WO2008091827A4 - Surgical navigational and neuromonitoring instrument - Google Patents

Surgical navigational and neuromonitoring instrument Download PDF

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Publication number
WO2008091827A4
WO2008091827A4 PCT/US2008/051593 US2008051593W WO2008091827A4 WO 2008091827 A4 WO2008091827 A4 WO 2008091827A4 US 2008051593 W US2008051593 W US 2008051593W WO 2008091827 A4 WO2008091827 A4 WO 2008091827A4
Authority
WO
WIPO (PCT)
Prior art keywords
instrument
neuromonitoring
handle
surgical tool
tool assembly
Prior art date
Application number
PCT/US2008/051593
Other languages
French (fr)
Other versions
WO2008091827A2 (en
WO2008091827A3 (en
Inventor
Robert S Teichman
Eric J Ryterski
Laurent Verard
William K Adcox
John B Clayton
David Mire
Original Assignee
Warsaw Orthopedic Inc
Robert S Teichman
Eric J Ryterski
Laurent Verard
William K Adcox
John B Clayton
David Mire
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Warsaw Orthopedic Inc, Robert S Teichman, Eric J Ryterski, Laurent Verard, William K Adcox, John B Clayton, David Mire filed Critical Warsaw Orthopedic Inc
Priority to JP2009547375A priority Critical patent/JP2010516402A/en
Priority to AU2008208051A priority patent/AU2008208051A1/en
Priority to KR1020097017588A priority patent/KR101157312B1/en
Priority to EP08728003A priority patent/EP2120733A2/en
Publication of WO2008091827A2 publication Critical patent/WO2008091827A2/en
Publication of WO2008091827A3 publication Critical patent/WO2008091827A3/en
Publication of WO2008091827A4 publication Critical patent/WO2008091827A4/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/50—Clinical applications
    • A61B6/506—Clinical applications involving diagnosis of nerves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1655—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for tapping
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8875—Screwdrivers, spanners or wrenches
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0551—Spinal or peripheral nerve electrodes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
    • A61B17/1671—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the spine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00026—Conductivity or impedance, e.g. of tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00039—Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00681—Aspects not otherwise provided for
    • A61B2017/00734—Aspects not otherwise provided for battery operated
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/101—Computer-aided simulation of surgical operations
    • A61B2034/105—Modelling of the patient, e.g. for ligaments or bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/107—Visualisation of planned trajectories or target regions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2051—Electromagnetic tracking systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/25—User interfaces for surgical systems
    • A61B2034/256—User interfaces for surgical systems having a database of accessory information, e.g. including context sensitive help or scientific articles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B2090/364—Correlation of different images or relation of image positions in respect to the body
    • A61B2090/365—Correlation of different images or relation of image positions in respect to the body augmented reality, i.e. correlating a live optical image with another image
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/25—User interfaces for surgical systems

Abstract

The invention relates to a surgical instrument capable of applying an electrostimulation to a neural structure. The surgical instrument also has a tracking system associated therewith to provide navigational tracking during a surgical procedure.

Claims

33
AMENDED CLAIMS received by the International Bureau on 22 December 2008 (22.12.08)
an energy source operable with the instrument and designed to provide electrical energy to the conductive member for application of electrostimulation to a neural structure when the neural structure is in contact with the portion of the conductive member and electrical energy is provided to the conductive member; and
a tracking system associated with the instrument and operative to provide information regarding a position of the instrument.
20. The surgical tool assembly of claim 19 wherein the energy source is a battery.
21. The surgical tool assembly of claim 20 wherein the battery is housed within the handle.
22. The surgical tool assembly of claim 19 wherein the insulating sheath includes a non-conductive coating on the conductive member.
23. The surgical tool assembly of claim 19 wherein the instrument is one of a probe, a retractor, a screwdriver, and a tap.
24. The surgical tool assembly of claim 19 wherein the instrument is capable of applying bipolar or unipolar electrostimulation to the neural structure.
25. The surgical tool assembly of claim 19 wherein the tracking system includes active, passive, or a combination of active and passive tracking elements.
26. A neuromonitoring instrument capable of applying electrostimuation to a neural structure, the instrument comprising:
a handle and a stylet extending from a distal end of the handle; and
a navigational sensor associated with at least one of the handle and the stylet, the navigation sensor operative to provide feedback regarding a position of the instrument. 34
27. The neuromonitoring probe of claim 26 further comprising a cannula of insulating material extending from the distal end of the handle and wherein the stylet is disposed within a lumen of the cannula.
28. The neuromonitoring probe of claim 27 wherein the navigational sensor is secured to an outer surface of the cannula.
29. The neuromonitoring probe of claim 28 wherein the navigational sensor is a reflector.
30. The neuromonitoring probe of claim 26 wherein the handle houses an energy source that provides energy to the stylet for the application of electrostimulation to a neural structure.
31. The neuromonitoring probe of claim 30 wherein the energy source is a battery.
32. The neuromonitoring probe of claim 26 wherein the stylet includes a pointed distal end capable of forming a hole in a pedicle.
PCT/US2008/051593 2007-01-25 2008-01-22 Surgical navigational and neuromonitoring instrument WO2008091827A2 (en)

Priority Applications (4)

Application Number Priority Date Filing Date Title
JP2009547375A JP2010516402A (en) 2007-01-25 2008-01-22 Surgical navigation nerve monitoring instrument
AU2008208051A AU2008208051A1 (en) 2007-01-25 2008-01-22 Surgical navigational and neuromonitoring instrument
KR1020097017588A KR101157312B1 (en) 2007-01-25 2008-01-22 Surgical navigational and neuromonitoring instrument
EP08728003A EP2120733A2 (en) 2007-01-25 2008-01-22 Surgical navigational and neuromonitoring instrument

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US11/626,917 US7987001B2 (en) 2007-01-25 2007-01-25 Surgical navigational and neuromonitoring instrument
US11/626,917 2007-01-25

Publications (3)

Publication Number Publication Date
WO2008091827A2 WO2008091827A2 (en) 2008-07-31
WO2008091827A3 WO2008091827A3 (en) 2008-12-18
WO2008091827A4 true WO2008091827A4 (en) 2009-02-19

Family

ID=39705026

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2008/051593 WO2008091827A2 (en) 2007-01-25 2008-01-22 Surgical navigational and neuromonitoring instrument

Country Status (6)

Country Link
US (2) US7987001B2 (en)
EP (1) EP2120733A2 (en)
JP (1) JP2010516402A (en)
CN (1) CN101594830A (en)
AU (1) AU2008208051A1 (en)
WO (1) WO2008091827A2 (en)

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