|Publication number||USRE45509 E1|
|Application number||US 13/919,648|
|Publication date||5 May 2015|
|Filing date||17 Jun 2013|
|Priority date||24 Sep 1997|
|Also published as||US6226548, US20050277832, US20060009780, USRE39133, USRE42194, USRE42226, USRE44305, WO1999015097A2, WO1999015097A3|
|Publication number||13919648, 919648, US RE45509 E1, US RE45509E1, US-E1-RE45509, USRE45509 E1, USRE45509E1|
|Inventors||Kevin T. Foley, John B. Clayton, Anthony J. Melkent, Michael C. Sherman|
|Original Assignee||Medtronic Navigation, Inc.|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (119), Non-Patent Citations (24), Classifications (17), Legal Events (1)|
|External Links: USPTO, USPTO Assignment, Espacenet|
This application is a reissue of U.S. Pat. No. 6,226,548 issued on May 1, 2001 and also claims benefit under 35 U.S.C. §120 as a reissue continuation of U.S. patent application Ser. No. 13/036,939, filed on Feb. 28, 2011, now U.S. Pat. No. Re. 44,305, issued on Jun. 18, 2013; which also claims benefit under 35 U.S.C. §120 as a continuation of U.S. patent application Ser. No. 11/451,594, filed on Jun. 12, 2006, now U.S. Pat. No. Re. 42,194; which also claims benefit under 35 U.S.C. §120 as a continuation of U.S. patent application Ser. No. 10/423,332 filed on Apr. 24, 2003, now U.S. Pat. No. Re. 39,133; which is also a reissue of U.S. Pat. No. 6,226,548 issued on May 1, 2001; which claims rights under 35 U.S.C. §119 of provisional application No. 60/059,915, filed on Sep. 24, 1997.
U.S. patent application Ser. No. 13/036,939, filed on Feb. 28, 2011, now U.S. Pat. No. Re. 44,305, issued on Jun. 18, 2013; also claims benefit under 35 U.S.C. §120 as a continuation of U.S. patent application Ser. No. 11/451,595, filed on Jun. 12, 2006, now U.S. Pat. No. Re. 42,226; which also claims benefit under 35 U.S.C. §120 as a continuation of U.S. patent application Ser. No. 10/423,332 filed on Apr. 24, 2003; which is a reissue of U.S. Pat. No. 6,226,548 issued on May 1, 2001; which claims rights under 35 U.S.C. §119 of provisional application No. 60/059,915, filed on Sep. 24, 1997.
The present invention claims rights under 35 U.S.C. §119 on provisional application No. 60/059,915, filed on Sep. 24, 1997, and entitled “Percutaneous Registration Apparatus and Method for Use in Computer-Assisted Surgical Navigation.”
The present invention relates generally to guiding, directing, or navigating instruments or implants in a body percutaneously, in conjunction with systems that use and generate images during medical and surgical procedures, which images assist in executing the procedures and indicate the relative position of various body parts, surgical implants, and instruments. In particular the invention relates to apparatus and minimally invasive procedures for navigating instruments and providing surgical implants percutaneously in the spine, for example, to stabilize the spine, correct deformity, or enhance fusion in conjunction with a surgical navigation system for generating images during medical and surgical procedures.
Typically, spinal surgical procedures used, for example, to provide stabilization, fusion, or to correct deformities, require large incisions and substantial exposure of the spinal areas to permit the placement of surgical implants such as, for example, various forms of screws or hooks linked by rods, wires, or plates into portions of the spine. This standard procedure is invasive and can result in trauma, blood loss, and post operative pain. Alternatively, fluoroscopes have been used to assist in placing screws beneath the skin. In this alternative procedure at least four incisions must be made in the patient's back for inserting rods or wires through previously inserted screws. However, this technique can be difficult in that fluoroscopes only provide two-dimensional images and require the surgeon to rotate the fluoroscope frequently in order to get a mental image of the anatomy in three dimensions. Fluoroscopes also generate radiation to which the patient and surgical staff may become over exposed over time. Additionally, the subcutaneous implants required for this procedure may irritate the patient. A lever arm effect can also occur with the screws that are not connected by the rods or wires at the spine. Fluoroscopic screw placement techniques have traditionally used rods or plates that are subcutaneous to connect screws from vertebra to vertebra. This is due in part to the fact that there is no fluoroscopic technique that has been designed which can always adequately place rods or plates at the submuscular region (or adjacent to the vertebrae). These subcutaneous rods or plates may not be well tolerated by the patient. They also may not provide the optimal mechanical support to the spine because the moment arm of the construct can be increased, thereby translating higher loads and stresses through the construct.
A number of different types of surgical navigation systems have been described that include indications of the positions of medical instruments and patient anatomy used in medical or surgical procedures. For example, U.S. Pat. No. 5,383,454 to Bucholz; PCT Application No. PCT/US94/04530 (Publication No. WO 94/24933) to Bucholz; and PCT Application No. PCT/US95/12894 (Publication No. WO 96/11624) to Bucholz et al., the entire disclosures of which are incorporated herein by reference, disclose systems for use during a medical or surgical procedure using scans generated by a scanner prior to the procedure. Surgical navigation systems typically include tracking means such as, for example, an LED array on the body part, LED emitters on the medical instruments, a digitizer to track the positions of the body part and the instruments, and a display for the position of an instrument used in a medical procedure relative to an image of a body part.
