Stereotactic computer assisted surgery based on three-dimensional visualization

Patent metadata

Field	Value
Publication number	US-10105168-B2
Application number	US-81212509-A
Country	US
Kind code	B2
Filing date	Jan 9, 2009
Priority date	Jan 9, 2008
Publication date	Oct 23, 2018
Grant date	Oct 23, 2018

Abstract

A computer assisted surgical system that includes an apparatus ( 110 ) for imaging a region of interest of a portion of an anatomy of a subject; a memory containing executable instructions; and a processor programmed using the instructions to receive two or more two-dimensional images of the region of interest taken at different angles from the apparatus and process the two or more two-dimensional images to produce three dimensional information associated with the region of interest.

First claim

The invention claimed is:

1. A method for operating a computer assisted surgical system for implanting a medical device having a main implant and a sub-implant, and being represented by a virtual medical device, the method comprising:
implanting the main implant coupled to a reference body having at least four fiducial markers arranged in a predetermined three-dimensional pattern, the reference body being in a known spatial relationship with the main implant, the fiducial markers detectable by a fluoroscopic imaging system;
fluoroscopically imaging a region of interest and the main implant associated with the reference body to produce first and second two-dimensional fluoroscopic images, the first and second fluoroscopic images representing the position of the main implant proximate the region of interest of a portion of an anatomy of a subject at a first angle to obtain the first two-dimensional image and at a second angle to obtain the second two dimensional image to produce three dimensional information associated with the region of interest;
detecting the presence of the reference body having the at least four fiducial markers in the first and second images;
repositioning the main implant and reference body;
processing one additional two-dimensional fluoroscopic image with respect to the repositioned reference body fiducial markers by identifying and registering the fiducial markers of the reference body in the one additional two-dimensional fluoroscopic image, to produce location information of the main implant superimposed over the region of interest, wherein the location information of the main implant is determined based solely on the location of the fiducial markers in the one additional fluoroscopic image;
associating, based on the location information of the main implant superimposed over the region of interest, the not yet implanted sub-implant with the region of interest in a predetermined relationship relative to the reference body representing the main implant, the main implant and the sub-implant having a fixed predefined spatial relationship to one another upon implantation; and
displaying the association of the main implant, the not yet implanted sub-implant and the region of interest as an image showing the virtual medical device superimposed over the region of interest such that the not yet implanted sub-implant is displayed as having a virtual fixed predefined spatial relationship to the main implant that is the same as the fixed predefined spatial relationship between the main implant and the sub-implant upon implantation.

2. The method of claim 1 , wherein the reference body is attachable to one of the main implant and a targeting device, wherein the reference body has a characteristic two-dimensional projection.

3. The method of claim 1 , further comprising:
associating, based on the three dimensional information of the main implant superimposed over the region of interest, the not yet implanted sub-implant with the region of interest in a predetermined relationship relative to the reference body representing the main implant; and
displaying the association of the main implant, the not yet implanted sub-implant and the region of interest as an image showing the virtual medical device superimposed over the region of interest.

4. The method of claim 3 , wherein the region of interest comprises a femoral head, the two dimensional images comprise anterior-to-posterior and axial images of the femoral region and estimating comprises forming an outline of the femoral head on the anterior-to-posterior and axial images.

5. The method of claim 1 , further comprising determining a length of the not yet implanted sub-implant for selecting the required sub-implant.

6. The method of claim 1 , further comprising detecting the presence of the reference body based on the fiducial markers.

7. The method of claim 1 , wherein processing further comprises estimating the contours of the region of interest in two dimensions based on the one two-dimensional image.

8. The method of claim 7 , wherein processing further comprises forming a three dimensional image associated with the region of interest based on the estimation.

9. The method of claim 1 , further comprising adjusting the position of the main implant and repeating the steps of imaging, processing, associating and displaying.

10. A computer assisted surgical system, comprising:
an apparatus for imaging a region of interest of a portion of an anatomy of a subject and a medical device having an implanted main implant and a sub-implant being represented by a virtual medical device;
a memory containing executable instructions; and
a processor programmed using the instructions to:
mount a reference body having a three-dimensional pattern of at least four radiopaque markers therein onto the main implant in a known relationship thereto;
obtain a plurality of two-dimensional images of the region of interest with the main implant associated with the reference body, the image representing the position of the main implant proximate the region of interest of a portion of an anatomy of a subject at a first and second angle;
process the two-dimensional images to produce three dimensional information of the region of interest and the reference body with respect to the reference body radiopaque markers to produce information of the main implant superimposed over the region of interest, wherein the information includes the actual spatial position of the main implant and the reference body radiopaque markers and registration of the reference body in the images;
associate, based on the position of the main implant superimposed over the region of interest and an image of the reference body and radiopaque markers, the not yet implanted sub-implant with the region of interest in a predetermined relationship relative to the reference body representing the main implant, the main implant and the sub-implant having a fixed predefined spatial relationship to one another upon implantation; and
generate a display signal associated with the main implant, the not yet implanted sub-implant and the region of interest as an image showing the virtual medical device superimposed over the region of interest such that the not yet implanted sub-implant is displayed as having a virtual fixed predefined spatial relationship to the main implant that is the same as the fixed predefined spatial relationship between the main implant and the sub-implant upon implantation.

11. The computer assisted surgical system of claim 10 , wherein the apparatus comprises a fluoroscope.

12. The computer assisted surgical system of claim 10 , wherein the associated sub-implant provides an estimate of the location of the main implant and one or more sub-implants within the region of interest.

13. The computer assisted surgical system of claim 10 , wherein the processor processes the one or more two-dimensional images by outlining the contours of the region of interest in two dimensions and creates a three dimensional object representing the region of interest.

14. The computer assisted surgical system of claim 13 , wherein the three dimensional object comprises a sphere.

15. The computer assisted surgical system of claim 13 , wherein the three dimensional object is derived from a database and based on age and gender of the patient.

16. The computer assisted surgical system of claim 13 , wherein the three dimensional object is determined based on landmarks associated with the region of interest.

17. The computer assisted surgical system of claim 10 , wherein the system is

Assignees

• Blau Arno
• Stryker European Holdings I Llc

Inventors

• Blau Arno

Classifications

• A61B17/1703

  using imaging means, e.g. by X-rays · CPC title

• A61B17/744 Primary

  the longitudinal elements coupled to an intramedullary nail · CPC title

• A61B34/25

  User interfaces for surgical systems · CPC title

• A61B17/746

  the longitudinal elements coupled to a plate opposite the femoral head · CPC title

• A61B2034/107

  Visualisation of planned trajectories or target regions · CPC title