from said positioning member.

36. The dynamic reference frame system of claim 34, wherein said positioning member fixes said tracking sensor relative to the bone.

37. 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, including;

passing a dilator through at least a portion of the cannula so that at least a portion of the dilator extends from an end of the cannula;

passing the cannula and dilator through the soft tissue, where the dilator assists in moving soft tissue for passage of the cannula; and

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

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

impacting the dynamic reference frame positioning member along its long axis 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.

38. The method of claim 37, 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.

39. The method of claim 37, further comprising:

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

40. The method of claim 39, 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.

41. The method of claim 39, further comprising:

tracking said tracking sensor with a tracking system.

42. The method of claim 41, 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.

43. The method of claim 37, further comprising:

removing the cannula;

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

44. The method of claim 37, further comprising:

removing the dynamic reference frame positioning member from the bone.

45. The method of claim 44, wherein removing the dynamic reference frame positioning member from the bone includes interconnecting a slap hammer with the dynamic reference frame positioning member.

46. The method of claim 37, further comprising:

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

47. The method of claim 37, further comprising obtaining image data of the anatomy.

48. The method of claim 47, 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.

49. The method of claim 47, further comprising:

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

50. The method of claim 49, 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.

51. 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 a single piece dynamic reference frame positioning member through said positioned cannula; and

striking 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;

removing the cannula through the soft tissue and away from said single piece dynamic reference frame positioning member;

after removing the cannula, interconnecting a tracking sensor directly to said single piece dynamic reference frame positioning member.

52. The method of claim 51, 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.

53. The method of claim 51, 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.

54. The method of claim 51, further comprising:

tracking a surgical instrument.

55. The method of claim 54, further comprising:

providing image data of the anatomy; and

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

56. The method of claim 51, further comprising:

removing the cannula.

57. The method of claim 51, further comprising:

providing the single piece dynamic reference frame positioning member as a unitary member.

58. 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 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;

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

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 resilient 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;

wherein the tracking sensor is resiliently interconnected with the dynamic reference frame positioning member.

59. The method of claim 58, wherein the resiliently deformable member moves the tracking sensor from an unengaged position to an engaged position when the applied force is removed.

60. The method of claim 58, further comprising:

applying the force relative to the dynamic reference frame positioning member to deform the resilient deformable member to a second orientation with the tracking sensor to move the tracking sensor from a first position to a second position relative to the dynamic reference frame positioning member; and

wherein removing the applied force allows the resiliently deformable member to rebound towards the first orientation to allow the engaging member to engage the tracking sensor.

61. 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;

a dynamic reference frame positioning member extending along an axis from a first end to a second end;

a tap cap;

a resilient portion extending from said first end of said dynamic reference frame positioning member; and

a catch member extending transverse to said axis and outwardly from said dynamic reference frame positioning member;

wherein said first end forms a one piece bone engaging portion having a first portion and a second portion extending at a fixed angle relative to one another;

wherein the tracking sensor is tracked by the tracking system;

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 configured to be axially impacted along the axis of the dynamic reference frame positioning member into the bone to hold said dynamic reference frame in a selected position;

wherein said dynamic reference frame has a engaging portion defining a first cylindrical sidewall, wherein said first cylindrical sidewall defines a void though said first cylindrical sidewall and a finger extending into said void, wherein said finger selectively engages said catch member;

wherein said resilient portion biases said finger towards said catch member;

wherein said tap cap has a second cylindrical sidewall, wherein said second cylindrical sidewall defines a passage through the second cylindrical sidewall to allow said catch member to pass through said second cylindrical sidewall so that a surface of the tap cap is operable to engage the bias member while the catch member is free of said second cylindrical sidewall.