Percutaneous registration apparatus and method for use in computer-assisted surgical navigation

Abstract

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. 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 implant system for facilitating percutaneous placement of an implant in an anatomy and adapted for use with a surgical navigation system to tracks positions of the implant system in space, said implant system comprising: 
 an implant inserter adapted to releasably attach to the implant; and    a position identification structure rigidly and removably attached to said implant inserter;    wherein said position identification structure includes an assembly for providing position information to the surgical navigation system.    
     
     
         2 . The implant system of  claim 1 , wherein said position identification structure includes at least one optical emitter.  
     
     
         3 . The implant system of  claim 1 , wherein said position identification structure includes at least one light emitting diode.  
     
     
         4 . The implant system of  claim 1 , wherein said position identification structure includes a selected geometrical shape.  
     
     
         5 . The implant system of  claim 1 , wherein said position identification structure includes at least one of reflective spheres, sound emitters, magnets, eletromagnets, light emitting diodes, or combinations thereof.  
     
     
         6 . The implant system of  claim 5 , wherein said reflectors can reflect at least one of visible light, infrared light, ultraviolet light, or combinations thereof.  
     
     
         7 . The implant system of  claim 5 , wherein said magnets or electromagnets are operable to produce a magnetic field.  
     
     
         8 . The implant system of  claim 1 , further comprising: 
 a rod;    wherein said rod can form a portion of the surgical implant.    
     
     
         9 . The implant system of  claim 8 , wherein said rod extends between a first end and a second end; 
 wherein said implant inserter is releasably attached to at least one of said first end, said second end, or combinations thereof.    
     
     
         10 . The implant system of  claim 8 , wherein said rod holder is operable to assist in moving a rod along a selected path.  
     
     
         11 . The implant system of  claim 8 , wherein said rod holder is operably interconnected with the implant to determine a position of at least a portion of the implant.  
     
     
         12 . The implant system of  claim 11 , wherein the implant includes a 
 screw head and a rod;    wherein said position identification structure attached to said rod holder is operable to determine a position of the rod relative to the screw head.    
     
     
         13 . The implant system of  claim 1 , wherein said implant inserter includes a rod holder.  
     
     
         14 . The implant system of  claim 1 , further comprising: 
 a bone screw;    wherein said bone screw can form a portion of the implant.    
     
     
         15 . The implant system of  claim 14 , wherein said bone screw includes a slot operable to be aligned.  
     
     
         16 . The implant system of  claim 15 , further comprising: 
 a second screw having a slot operable to be aligned percutaneously with said bone screw.    
     
     
         17 . The implant system of  claim 1 , further comprising: 
 an imaging system operable to produce image data of the anatomy.    
     
     
         18 . The implant system of  claim 17 , further comprising: 
 a display;    wherein the position of the implant inserter, the position of the implant, or combinations thereof can be displayed on the display with the image data.    
     
     
         19 . The implant system of  claim 18 , further comprising: 
 a bone screw operable to be positioned in the anatomy;    wherein the geometry of the bone screw can be displayed on said display relative to the image data.    
     
     
         20 . The implant system of  claim 19 , wherein the position of the implant, the geometry of the screw, and combinations thereof can be used intra-operably to determine bending of a rod.  
     
     
         21 . The implant system of  claim 18 , wherein the display allows for substantially percutaneous placements of the implant relative to the anatomy.  
     
     
         22 . The implant system of  claim 1 , further comprising: 
 an optical tracking system; an acoustic tracking system; an electromagnetic tracking system; a micropulsed radar tracking system; or combinations thereof.    
     
     
         23 . An implant system for facilitating percutaneous placement of an implant in an anatomy and adapted use with a surgical navigation system to track positions in space, said implant system comprising: 
 an implant inserter operably interconnected to the implant;    a reference structure operably interconnected with said implant inserter;    wherein said reference structure is operable with the surgical navigation system to determine a position of at least one of said implant inserter, said implant, said reference structure, or combinations thereof.    
     
     
         24 . The implant system of  claim 23 , further comprising: 
 a rod;    wherein said rod can form a portion of the implant;    wherein said rod extends between a first end and a second end.    
     
     
         25 . The implant system of  claim 24 , wherein said implant inserter is operable to be interconnected with at least one of said first end, said second end, or combinations thereof.  
     
     
         26 . The implant system of  claim 24 , wherein said implant inserter is operable to assist in moving said rod along a selected path.  
     
     
         27 . The implant system of  claim 26 , further comprising: 
 a bone screw;    wherein said bone screw can form a portion of the implant.    
     