Bucholz et al. WO 96/11624 is of particular interest, in that it identifies special issues associated with surgical navigation in the spine, where there are multiple vertebral bodies that can move with respect to each other. Bucholz et al. describes a procedure for operating on the spine during an open process where, after imaging, the spinous process reference points may move with respect to each other. It also discloses a procedure for modifying and repositioning the image data set to match the actual position of the anatomical elements. When there is an opportunity for anatomical movement, such movement degrades the fidelity of the pre-procedural images in depicting the intra-procedural anatomy. Therefore, additional innovations are desirable to bring image guidance to the parts of the body experiencing anatomical movement.
Furthermore, spinal surgical procedures are typically highly invasive. There is, thus, a need for more minimally invasive techniques for performing these spinal procedures, such as biopsy, spinal fixation, endoscopy, spinal implant insertion, fusion, and insertion of drug delivery systems, by reducing incision size and amount. One such way is to use surgical navigation equipment to perform procedures percutaneously, that is beneath the skin. To do so by means of surgical navigation also requires apparatus that can indicate the position of the spinal elements, such as, for example the vertebrae, involved in the procedure relative to the instruments and implants being inserted beneath the patient's skin and into the patient's spine. Additionally, because the spinal elements naturally move relative to each other, the user requires the ability to reorient these spinal elements to align with earlier scanned images stored in the surgical navigation system computer, to assure the correct location of those elements relative to the instruments and implants being applied or inserted percutaneously.
In light of the foregoing, there is a need in the art for apparatus and minimally invasive procedures for percutaneous placement of surgical implants and instruments in the spine, reducing the size and amount of incisions and utilizing surgical navigation techniques.
Accordingly, the present invention is directed to 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. More specifically, one object of the present invention is directed to apparatus and procedures for the percutaneous placement of surgical implants and instruments into various elements of the spine using image guided surgery.
To achieve these objects and other advantages and in accordance with the purpose of the invention, as embodied and broadly described herein, the invention includes an apparatus for use with a surgical navigation system and comprises 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 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.
In one aspect, the attaching device is a clamp with jaws and sharp teeth for biting into the spinous process.
In another aspect, the fixture is a screw, having a head, wherein the screw is implanted into the spinous process and a relatively rigid wire is attached to the head of the screw and also implanted into the spinous process at an angle to the axis of the screw to prevent the screw from rotating in either direction.
In another aspect, the superstructure includes a central post, and a fiducial array and a reference arc rigidly but removably attached to the central post. The fiducial array is composed of image-compatible materials, and includes fiducials for providing a reference point, indicating the position of the array, which are rigidly attached to the fiducial array, composed of, for example titanium or aluminum spheres. The reference arc includes emitters, such as, for example Light Emitting Diodes (“LEDs”), passive reflective spheres, or other tracking means such as acoustic, magnetic, electromagnetic, radiologic, or micropulsed radar, for indicating the location of the reference arc and, thus, the body part it is attached to, during medical procedures.
In addition, the invention further comprises a method for monitoring the location of an instrument, surgical implants and the various portions of the body, for example, vertebrae, to be operated on in a surgical navigation system comprising the steps of: attaching a fixture to the spinous process; attaching a superstructure including a fiducial array with fiducials and a reference arc to the fixture; scanning the patient using CT, MRI or some other three-dimensional method, with fiducial array rigidly fixed to patient to identify it on the scanned image; and thereafter, in an operating room, using image-guided technology, touching an image-guided surgical pointer or other instrument to one or more of the fiducials on the fiducial array to register the location of the spinal element fixed to the array and emitting an audio, visual, radiologic, magnetic or other detectable signal from the reference arc to an instrument such as, for example, a digitizer or other position-sensing unit, to indicate changes in position of the spinal element during a surgical procedure, and performing a surgical or medical procedure percutaneously on the patient using instruments and implants locatable relative to spinal elements in a known position in the surgical navigation system.
In another aspect, the method includes inserting screws or rigid wires in spinal elements in the area involved in the anticipated surgical procedure before scanning the patient, and after scanning the patient and bringing the patient to the operating area, touching an image-guided or tracked surgical pointer to these screws and wires attached to the vertebrae to positively register their location in the surgical navigation computer, and manipulating either the patient's spine or the image to align the actual position of the spinal elements with the scanned image.
In another aspect, the method includes percutaneously implanting screws into spinal elements, which screws are located using image guided surgical navigation techniques, and further manipulating the orientation of the screw heads percutaneously using a head-positioning probe containing an emitter, that can communicate to the surgical navigation computer the orientation of the screw heads and position them, by use of a specially designed head-positioning tool with an end portion that mates with the heads of the screws and can rotate those screw heads to receive a rod, wire, plate, or other connecting implant. If a rod is being inserted into the screw heads for example, the method further includes tracking the location and position of the rod, percutaneously using a rod inserter having one or more emitters communicating the location and orientation of the rod to the surgical navigation computer.
