최소 단어 이상 선택하여야 합니다.
최대 10 단어까지만 선택 가능합니다.
다음과 같은 기능을 한번의 로그인으로 사용 할 수 있습니다.
NTIS 바로가기다음과 같은 기능을 한번의 로그인으로 사용 할 수 있습니다.
DataON 바로가기다음과 같은 기능을 한번의 로그인으로 사용 할 수 있습니다.
Edison 바로가기다음과 같은 기능을 한번의 로그인으로 사용 할 수 있습니다.
Kafe 바로가기국가/구분 | United States(US) Patent 등록 |
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국제특허분류(IPC7판) |
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출원번호 | US-0036939 (2011-02-28) |
등록번호 | US-RE44305 (2013-06-18) |
발명자 / 주소 |
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출원인 / 주소 |
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대리인 / 주소 |
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인용정보 | 피인용 횟수 : 8 인용 특허 : 542 |
An apparatus and procedures for percutaneous placement of surgical implants and instruments such as, for example, screws, rods, wires and plates into various body parts using image guided surgery. The invention includes an apparatus for use with a surgical navigation system, an attaching device rigi
An apparatus and procedures for percutaneous placement of surgical implants and instruments such as, for example, screws, rods, wires and plates into various body parts using image guided surgery. The invention includes an apparatus for use with a surgical navigation system, an attaching device rigidly connected to a body part, such as the spinous process of a vertebrae, with an identification superstructure rigidly but removably connected to the attaching device. This identification superstructure, for example, is a reference arc and fiducial array which accomplishes the function of identifying the location of the superstructure, and, therefore, the body part to which it is fixed, during imaging by CAT scan or MRI, and later during medical procedures.
1. An apparatus for facilitating percutaneous placement of surgical instruments into the spine, adapted for use with a surgical navigation system employing an energy-detecting array in communication with a surgical navigation computer to track positions of instruments in three dimensional space rela
1. An apparatus for facilitating percutaneous placement of surgical instruments into the spine, adapted for use with a surgical navigation system employing an energy-detecting array in communication with a surgical navigation computer to track positions of instruments in three dimensional space relative to a known reference point, said apparatus comprising: a connector adapted to be rigidly attached to a portion of the spine;at least one central post connected to said connector;a position identification structure rigidly and removably connected to said central post at a predetermined position on said central post and adapted to be reconnected at the same said predetermined position, said identification structure being further adapted to allow a patient to be scanned with the structure connected to the central post, said structure including an assembly for communicating positioning information with respect to said assembly to the energy detecting array and surgical navigation computer; anda connector assembly for said reconnecting of said structure substantially to said predetermined position on said central post. 2. The apparatus of claim 1, wherein the connector is a clamp having teeth adapted for biting into a spinous process. 3. The apparatus of claim 1, wherein the connector includes an elongated fixture with a central axis and a threaded end adapted to be inserted into the spinous process and a substantially rigid wire connected to the fixture with the central axis of the wire adapted to be implanted into the spinous process at an angle to elongated fixture to prevent the fixture from rotating. 4. The apparatus of claim 1, wherein said assembly for communication positioning information is a substantially H-shaped frame. 5. The apparatus of claim 1, wherein said assembly for communicating positioning information is a substantially W-shaped frame. 6. The apparatus of claim 1, wherein said assembly for communicating positioning information is a substantially U-shaped frame. 7. The apparatus of claim 1, wherein said assembly for communicating positioning information is a substantially X-shaped frame. 8. The apparatus of claim 1, wherein said assembly for communicating positioning information comprises: a fiducial array for registering the location of a spinal element with rigidly connected fiducials; anda reference arc for signaling the position of a spinal element, said arc further comprising rigidly connected emitters. 9. The apparatus of claim 1, wherein said reference point is on the spine. 10. A method for monitoring the location of an instrument, surgical implant and various portions of the body, to be operated on, using a surgical navigation system with a surgical navigation computer and a digitizer array for monitoring the location of instruments in three-dimensional space relative to a known reference point, said method comprising the steps of: attaching a fixture having a central post to a portion of the spine;removably attaching an identification structure including a fiducial array and a reference arc to said central post;providing a scanned three-dimensional image of a patient including said fiducial array rigidly attached to said central post of said fixture, said fixture being rigidly attached to the patient to identify the position of said fixture and said fiducial array on the scanned image;using an image-guided system, by touching an image guided surgical pointer to one or more fiducials on the fiducial array to register the location of a spinal element fixed to said array; andemitting a signal from said reference arc to indicate changes in position of the spinal element during a surgical procedure. 