Systems, devices, and methods for facilitating spinal correction and fusion surgery

Patent metadata

Field	Value
Publication number	US-2023371984-A1
Application number	US-202318319445-A
Country	US
Kind code	A1
Filing date	May 17, 2023
Priority date	May 17, 2022
Publication date	Nov 23, 2023
Grant date	—

Abstract

Among the various aspects of the present disclosure is the provision of devices, systems, and methods for tracking the positions and orientations of at least one bone screw implanted within a surgical site. The disclosed device includes an extension that includes an extension base configured to couple to the bone screw, a marker arm coupled at one end to the extension base in a hinged arrangement, and an optical marker attached to a free end of the marker arm opposite the hinged attachment. The optical marker includes a pair of lenticular arrays in a coplanar arrangement in which the major axes of the lenticular arrays are mutually perpendicular. Each lenticular array is configured to display different hues at different viewing angles. The disclosed method includes transforming a single image of a surgical site containing at least one bone screw and extension into the global positions of each bone screw based on the pixel positions and hues corresponding to the lenticular arrays of each optical marker.

First claim

What is claimed is:

1 . An extension for a bone screw configured to track a position and orientation of the bone screw, the extension comprising:
a. an extension base comprising an attachment fitting configured to couple to the bone screw and further comprising a hinge fitting; b. a marker arm comprising a hinge end and a marker support at opposite ends of the marker arm, wherein the hinge end is coupled to the hinge fitting to form a hinged joint; and c. an optical marker attached to the marker support, the optical marker comprising a first and second lenticular array comprising first and second major axes, respectively, wherein the first and second lenticular arrays are positioned in a coplanar arrangement on the marker support and the first and second major axes are oriented perpendicularly.

2 . The extension of claim 1 , wherein the attachment fitting comprises a threaded end configured to mesh with a corresponding threaded tulip head of the bone screw.

3 . The extension of claim 2 , wherein the attachment fitting further comprises a drive fitting projecting downward from the attachment fitting, the drive fitting ending in a drive end configured to mesh with a shank head of the bone screw.

4 . The extension of claim 3 , wherein the drive fitting is further configured to constrain the tulip head of the bone screw to a monoaxial configuration.

5 . The extension of claim 2 , wherein the tulip head of the bone screw is constrained to rotate in an azimuthal rotation about a screw axis of the bone screw.

6 . The extension of claim 1 , wherein the hinged joint constrains the marker arm to rotate in a polar rotation relative to the screw axis.

7 . The extension of claim 1 , wherein the hinge fitting and hinge end of the marker are further comprised of interlocking features to selectively lock the polar rotation of the marker arm to one of at least two predetermined polar angles.

8 . The extension of claim 7 , wherein the at least two predetermined polar angles are selected from 0°, 15°, 30°, 45°, 60°, and 90°, wherein 0° corresponds to the marker arm projecting upward and parallel to the screw axis and 90° corresponds to the marker arm oriented perpendicular to the screw axis.

9 . The extension of claim 8 , wherein the predetermined polar angles are selected from 0°, 30°, 60°, and 90°.

10 . The extension of claim 1 , wherein the bone screw is selected from a monoaxial screw, a polyaxial screw, a uniaxial screw, a uniplanar pedicle screw, and a reduction iliac screw.

11 . The extension of claim 1 , wherein the first and second lenticular arrays are each configured to display a hue that varies with an orientation of each lenticular array relative to a viewer or image recording device.

12 . A trackable bone screw, comprising an extension for a bone screw configured to track a position and orientation of the bone screw. the extension coupled to a bone screw, the extension comprising:
a. an extension base comprising an attachment fitting configured to couple to the bone screw and further comprising a hinge fitting; b. a marker arm comprising a hinge end and a marker support at opposite ends of the marker arm, wherein the hinge end is coupled to the hinge fitting to form a hinged joint; and c. an optical marker attached to the marker support, the optical marker comprising a first and second lenticular array comprising first and second major axes, respectively, wherein the first and second lenticular arrays are positioned in a coplanar arrangement on the marker support and the first and second major axes are oriented perpendicularly.