The objects of the invention are to provide a user, such as a surgeon, with the system and method to track an instrument and surgical implants used in conjunction with a surgical navigation system in such a manner to operate percutaneously on a patient's body parts, such as spinal vertebrae which can move relative to each other.
It is a further object of this invention to provide a system and method to simply and yet positively indicate to the user a change in position of body parts, such as spinal vertebrae segments, from that identified in a stored image scan, such as from an MRI or CAT scan, and provide a method to realign those body parts to correspond with a previously stored image or the image to correspond with the actual current position of the body parts.
It is a further object of this invention to provide a system or method for allowing a fiducial array or reference arc that is removable from a location rigidly fixed to a body part and replaceable back in that precise location.
It is another object of this invention to provide a system and method for positively generating a display of instruments and surgical implants, such as, for example screws and rods, placed percutaneously in a patient using image-guided surgical methods and techniques.
It is another object of this invention for a percutaneous reference array and fiducial array, as described in this appplication, to be used to register and track the position of the vertebrae for the purposes of targeting a radiation dose to a diseased portion of said vertebrae using a traditional radiosurgical technique.
Additional objects and advantages of the invention will be set forth in part in the description which follows, and in part will be obvious from the description, or may be learned by practice of the invention. The objects and advantages of the invention will be realized and attained by means of the elements and combinations particularly pointed out in this description.
It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention.
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate one embodiment of the invention and together with the description, serve to explain the principles of the invention.
Reference will now be made in detail to the present preferred embodiment of the invention, an example of which is illustrated in the accompanying drawings. Wherever possible, the same reference numbers will be used throughout the drawings to refer to the same or like parts. The following example is intended to be purely exemplary of the invention.
As generally described in PCT/US95/12894, the entire disclosure of which is incorporated herein by reference, a typical surgical navigation system is shown in
The system includes an apparatus such as a digitizer or other Position Sensing Unit (PSU), such as for example sensor array 110 on support 112 for identifying, during the procedure, the relative position of each of the reference points to be displayed by tracking the position of emitters 122 on arc 120. The system also includes a processor 114 such as a PC or other suitable workstation processor associated with controller 108 for modifying the image data set according to the identified relative position of each of the reference points during the procedure, as identified by digitizer 110. The processor 114 can then, for example, generate an image data set representing the position of the body elements during the procedure for display on monitor 106. A surgical instrument 130, such as a probe or drill or other tool, may be included in the system, which is positioned relative to a body part and similarly tracked by sensor array 110.
In summary, the general operation of a surgical navigating system is well known in the art and need not further be described here.
In accordance with the preferred embodiment of the present invention, with further reference to
With reference now to
Also rigidly attached to the central post 150, as part of the superstructure 20 preferably at a location closer to the skin, or possibly collocated with or also performing the function of the reference arc 120, is a fiducial array 170, which can be of various different shapes, such as, for example the H-shaped frame 170 depicted in
Additionally, the fiducial array 170, can be located at various heights on the post 150 to accomodate variations in patient tissue depth and size, preferably as close to the patient's body as possible, and then fixed at that specific height by the use of pins or indents matched to holes 19 (shown in
Alternatively, rather than using clamp 30, a screw 42 and rigid wire 45 attachment, as depicted in
Another embodiment for preventing the superstructure 20 from rotating as depicted in
Having described the preferred embodiment of this apparatus of the present system, the method of using this apparatus to practice the invention of registering a single vertebrae will now be discussed. The operation of a surgical navigating system is generally well known and is described in PCT/US95/12894. In the preferred method of operation, clamp 30 of
After scanning the patient, the array 120 and post 150 can be removed from the patient, while leaving in place the rigidly connected clamp 30 or screw 42. For example, as depicted in
Once in the operating room, the patient may be positioned in an apparatus, such as, for example, a spinal surgery frame 125 to help keep the spinal elements in a particular position and relatively motionless. The superstructure 20 is then replaced on the clamp 30 or screw 42 in a precise manner to the same relative position to the spinal elements as it was in the earlier CAT scan or MRI imaging. The reference arc 120 is fixed to the starburst or other interface connector 60 on the central post 150 which is fixed to the clamp 30 or screw 42. The operator, for example a surgeon, then touches an instrument with a tracking emitter such as a surgical pointer 130 with emitters 195 to the divots 29 on the fiducial array 170 to register the location of the array 170 and, thus, because the spinal process is fixed to the fiducial array 170, the location of the spinal element is also registered in the surgical navigation system.
Once the superstructure 20 is placed back on the patient, any instrument 130 fitted with tracking emitters thereon such as, for example, a drill or screw driver, can be tracked in space relative to the spine in the surgical navigation system without further surgical exposure of the spine. The position of the instrument 130 is determined by the user stepping on a foot pedal 116 to begin tracking the emitter array 190. The emitters 195 generate infrared signals to be picked up by camera digitizer array 110 and triangulated to determine the position of the instrument 130. Additionally, other methods may be employed to track reference arcs, pointer probes, and other tracked instruments, such as with reflective spheres, or sound or magnetic emitters, instead of LED's. For example, reflective spheres can reflect infrared light that is emitted from the camera array 110 back to the camera array 110. The relative position of the body part, such as the spinal process is determined in a similar manner, through the use of similar emitters 122 mounted on the reference frame 120 in mechanical communication with the spinal segment. As is well known in this art and described generally in PCT/US95/12894, based upon the relative position of the spinal segment and the instrument 130 (such as by touching a known reference point) the computer would illustrate a preoperative scan—such as the proper CAT scan slice—on the screen of monitor 106 which would indicate the position of the tool 130 and the spinal segment for the area of the spine involved in the medical procedure.
