Method and apparatus for positioning a guide relative to a base

• US 8,165,658 B2
• Filed: 09/26/2008
• Issued: 04/24/2012
• Est. Priority Date: 09/26/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Waynik, Jeffrey M., Csavoy, Andrew N., Sootsman, Keith, Solar, Matthew S., Miller, Thomas I.
• Primary Examiner(s): Casler, Brian
• Assistant Examiner(s): Lamprecht, Joel
• Application Number:
  US12/239,114
• Publication Number:
  US 20100081914A1
• Time in Patent Office: 1,306 Days
• Field of Search: 600/407, 600/424, 600/426, 600/429, 606/130
• US Class Current: 600/426
• CPC Class Codes: A61B 17/1739 specially adapted for particular parts of the body
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis

Abstract

A system for positioning a guide relative to an anatomy is provided. The system can include a base adapted to be coupled to the anatomy, and a guide that can move relative to the base. The system can include at least one tracking device that can be coupled to the base and the guide, and a tracking system that tracks a position of the tracking device. The system can include a navigation system that determines a position of the base and the guide relative to the anatomy, and whether the position of the base and the guide are in a desired position. The system can include a display, which can display at least one icon superimposed on the image of the anatomy that graphically indicates a manipulation of the guide required to move the guide into the desired position.

Claims

1. A system for positioning a guide relative to an anatomy comprising:

a base adapted to be moved relative to the anatomy and thereafter immoveably coupled to the anatomy;

a guide moveably coupled to the base, wherein the guide is configured to move relative to the base at least when the base is immoveably coupled to the anatomy;

a first tracking device coupled to the base and a second tracking device coupled to the guide;

a tracking system that tracks a position of the first tracking device and the second tracking device relative to the anatomy;

a navigation system configured to independently determine a position of both the base and the guide relative to the anatomy based on the position of the first tracking device and the second tracking device and determine if the determined position of the base and the determined position of the guide are about equal to a desired position of the base and a desired position of the guide; and

a display configured to display the desired position of the base and the guide superimposed on an image of the anatomy, a first directional icon superimposed on the image of the anatomy that graphically indicates a desired manipulation of the base required to move the base into the desired position of the base relative to the anatomy and a second directional icon superimposed on the image of the anatomy that graphically indicates a desired manipulation of the guide required to move the guide into the desired position of the guide relative to the anatomy.

2. The system of claim 1, wherein the desired position of the base and the desired position the guide relative to the anatomy are both predetermined from a surgical plan.

3. The system of claim 2, wherein the base and the guide each define a central bore, and the system further comprises:

at least one instrument movable through the central bore of the base and the guide to perform a procedure on the anatomy.

4. The system of claim 3, wherein the surgical plan includes a target site within the anatomy for the at least one instrument to perform the procedure, and the desired position of the base and the desired position the guide is aligned with a trajectory for the at least one instrument to travel to reach the target site.

5. The system of claim 1, wherein the image of the anatomy is acquired by an imaging device selected from at least one of a fluoroscopy device, an O-arm device, a bi-plane fluoroscopy device, an ultrasound device, a computed tomography (CT) device, a multi-slice computed tomography (MSCT) device, a magnetic resonance imaging (MRI) device, a high frequency ultrasound (HFU) device, a positron emission tomography (PET) device, an optical coherence tomography (OCT) device, an intra-vascular ultrasound (IVUS) device, an intra-operative CT device, an intra-operative MRI device or combinations thereof.

6. The system of claim 1, wherein the target site is selected from at least one of a surgical site, an anatomical site, a navigation area and combinations thereof.

7. The system of claim 1, wherein the first tracking device comprises at least one optical tracking device to track at least one degree of freedom information.

8. The system of claim 1, wherein the first tracking device and the second tracking device comprises at least one electromagnetic tracking device selected from the group including:

an electromagnetic receiver tracking device, an electromagnetic transmitter tracking device or combinations thereof.

9. The system of claim 1, wherein the guide is rotatable relative to the anatomy.

10. The system of claim 9, wherein the first directional icon includes a third arrow that graphically represents an amount of rotation and a direction of rotation for the base, a second arrow that graphically represents an amount of translation and a direction of translation for the base, or combinations thereof;

wherein the second directional icon includes a first arrow that graphically represents an amount of rotation and a direction of rotation for the guide, a second arrow that graphically represents an amount of translation and a direction of translation for the guide, or combinations thereof.