13 . The trackable bone screw of claim 12 , wherein the bone screw is selected from a monoaxial screw, a polyaxial screw, a uniaxial screw, a uniplanar pedicle screw, and a reduction iliac screw.

14 . A system for tracking a position and orientation of at least one trackable bone screw, the system comprising a computing device, the computing device comprising at least one processor configured to:
a. receive an image of a surgical region, the image comprising a plurality of pixels, each pixel comprising a pixel position and a hue, wherein at least one pixel portion of the plurality of pixels corresponds to an optical marker of a trackable bone screw of any preceding claim; b. for each of the at least one trackable bone screws:
i. extract, using the computing device, a first pixel portion of the plurality of pixels corresponding to the optical marker;
ii. transform the first pixel portion into a global position and orientation of the optical marker based on the pixel positions and hues of the first pixel portion;
iii. determine a relative displacement of the optical marker from a screw head of the bone screw based on a polar angle, an azimuth angle, and a length of the marker arm of the extension of the bone screw; and
iv. determine the global position and orientation of the bone screw by combining the relative displacement of the optical marker from the screw head with the global position and orientation of the optical marker.

15 . The system of claim 14 , wherein the first pixel portion is transformed into the global position and orientation of the optical marker based on a pinhole camera model subject to a group of constraints corresponding to the pixel positions and hues of the first pixel portion.

16 . The system of claim 15 , wherein the global position of the first pixel group comprises a rotation matrix R and a translation matrix T defining the rotation and translation of the pixels within a camera coordinate system to corresponding objects in a global coordinate system.

17 . The system of claim 16 , wherein the rotation matrix R is obtained by solving the equations:
R{right arrow over (n)} hue 1 ·{right arrow over (r)} 1 =0  Eqn. (8);
R{right arrow over (n)} hue 2 ·{right arrow over (r)} 2 =0  Eqn. (9); and
R ( C 2 - C 1 )×( {right arrow over (r)} 1 ×r 2 )=0  Eqn. (10),
wherein: {right arrow over (n)} hue 1 and {right arrow over (n)} hue 2 are vectors based on the pixel hues corresponding to the first and second lenticular arrays, respectively; {right arrow over (r)} 1 and {right arrow over (n)} hue 2 are rays passing from the origin of a camera origin system through portions of the first pixel group corresponding to the first and second lenticular arrays, respectively; and (C 2 -C 1 ) is the global displacement distance between the first and second lenticular arrays.

18 . The system of claim 16 , wherein the translation matrix T is obtained by solving the equations:
( RC 1 +T )· {right arrow over (r)} 1 ={right arrow over (0)}  Eqn. (12)
( RC 2 +T )· {right arrow over (r)} 2 ={right arrow over (0)}  Eqn. (13)

wherein C 1 and C 2 are the global positions of the first and second lenticular arrays, respectively.

19 . The system of claim 18 , wherein the wherein {right arrow over (n)} hue 1 and {right arrow over (n)} hue 1 are obtained based on the hues of the portions of the first pixel group corresponding to the first and second lenticular arrays, respectively, using at least one predetermined hue response function.

20 . The system of claim 14 , further comprising an imaging device operatively coupled to the computing device, wherein the imaging device is configured to obtain the image of the surgical region.

Assignees

• Washington University St Louis
• Univ George Washington

Inventors

• Leuthardt Eric
• Genin Guy
• Brunner Peter
• Pless Robert
• Molina Camilo
• Hacker Carl
• Moran Daniel
• Repka Alicia
• Lowe Halle
• Sandler Jacob

Classifications

• A61B17/58 Primary

  for osteosynthesis, e.g. bone plates, screws or setting implements (A61B17/14, A61B17/16 take precedence) · CPC title

• A61B34/20

  Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis · CPC title

• A61B90/39 Primary

  Markers, e.g. radio-opaque or breast lesions markers · CPC title

• A61B2034/2055

  Optical tracking systems · CPC title

• A61B2090/3983

  Reference marker arrangements for use with image guided surgery · CPC title