11. The method of claim 10, further comprising: performing a surgical procedure percutaneously on a patient using an instrument and implant locatable relative to the spinal element and said structure in known positions identified in the surgical navigation system. 12. The method of claim 10, further comprising: inserting a threaded fixture having a substantially rigid wire into a spinal element; andtouching an image guided pointer to said threaded fixture and wire to positively register the location of said fixture and wire in a surgical navigation computer. 13. The method of claim 10, further comprising: implanting imageable devices into spinal elements to identify the location of the spinal elements in the surgical navigation computer. 14. The method of claim 10, further comprising: implanting imageable devices into a plurality of spinal elements; andmanipulating the patient's spine by viewing the location of the implanted devices, as communicated to the surgical navigation computer by touching an instrument with a tracking emitter to said implanted imageable devices to align the actual position of the spinal elements with the previously scanned image. 15. The method of claim 10 further comprising: percutaneously implanting screws into spinal elements; andlocating the position of said screws using image guided surgical navigation techniques. 16. The method of claim 15 further comprising: manipulating the orientation of the screw heads percutaneously using a head-positioning probe for communicating location containing an emitter, said probe communicating to the surgical navigation computer the orientation of the screw heads; andusing a head positioning tool for manipulating implants having an end portion that mates with the heads of the screws and rotating the screws to receive a connecting implant. 17. The method of claim 16 further comprising: tracking the location and position of the connecting implant by means of an instrument affixed to the implant having emitters capable of communicating orientation and location to the surgical navigation computer. 18. A system for use in performing the percutaneous placement of surgical implants and instruments into the spine using image guided surgery and a surgical navigation computer and energy detecting array, said system comprising: means for attaching a fixture to a portion of the spine;means for communicating position information to the surgical navigation computer and energy detecting array said means rigidly and removably connected to said means for attaching a fixture;means for providing location information of said spinal portion to the surgical navigation system adapted to be connected to spinal elements;means for indicating screw-head position said means electrically connected to the surgical navigation system and adapted to mate with the head of a screw implanted in one or more of said spinal elements. 19. The system of claim 18 further comprising: an elongated implant adapted to be inserted into said implanted screws;means for indicating the position of said elongated implant electrically connected to the surgical navigation system and adapted to mate with the elongated implant. 20. The system of claim 18, wherein said implanted screws have heads and the elongated implant is a rod adapted to be guided through holes in said implanted screw heads. 21. An apparatus for use in computer assisted procedures, comprising: a device operable to be connected to a structure and including: a clamp operable to engage the structure having a first member and a second member to engage substantially opposite sides of the structure;a member extending from and detachably connected to the clamp; andat least one of a reference portion operable to be detachably connected to the member or a fiducial member operable to be connected to the member;wherein the first member of the clamp includes a first arm and the second member of the clamp includes a second arm operable to compress the structure therebetween to hold the device relative to the structure;wherein the reference portion is operable to determine a location of the structure and the fiducial member is operable to be registered relative to an image of the structure. 22. An apparatus for use in computer assisted procedures, comprising: a device operable to be connected to a structure and including: a clamp operable to engage the structure having a first member and a second member to engage substantially opposite sides of the structure;a member extending from and connected to the clamp; andat least one of a reference portion operable to be detachably connected to the member or a fiducial member operable to be detachably connected to the member;a monitor;a screw or wire positioned in a bone; anda pointer operable to touch at least one of the screw or the wire;wherein the monitor is operable to display an image of at least one of the screw or the wire and an indication of a position of at least one of the screw or the wire based on the pointer touching at least one of the screw or the wire;wherein the reference portion is operable to determine a location of the structure and the fiducial member is operable to be registered relative to an image of the structure. 23. The apparatus of claim 21, further comprising: a fiducial sphere associated with the fiducial member and imageable with the structure. 24. The apparatus of claim 21, further comprising: a connector connected to the member;wherein the member extends from a first end to a second end, where the first end is operable to be connected to the clamp;wherein the connector is connected near the second end;wherein the connector is operable to interconnect the reference portion and the member. 25. The apparatus of claim 21, wherein the clamp and the member are configured such that the clamp and the member can be separated and replaced in the same geometric orientation and location. 