11. The system of claim 4, wherein based on the surgical plan, the navigation system displays the second directional icon as a first arrow and a second arrow that indicates an alignment for the guide to allow the instrument to follow a trajectory through the base and the guide.

21. The system of claim 1, wherein at least one of the first directional icon or the second directional icon includes at least one of a change in color, a pop-up message, an audible signal, or a text display.

22. The system of claim 1, further comprising:

a drive system coupled to the guide to be moved to a selected location and/or orientation relative to the anatomy by movement of the guide.

23. The system of claim 10, wherein the base is moveable independently of the guide and the first directional icon illustrates a direction of movement of the base to reach the desired base position independent of movement of the guide;

wherein the first directional icon and the second directional icon are the same icon and shown sequentially regarding movement of the base or movement of the guide.

24. The system of claim 10, wherein the first directional icon is removed when the base reaches the desired base position and the second directional icon is removed when the guide reaches the desired guide position.

12. A method for positioning a guide relative to an anatomy comprising:

acquiring a surgical plan for a surgical procedure to be performed on the anatomy that includes a trajectory for an instrument;

tracking a first tracking device coupled to a base relative to the anatomy;

tracking a second tracking device coupled to a guide relative to the anatomy, the guide movable relative to the base;

determining a position of the base and guide relative to the anatomy;

comparing the position of the base and the guide relative to the anatomy with a desired base position for the base and a desired guide position for the guide in the surgical plan that enables the guide to guide the instrument along the trajectory; and

displaying at least a first icon superimposed onto an image of the anatomy that indicates an amount and direction of a first manipulation required to move the guide into the desired position and at least a second icon superimposed onto an image of the anatomy that indicates an amount and direction of a second manipulation required to move the guide relative to the base into the desired position.

13. The method of claim 12, further comprising:

moving the guide within a track defined on the guide relative to the base.

14. The method of claim 12, further comprising:

tracking a position of the base;

displaying a third icon superimposed onto an image of the anatomy that indicates an amount and direction of a third manipulation required to move the base into the desired base position;

coupling the base to the anatomy with at least one bone screw when the base is in the desired base position; and

coupling the guide to the base with at least one locking screw to immoveably fix the guide relative to the base when the guide is in the desired position.

15. The method of claim 12, further comprising:

superimposing an icon representing the base onto the image of the anatomy.

16. The method of claim 12 wherein the displayed at least first icon reduces in size as the guide approaches the desired location during the first manipulation, wherein the displayed at least second icon reduces in size as the guide approaches the desired location during the second manipulation, or combinations thereof.

25. The method of claim 12, wherein at least one of the first icon or the second icon diminishes or disappears as the guide moves towards the desired guide position, and

wherein the third icon diminishes or disappears as the base moves towards the desired base position.

26. The method of claim 14, wherein the base is moved independently of moving the guide;

wherein the base is coupled to the anatomy prior to coupling the guide to the base.

17. A system for positioning a guide relative to an anatomy comprising:

a base adapted to be fixedly coupled at a selected location to the anatomy;

a guide that moves relative to the base to guide at least one instrument into the anatomy, the guide operable to be coupled to a drive system;

a first tracking device coupled to the base;

a second tracking device coupled to the guide;

a tracking system that tracks a position of the first tracking device and a position of the second device relative to the anatomy;

a navigation control module that receives patient image data and surgical plan data, the surgical plan data including a desired base position for the base and a desired guide position for the guide relative to the anatomy;

a navigation system that determines a position of the base and the guide relative to the anatomy based on the position of the first tracking device and the second tracking device, and determines if both the position of the base is about equal to the desired base position and if the position of the guide is about equal to the desired guide position; and

wherein the navigation control module outputs image data that includes;

a first arrow icon superimposed onto the patient image data that graphically represents an amount of movement required to move the base to the desired base position,

a second arrow icon superimposed onto the patient image data that graphically represents an amount of rotation and a direction of rotation for the guide to move the guide to the desired guide position, and

a third arrow icon superimposed onto the patient image data that graphically represents an amount of translation and a direction of translation for the guide to move the guide to the desired guide position, or combinations thereof.

18. The system of claim 17, further comprising:

a display that displays the image data.

19. The system of claim 17, wherein the surgical plan data includes a target site within the anatomy, and the image data further comprises an icon of the target site superimposed onto the patient image data.

20. The system of claim 17, wherein the first arrow icon reduces in size as the base approaches the desired position;

wherein the second arrow icon and the third arrow icon also reduce in size as the guide approaches the desired position.