For better access by the operator of various areas near the central post 150, the fiducial array 170 can be removed from the central post 150, by, for example, loosening screw 42 and sliding the array 170 off post 150, leaving the reference arc 120 in place or replacing it after removal of array 170. By leaving the reference arc 120 in place, the registration of the location of the spinal process is maintained. Additionally, the central post 150, reference arc 120, and fiducial array 170 can be removed after the spinal element has been registered leaving only the clamp 30 or screw 42 in place. The entire surgical field can then be sterilized and a sterile post 150 and reference arc 170 fixed to the clamp 30 or screw 42 with the registration maintained.
This surgical navigation system, with spinal element registration maintained, can then be used, for example, to place necessary and desired screws, rods, hooks, plates, wires, and other surgical instruments and implants percutaneously, using image-guided technology. Once the location of the spinal element 100 involved in the procedure is registered, by the process described above, in relation to the image data set and image 105 projected on monitor 106, other instruments 130 and surgical implants can be placed under the patient's skin at locations indicated by the instrument 130 relative to the spinal element 100.
Additionally, the location of other spinal elements, relative to the spinal element 100 containing the fiducial array 170, can be registered in the surgical navigation system by, for example, inserting additional screws 250, rigid wires 260, or other rigid implants or imageable devices into the spinal segment.
For example, as depicted in
For additional positioning information, the operator can place additional rigid wires 260 or screws 250 into the vertebrae, for example, located at the superior (toward the patient's head) and inferior (towards the patient's feet) ends of the spinal process to more accurately position those vertebrae relative to the other vertebrae and the image data. Additionally, the wires 260 and screws 250 implanted to provide positioning information can also be equipped with emitters, such as, for example, LEDs, to provide additional information to the surgical navigation system on the location of the wire 260 or screw 250, and thus the vertebra to which they are affixed.
Alternatively, the patient can be placed in a position stabilizing device, such as a spinal surgery frame 125 or board, before a scan is taken, and then moved to the operating facility for the procedure, maintaining the spine segments in the same position from the time of scanning until the time of surgery. Alternatively, a fluoroscope can be used to reposition the spinal segments relative to the earlier image from the scan. An ultrasound probe can be used to take real-time images of the spinal segment which can be portrayed by monitor 106 overlayed or superimposed on image 105. Then the operator can manually manipulate the spinal elements and take additional images of these elements with the fluoroscope to, in an iterative fashion, align the spinal elements with the previously scanned image 105.
Alternatively, a clamp 30 or screw 42 and superstructure 20 can be rigidly fixed to each vertebra involved in the surgical or medical procedure to register the position of each vertebra as explained previously for a single vertebra:
After the spinal elements are registered in the spine, various medical and surgical procedures can be performed on that patient. For example, spinal implants, endoscopes, or biopsy probes can be passed into the spine and procedures such as, for example, spinal fusion, manipulation, or disc removal can be performed percutaneously and facilitated by the surgical navigation image-guiding system. Additionally, a radiation dose can be targeted to a specific region of the vertebrae.
One such procedure facilitated by the apparatus and methods described above is the percutaneous insertion of screws and rods, fixed to different vertebra in a spine to stabilize them. Once screws, for example multiaxial screws 250, (as depicted in
In an alternative procedure, one or more plates and/or one or more wires may be inserted instead of one or more rods 360.