26. An apparatus for use in computer assisted procedures, comprising: a device operable to be connected to a structure and including: a clamp operable to engage the structure having a first member and a second member to engage substantially opposite sides of the structure;a member extending from and detachably connected to the clamp; andat least one of a reference portion operable to be detachably connected to the member or a fiducial member operable to be detachably connected to the member;a tool;a tracking device fixed to the tool to track the tool relative to the structure; anda tracking system to track the tracking device and the reference portion;wherein the reference portion is operable to determine a location of the structure and the fiducial member is operable to be registered relative to an image of the structure. 27. The apparatus of claim 21, wherein the fiducial portion includes a plurality of divots operable to be registered to increase accuracy when compared to a single registered divot and to be connected simultaneously with the reference portion to the member. 28. The apparatus of claim 27, wherein the fiducial portion includes an elongated arm member such that each of the plurality of divots are spaced apart from one another. 29. The apparatus of claim 27, wherein the elongated member is collapsible and operable to fold together. 30. An apparatus for use in computer assisted procedures, comprising: a device operable to be connected to a structure and including: a clamp operable to engage the structure having a first member and a second member to engage substantially opposite sides of the structure;a member extending from and connected to the clamp; andat least one of a reference portion operable to be detachably connected to the member or a fiducial member operable to be detachably connected to the member;wherein the reference portion is operable to determine a location of the structure and the fiducial member is operable to be registered relative to an image of the structure;wherein the clamp and the member are configured in a geometric orientation and location;wherein the at least one of a reference portion is operable to be detachably connected to the member or a fiducial member is operable to be detachably connected to the member with a starburst connector. 31. An apparatus for use in computer assisted procedures, comprising: a device operable to be connected to a structure and including: a screw operable to be driven into the structure;a member extending and detachable from the screw; andat least one of a reference portion operable to be detachably connected to the member or a fiducial member operable to be detachably connected to the member;wherein the reference portion is operable to determine a location of the structure and the fiducial member is operable to be registered relative to an image of the structure. 32. The apparatus of claim 31, further comprising: a fiducial sphere associated with the fiducial member. 33. The apparatus of claim 31, further comprising: a connector connected to the member;wherein the member extends from a first end to a second end, wherein one of the first end or the second end of the member is operable to be connected to the screw;wherein the connector is connected near the second end;wherein the connector is operable to interconnect the reference portion and the member. 34. The apparatus of claim 33, wherein the connector includes a uniquely shaped interface such that the screw and the member can be separated and replaced in the same geometric orientation and location. 35. The apparatus of claim 34, wherein the uniquely shaped connector is a starburst connector. 36. The apparatus of claim 35, wherein the fiducial member includes a plurality of divots operable to be registered to increase accuracy when compared to a single registered divot and connected to the screw with the connector. 37. The apparatus of claim 36, wherein the fiducial portion includes an elongated arm member such that each of the plurality of divots are spaced apart from one another; wherein the elongated member is collapsible and operable to fold together. 38. A method of registering a physical space defined relative to a subject to an image space of the subject, comprising: fixing a clamp to a structure of the subject;fixing a fiducial portion to the clamp with a connector;acquiring image data of the subject and the fiducial portion connected to the subject;removing the fiducial portion from the clamp after acquiring the image data;registering the subject space to the image space of the acquired image data, including: reattaching the fiducial portion to the clamp in a same geometric orientation and location as during the acquiring the image data;determining a location of a registration portion of the fiducial portion. 39. The method of claim 38, further comprising: attaching reference arc to the clamp. 40. The method of claim 38, wherein determining a location of a registration portion of the fiducial portion includes determining a location of a plurality of divots on the fiducial portion. 41. The method of claim 40, further comprising: folding the fiducial portion to reduce a volume encompassed by the fiducial portion. 42. The method of claim 40, further comprising: removing the fiducial portion subsequent to the registering the subject space to the image space and maintaining registration of the subject space to the image space via the attached reference arc. 43. The method of claim 38, wherein the fixing a clamp to a structure of the subject includes moving a first arm and a second arm towards one another to compress the structure therebetween to hold the clamp relative to the structure.
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