     
         28 . The implant system of  claim 27 , wherein the surgical navigation system assists in displaying a position of said rod relative to said bone screw to intra-operatively determine a configuration of said rod.  
     
     
         29 . The implant system of  claim 23 , wherein said position identification structure includes a selected geometrical shape.  
     
     
         30 . The implant system of  claim 23 , wherein said position identification structure includes at least one of reflective spheres, sound emitters, magnets, electromagnets, emitting members, or combinations thereof.  
     
     
         31 . The implant system of  claim 24 , wherein said emitting members include light emitting diodes.  
     
     
         32 . The implant system of  claim 30 , wherein said reflectors can reflect at least one of visible light, infrared light, ultraviolet light, or combinations thereof.  
     
     
         33 . The implant system of  claim 23 , further comprising: 
 an imaging system operable to produce image data of the anatomy.    
     
     
         34 . The implant system of  claim 33 , further comprising: 
 a display;    wherein the position of the implant inserter, the position of the surgical implant, or combinations thereof can be displayed on the display with the image data.    
     
     
         35 . The implant system of  claim 34 , further comprising: 
 a bone screw operable to be positioned in the anatomy;    wherein the geometry of the bone screw can be displayed on said display relative to the image data.    
     
     
         36 . The implant system of  claim 35 , wherein the position of the implant, the geometry of the screw, and combinations thereof can be used intra-operably to determine bending of a rod.  
     
     
         37 . The implant system of  claim 34 , wherein the display allows for substantially percutaneous placements of the implant relative to the anatomy.  
     
     
         38 . The implant system of  claim 23 , wherein said reference structure is removably connected to said implant inserter.  
     
     
         39 . The implant system of  claim 23 , further comprising: 
 an optical tracking system; an acoustic tracking system; an electromagnetic tracking system; a micropulsed radar tracking system; or combinations thereof.    
     
     
         40 . An implant system for facilitating percutaneous placement of an implant in an anatomy that can be used with a surgical navigation system to track positions in space, the implant system comprising: 
 an implant having a head and a body operable to be positioned relative to a selected portion of the anatomy;    an implant inserter operable to be interconnected to said head of said implant; and    a reference structure operable to be interconnected with said implant inserter;    wherein said reference structure is operable with the surgical navigation system to determine a position and produce position data of at least one of said implant inserter, said implant, said reference structure, or combinations thereof;    wherein said implant inserter is operable to move said implant relative to the anatomy.    
     
     
         41 . The implant system of  claim 40 , wherein said implant includes a screw and said body includes a thread operable to engage the anatomy; 
 wherein said implant inserter is operable to interconnect with at least the head of said screw.    
     
     
         42 . The implant system of  claim 40 , further comprising: 
 an imaging device that produces image data of the anatomy.    
     
     
         43 . The implant system of  claim 42 , further comprising: 
 a display;    wherein said display is operable to display the image data of the anatomy.    
     
     
         44 . The implant system of  claim 43 , wherein the position data of said implant is determined by determining a position of the reference's structure relative to the anatomy; 
 wherein said implant position data is displayed on the display.    
     
     
         45 . The implant system of  claim 44 , wherein said implant position data includes a position of said head.  
     
     
         46 . The implant system of  claim 42 , wherein said head includes a slot.  
     
     
         47 . The implant system of  claim 46 , wherein said implant position data includes a position of said slot.  
     
     
         48 . The implant system of  claim 44 , wherein said position data displayed on the display is determined with a processor.  
     
     
         49 . The implant system of  claim 40 , wherein said implant is operable to be positioned percutaneously relative to the anatomy via said implant inserter; 
 wherein said implant is operable to be manipulated percutaneously via said implant inserter and said referenced structure.    
     
     
         50 . The implant system of  claim 49 , wherein the position image data of the implant is displayed on a display relative to image data of the anatomy to facilitate percutaneous placement of the implant relative to the anatomy.  
     
     
         51 . The implant system of  claim 50 , wherein positioning of the implants includes positioning a head of a bone screw in a selected orientation relative to the anatomy.  
     
     
         52 . The implant system of  claim 37 , wherein said implant is a screw.  
     
     
         53 . The implant system of  claim 52 , further comprising: 
 a rod implant;    a rod implant inserter;    a rod inserter reference structure operably interconnected with said rod inserter, wherein said rod inserter reference structure is operable with the surgical navigation system to determine a position of at least a portion of said rod implant;    wherein said implant inserter is operable to position said head relative to the anatomy percutaneously;    wherein said rod inserter is operable to position said rod implant relative to said head that has been positioned with said implant inserter.