It will be apparent to those skilled in the art that various modifications and variations can be made in the present invention and in construction of this surgical navigation system without departing from the scope or spirit of the invention. Other embodiments of the invention will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. It is intended that the specification and examples be considered as exemplary only.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|US3821469||15 May 1972||28 Jun 1974||Amperex Electronic Corp||Graphical data device|
|US3983474||21 Feb 1975||28 Sep 1976||Polhemus Navigation Sciences, Inc.||Tracking and determining orientation of object using coordinate transformation means, system and process|
|US4058114||10 Sep 1975||15 Nov 1977||Siemens Aktiengesellschaft||Ultrasonic arrangement for puncturing internal body organs, vessels and the like|
|US4209254||1 Feb 1979||24 Jun 1980||Thomson-Csf||System for monitoring the movements of one or more point sources of luminous radiation|
|US4259725||1 Mar 1979||31 Mar 1981||General Electric Company||Cursor generator for use in computerized tomography and other image display systems|
|US4262306||21 Nov 1979||14 Apr 1981||Karlheinz Renner||Method and apparatus for monitoring of positions of patients and/or radiation units|
|US4341220||13 Apr 1979||27 Jul 1982||Pfizer Inc.||Stereotactic surgery apparatus and method|
|US4396945||19 Aug 1981||2 Aug 1983||Solid Photography Inc.||Method of sensing the position and orientation of elements in space|
|US4398540||4 Nov 1980||16 Aug 1983||Tokyo Shibaura Denki Kabushiki Kaisha||Compound mode ultrasound diagnosis apparatus|
|US4419012||3 Sep 1980||6 Dec 1983||Elliott Brothers (London) Limited||Position measuring system|
|US4457311||3 Sep 1982||3 Jul 1984||Medtronic, Inc.||Ultrasound imaging system for scanning the human back|
|US4543959||25 Jan 1985||1 Oct 1985||Instrumentarium Oy||Diagnosis apparatus and the determination of tissue structure and quality|
|US4583538||4 May 1984||22 Apr 1986||Onik Gary M||Method and apparatus for stereotaxic placement of probes in the body utilizing CT scanner localization|
|US4592352||30 Nov 1984||3 Jun 1986||Patil Arun A||Computer-assisted tomography stereotactic system|
|US4602622||3 Nov 1980||29 Jul 1986||Siemens Aktiengesellschaft||Medical examination installation|
|US4608977||20 Dec 1982||2 Sep 1986||Brown Russell A||System using computed tomography as for selective body treatment|
|US4638798||10 Sep 1980||27 Jan 1987||Shelden C Hunter||Stereotactic method and apparatus for locating and treating or removing lesions|
|US4649504||22 May 1984||10 Mar 1987||Cae Electronics, Ltd.||Optical position and orientation measurement techniques|
|US4686997||13 Nov 1986||18 Aug 1987||The United States Of America As Represented By The Secretary Of The Air Force||Skeletal bone remodeling studies using guided trephine sample|
|US4701049||19 Jun 1984||20 Oct 1987||B.V. Optische Industrie "De Oude Delft"||Measuring system employing a measuring method based on the triangulation principle for the non-contact measurement of a distance from the surface of a contoured object to a reference level. _|
|US4705395||3 Oct 1984||10 Nov 1987||Diffracto Ltd.||Triangulation data integrity|
|US4705401||12 Aug 1985||10 Nov 1987||Cyberware Laboratory Inc.||Rapid three-dimensional surface digitizer|
|US4706665||17 Dec 1984||17 Nov 1987||Gouda Kasim I||Frame for stereotactic surgery|
|US4723544||9 Jul 1986||9 Feb 1988||Moore Robert R||Hemispherical vectoring needle guide for discolysis|
|US4733661||27 Apr 1987||29 Mar 1988||Palestrant Aubrey M||Guidance device for C.T. guided drainage and biopsy procedures|
|US4737921||3 Jun 1985||12 Apr 1988||Dynamic Digital Displays, Inc.||Three dimensional medical image display system|
|US4750487||24 Nov 1986||14 Jun 1988||Zanetti Paul H||Stereotactic frame|
|US4771787||11 Dec 1986||20 Sep 1988||Richard Wolf Gmbh||Ultrasonic scanner and shock wave generator|
|US4779212||6 Aug 1986||18 Oct 1988||Levy Nessim I||Distance measuring device|
|US4782239||1 Apr 1986||1 Nov 1988||Nippon Kogaku K. K.||Optical position measuring apparatus|
|US4788481||10 Mar 1987||29 Nov 1988||Mitsubishi Denki Kabushiki Kaisha||Numerical control apparatus|
|US4791934||7 Aug 1986||20 Dec 1988||Picker International, Inc.||Computer tomography assisted stereotactic surgery system and method|
|US4793355||17 Apr 1987||27 Dec 1988||Biomagnetic Technologies, Inc.||Apparatus for process for making biomagnetic measurements|
|US4805615||2 Jul 1985||21 Feb 1989||Carol Mark P||Method and apparatus for performing stereotactic surgery|
|US4809694||19 May 1987||7 Mar 1989||Ferrara Vincent L||Biopsy guide|
|US4836778||26 May 1987||6 Jun 1989||Vexcel Corporation||Mandibular motion monitoring system|
|US4841967||30 Jan 1984||27 Jun 1989||Chang Ming Z||Positioning device for percutaneous needle insertion|
|US4875478||5 Apr 1989||24 Oct 1989||Chen Harry H||Portable compression grid & needle holder|
|US4896673||15 Jul 1988||30 Jan 1990||Medstone International, Inc.||Method and apparatus for stone localization using ultrasound imaging|
|US4931056||24 Oct 1988||5 Jun 1990||Neurodynamics, Inc.||Catheter guide apparatus for perpendicular insertion into a cranium orifice|
|US4943296||12 Dec 1988||24 Jul 1990||Life Technology Research Foundation||Robot for surgical operation|
|US4945914||18 Jul 1988||7 Aug 1990||Allen George S||Method and apparatus for providing related images over time of a portion of the anatomy using at least four fiducial implants|
|US4955891||22 Oct 1987||11 Sep 1990||Ohio Medical Instrument Company, Inc.||Method and apparatus for performing stereotactic surgery|
|US4991579||10 Nov 1987||12 Feb 1991||Allen George S||Method and apparatus for providing related images over time of a portion of the anatomy using fiducial implants|
|US5016639||13 Feb 1990||21 May 1991||Allen George S||Method and apparatus for imaging the anatomy|
|US5047036||17 Nov 1989||10 Sep 1991||Koutrouvelis Panos G||Stereotactic device|
|US5078140||23 Sep 1986||7 Jan 1992||Kwoh Yik S||Imaging device - aided robotic stereotaxis system|
|US5080662||27 Nov 1989||14 Jan 1992||Paul Kamaljit S||Spinal stereotaxic device and method|
|US5094241||19 Jan 1990||10 Mar 1992||Allen George S||Apparatus for imaging the anatomy|
|US5097839||13 Feb 1990||24 Mar 1992||Allen George S||Apparatus for imaging the anatomy|
|US5119817||19 Jan 1990||9 Jun 1992||Allen George S||Apparatus for imaging the anatomy|
|US5142930||29 Mar 1991||1 Sep 1992||Allen George S||Interactive image-guided surgical system|
|US5178164||29 Mar 1991||12 Jan 1993||Allen George S||Method for implanting a fiducial implant into a patient|
|US5186174||29 Jan 1990||16 Feb 1993||G. M. Piaff||Process and device for the reproducible optical representation of a surgical operation|
|US5198877||15 Oct 1990||30 Mar 1993||Pixsys, Inc.||Method and apparatus for three-dimensional non-contact shape sensing|
|US5211164||29 Mar 1991||18 May 1993||Allen George S||Method of locating a target on a portion of anatomy|
|US5222499||26 Mar 1992||29 Jun 1993||Allen George S||Method and apparatus for imaging the anatomy|
|US5230338||22 Apr 1992||27 Jul 1993||Allen George S||Interactive image-guided surgical system for displaying images corresponding to the placement of a surgical tool or the like|
|US5230623||10 Dec 1991||27 Jul 1993||Radionics, Inc.||Operating pointer with interactive computergraphics|
|US5249581||15 Jul 1991||5 Oct 1993||Horbal Mark T||Precision bone alignment|
|US5251127||31 Jul 1990||5 Oct 1993||Faro Medical Technologies Inc.||Computer-aided surgery apparatus|
|US5257998||30 Jun 1992||2 Nov 1993||Mitaka Kohki Co., Ltd.||Medical three-dimensional locating apparatus|
|US5279309||27 Jul 1992||18 Jan 1994||International Business Machines Corporation||Signaling device and method for monitoring positions in a surgical operation|
|US5295200||3 Dec 1992||15 Mar 1994||Board Of Regents, The University Of Texas System||Method and apparatus for determining the alignment of an object|
|US5295483||11 Oct 1991||22 Mar 1994||Christopher Nowacki||Locating target in human body|
|US5299288||18 Sep 1991||29 Mar 1994||International Business Machines Corporation||Image-directed robotic system for precise robotic surgery including redundant consistency checking|
|US5305203||2 Oct 1990||19 Apr 1994||Faro Medical Technologies Inc.||Computer-aided surgery apparatus|
|US5309913||30 Nov 1992||10 May 1994||The Cleveland Clinic Foundation||Frameless stereotaxy system|
|US5371778||29 Nov 1991||6 Dec 1994||Picker International, Inc.||Concurrent display and adjustment of 3D projection, coronal slice, sagittal slice, and transverse slice images|
|US5383454||2 Jul 1992||24 Jan 1995||St. Louis University||System for indicating the position of a surgical probe within a head on an image of the head|
|US5389101||21 Apr 1992||14 Feb 1995||University Of Utah||Apparatus and method for photogrammetric surgical localization|
|US5402801||28 Apr 1994||4 Apr 1995||International Business Machines Corporation||System and method for augmentation of surgery|
|US5447154||30 Jul 1993||5 Sep 1995||Universite Joseph Fourier||Method for determining the position of an organ|
|US5483961||29 Aug 1994||16 Jan 1996||Kelly; Patrick J.||Magnetic field digitizer for stereotactic surgery|
|US5494034||15 Jun 1994||27 Feb 1996||Georg Schlondorff||Process and device for the reproducible optical representation of a surgical operation|
|US5515160||20 Feb 1993||7 May 1996||Aesculap Ag||Method and apparatus for representing a work area in a three-dimensional structure|
|US5517990||8 Apr 1994||21 May 1996||The Cleveland Clinic Foundation||Stereotaxy wand and tool guide|
|US5526576||12 Sep 1994||18 Jun 1996||Carl-Zeiss-Stiftung, Heidenheim (Brenz)||Coordinate measurement machine having a probe head and an electronic system for processing probe signals|
|US5551429||2 Jun 1995||3 Sep 1996||Fitzpatrick; J. Michael||Method for relating the data of an image space to physical space|
|US5572999||26 Jan 1995||12 Nov 1996||International Business Machines Corporation||Robotic system for positioning a surgical instrument relative to a patient's body|
|US5603318||29 Oct 1993||18 Feb 1997||University Of Utah Research Foundation||Apparatus and method for photogrammetric surgical localization|
|US5603328||18 Jan 1994||18 Feb 1997||The State Of Israel, Ministry Of Defence, Armament Development Authority||Infra-red vascular angiography system|
|US5617857||6 Jun 1995||8 Apr 1997||Image Guided Technologies, Inc.||Imaging system having interactive medical instruments and methods|
|US5622170||4 Oct 1994||22 Apr 1997||Image Guided Technologies, Inc.||Apparatus for determining the position and orientation of an invasive portion of a probe inside a three-dimensional body|
|US5630431||11 Oct 1994||20 May 1997||International Business Machines Corporation||System and method for augmentation of surgery|
|US5638819||29 Aug 1995||17 Jun 1997||Manwaring; Kim H.||Method and apparatus for guiding an instrument to a target|
|US5662111||16 May 1995||2 Sep 1997||Cosman; Eric R.||Process of stereotactic optical navigation|
|US5676673||24 Apr 1996||14 Oct 1997||Visualization Technology, Inc.||Position tracking and imaging system with error detection for use in medical applications|
|US5748767||10 Aug 1993||5 May 1998||Faro Technology, Inc.||Computer-aided surgery apparatus|
|US5749362||26 Jan 1995||12 May 1998||International Business Machines Corporation||Method of creating an image of an anatomical feature where the feature is within a patient's body|
|US5755725||6 Sep 1994||26 May 1998||Deemed International, S.A.||Computer-assisted microsurgery methods and equipment|
|US5772594 *||16 Oct 1996||30 Jun 1998||Barrick; Earl F.||Fluoroscopic image guided orthopaedic surgery system with intraoperative registration|
|US5795294||30 May 1995||18 Aug 1998||Carl-Zeiss-Stiftung||Procedure for the correlation of different coordinate systems in computer-supported, stereotactic surgery|
|US5823958||15 Jun 1994||20 Oct 1998||Truppe; Michael||System and method for displaying a structural data image in real-time correlation with moveable body|
|US5834759||22 May 1997||10 Nov 1998||Glossop; Neil David||Tracking device having emitter groups with different emitting directions|
|US5836954||18 Feb 1997||17 Nov 1998||University Of Utah Research Foundation||Apparatus and method for photogrammetric surgical localization|
|US5848967||7 Jun 1995||15 Dec 1998||Cosman; Eric R.||Optically coupled frameless stereotactic system and method|
|US5851183||16 Oct 1995||22 Dec 1998||St. Louis University||System for indicating the position of a surgical probe within a head on an image of the head|
|US5868675||10 May 1990||9 Feb 1999||Elekta Igs S.A.||Interactive system for local intervention inside a nonhumogeneous structure|
|US5871445||7 Sep 1995||16 Feb 1999||St. Louis University||System for indicating the position of a surgical probe within a head on an image of the head|
|US5891034 *||7 Jun 1995||6 Apr 1999||St. Louis University||System for indicating the position of a surgical probe within a head on an image of the head|
|US6006126 *||7 Jun 1995||21 Dec 1999||Cosman; Eric R.||System and method for stereotactic registration of image scan data|
|USRE35816||30 Mar 1995||2 Jun 1998||Image Guided Technologies Inc.||Method and apparatus for three-dimensional non-contact shape sensing|
|DE19715202A1||11 Apr 1997||15 Oct 1998||Brainlab Med Computersyst Gmbh||Position referencing system for medical examinations or treatment|
|EP0018166A1||9 Apr 1980||29 Oct 1980||Pfizer Inc.||Apparatus for use in stereotactic surgery|
|EP0326768A2||13 Dec 1988||9 Aug 1989||Faro Medical Technologies Inc.||Computer-aided surgery apparatus|
|EP0359773B1||21 May 1988||6 Oct 1993||Schlöndorff, Georg, Prof. Dr. med.||Process and device for optical representation of surgical operations|
|EP0427358A1||19 Oct 1990||15 May 1991||George S. Allen||Mechanical arm for and interactive image-guided surgical system|
|EP0456103A2||2 May 1991||13 Nov 1991||International Business Machines Corporation||Image-directed robotic system for precise surgery|
|EP0469966A1||25 Jul 1991||5 Feb 1992||Faro Medical Technologies (Us) Inc.||Computer-aided surgery apparatus|
|EP0501993B1||21 Nov 1990||11 Jun 1997||I.S.G. Technologies Inc.||Probe-correlated viewing of anatomical image data|
|WO1988009151A1||21 May 1988||1 Dec 1988||Schloendorff Georg||Process and device for optical representation of surgical operations|
|WO1991007726A1||21 Nov 1990||30 May 1991||I.S.G. Technologies Inc.||Probe-correlated viewing of anatomical image data|
|WO1992006645A1||17 Oct 1991||30 Apr 1992||St. Louis University||Surgical probe locating system for head use|
|WO1994023647A1||22 Apr 1994||27 Oct 1994||Pixsys, Inc.||System for locating relative positions of objects|
|WO1994024933B1||22 Dec 1994||Indicating the position of a surgical probe|
|WO1996011624A3||5 Oct 1995||18 Jul 1996||Univ St Louis||Surgical navigation systems including reference and localization frames|
|WO1996032059A1||6 Nov 1995||17 Oct 1996||Compass International Incorporated||Magnetic field digitizer for stereotactic surgery|
|WO1997040764A3||25 Apr 1997||24 Dec 1997||James L Day||Apparatus for surgical stereotactic procedures|
|1||3-D Digitizer Captures the World, BYTE, Oct. 1990, p. 43.|
|2||Adams et al., Computer-Assisted Surgery, IEEE Computer Graphics & Applications , May 1990, pp. 43-51.|
|3||Alignment Procedure for the PixSys Two-Emitter Offset Probe for the SAC GP-8-3d Sonic Digitizer, PixSys, Jul. 2, 1992, pp. 1-4.|
|4||Awwad, et al., Post-traumatic Spinal Synovial Cyst with Spondylolysis: CT Features, Journal of Computer Assisted Tomography, vol. 13, No. 2, 1989, pp. 334-337.|
|5||Bucholz, et al., Halo vest versus spinal fusion for cervical injury: evidence from an outcome study, J. Neurosurg., vol. 70, pp. 884-892.|
|6||Bucholz, et al., Image-Guided Surgical Techniques for Infections and Trauma of the Central Nervous Systems, Neurosurgery Clinics of North America, vol. 7, No. 2, Apr. 1996, pp. 187-200.|
|7||Bucholz, et al., Intraoperative localization using a three dimensional optical digitizer, SPIEvol. 1894, Jan. 17, 1993, pp. 312-322.|
|8||Cinquin, et al., GOR: Image Guided Operating Robot. Methodology, Application, IEEE EMBS, Paris 1992, pp. 1-2.|
|9||Foley, et al., Image-guided Intraoperative Spinal Localization, Intraoperative Neuroprotection: Monitoring, Part Three, 1996, pp. 325-340.|
|10||J.F. Mallet, et al., Post-Laminectomy Cervical-Thoracic Kyphosis in a Patient with Von Recklinghausen's Disease, Spinal Frontiers, vol. Three, Issue One, Apr. 1996, pp. 1-15.|
|11||Kato, et al., A frameless, armless navigational system fo computer-assisted neurosurgery, J. Neurosurg 74, 1991, pp. 845-849.|
|12||Kelly, The NeuroStation System for Image-Guided, Frameless Stereotaxy, Neurosugery, vol. 37, No. 2, Aug. 1995, pp. 348-350.|
|13||Lavallée, et al., Computer Assisted Medical Interventions, NATO ASI Series, vol. F 60, 1990, pp. 301-312.|
|14||Mazier, et al., Computer Assisted Interventionist Imaging: Application to the Vertebral Column Surgery, Annual International Conference of the IEEE Engineering in Medicine and Biology Society, vol. 12, No. 1, 1990, pp. 0430-0431.|
|15||Reinhardt, et al., Interactive Sonar-Operated Device for Stereotactic and Open Surgery, Proceedings of the Xth Meeting of the World Society for Stereotactic and Functional Neurosurgery, Maebashi, Japan, Oct. 1989, pp. 393-397.|
|16||Reinhardt, Neuronavigation: A Ten-Year Review, Neurosurgery, 1993, pp. 329-341.|
|17||Sautot et al., Computer Assisted Spine Surgery: a first step toward clinical application in orthopaedics, IEEE, 1992, p. 1071-1072.|
|18||Smith et al., Multimodality Image Analysis and Display Methods for Improved Tumor Localization in Stereotatic Neurosurgery, Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, vol. 13, 1991, p. 0210.|
|19||Smith, et al., Computer Methods for Improved Diagnostic Image Display Applied to Stereotatic Neurosurgery, Automedica, 1992, vol. 14, pp. 371-382.|
|20||Smith, et al., The Neurostation(TM)-A Highly Accurate, Minimally Invasive Solution to Frameless Stereotactic Neurosurgery, Computerized Medical Imaging and Graphics, vol. 18, 1994, pp. 247-256.|
|21||Smith, et al., The Neurostation™-A Highly Accurate, Minimally Invasive Solution to Frameless Stereotactic Neurosurgery, Computerized Medical Imaging and Graphics, vol. 18, 1994, pp. 247-256.|
|22||Vector Vision: The Power of Surgical Tracking, BrainLab, 1997.|
|23||Weinstein, et al., Spinal Pedicle Fixation: Reliability and Validity of Roentgenogram-Based Assessment and Surgical Factors on Successful Screw Placement, Spine, vol. 13, No. 9, 1988, pp. 1012-1018.|
|24||Weinstein, et al., Spinal Pedicle Fixation: Reliability and Validity of Roentgenogram—Based Assessment and Surgical Factors on Successful Screw Placement, Spine, vol. 13, No. 9, 1988, pp. 1012-1018.|
|International Classification||A61B17/88, A61B5/05, A61B17/70, A61B19/00|
|Cooperative Classification||A61B2090/363, A61B2034/2055, A61B2090/3983, A61B2090/3945, A61B34/10, A61B34/20, A61B2034/2072, A61B90/11, A61B2017/00477, A61B17/7032, A61B17/70, A61B17/7083|
|26 Aug 2013||AS||Assignment|
Owner name: SURGICAL NAVIGATION TECHNOLOGIES, INC., COLORADO
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:CLAYTON, JOHN B.;FOLEY, KEVIN T.;MELKENT, ANTHONY;AND OTHERS;SIGNING DATES FROM 19980713 TO 19980901;REEL/FRAME:031078/0156
Owner name: MEDTRONIC NAVIGATION, INC., COLORADO
Free format text: CHANGE OF NAME;ASSIGNOR:SURGICAL NAVIGATION TECHNOLOGIES, INC.;REEL/FRAME:031078/0174
Effective date: 20041220