Augmented Reality Guidance for Spinal Surgery and Spinal Procedures

Abstract

Embodiments disclose a real-time surgery method and apparatus for displaying a stereoscopic augmented view of a patient from a static or dynamic viewpoint of the surgeon, which employs real-time three-dimensional surface reconstruction for preoperative and intraoperative image registration. Stereoscopic cameras provide real-time images of the scene including the patient. A stereoscopic video display is used by the surgeon, who sees a graphical representation of the preoperative or intraoperative images blended with the video images in a stereoscopic manner through a see through display.

1 . A system comprising:
 a stereoscopic optical see-through head mounted display;   at least one computing system configured to receive preoperative, intraoperative or preoperative and intraoperative image information of the physical spine of a patient,   at least one marker configured to be attached to the patient,   wherein the at least one computing system is configured to register the image information of the physical spine in a common coordinate system,   wherein the at least one computing system is configured to register the at least one marker in the common coordinate system,   wherein the at least one computing system is configured to generate a stereoscopic display by the optical see-through head mounted display based on the image information of the physical spine,   wherein the at least one computing system is configured to track movement from a first position to a second position of the physical spine during surgery,   wherein the at least one computing system is configured to track the location and orientation of the optical see-through head mounted display in the common coordinate system,   wherein the at least one computing system is configured to superimpose the stereoscopic display on a target portion of the physical spine visible directly through the stereoscopic optical see-through head mounted display,   wherein the at least one computing system is configured to adjust in real time the stereoscopic display based on the location and orientation of the optical see-through head mounted display,   wherein the at least one computing system is configured to adjust in real time the stereoscopic display based on the tracked movement from the first position to the second position of the physical spine,   and   wherein the first and second positions of the physical spine of the patient are different.   
     
     
         2 . The system of  claim 1 , wherein the at least one computing system is configured to reconstruct one or more preoperative, intraoperative or preoperative and intraoperative two-dimensional (2D) images into three-dimensional (3D) images using 2D to 3D reconstruction. 
     
     
         3 . The system of  claim 1 , wherein the at least one computing system is configured to track movement from the first position to the second position of the physical spine by tracking the position of the at least one markers in real time. 
     
     
         4 . The system of  claim 1 , wherein the at least one computing system is configured to compare tracking data of one or more instruments and/or one or more devices to the tracked position of the physical spine during surgery in real time. 
     
     
         5 . The system of  claim 1 , wherein the at least one computing system is configured to track the location and/or orientation of one or more instruments, one or more devices, the physical spine, the surgeon, the optical see-through head mounted display or combinations thereof in real time. 
     
     
         6 . (canceled) 
     
     
         7 . (canceled) 
     
     
         8 . (canceled) 
     
     
         9 . (canceled) 
     
     
         10 . (canceled) 
     
     
         11 . (canceled) 
     
     
         12 . The system of  claim 1 , wherein the image information of the physical spine of the patient is registered with one or more structures of the physical spine using a navigation system. 
     
     
         13 . The system of  claim 1 , wherein the at least one computing system is configured to provide for adjustment of transparency, color and contrast of the stereoscopic display displayed by the optical see-through head mounted display superimposed on the physical spine. 
     
     
         14 . The system of  claim 1 , wherein the at least one computing system is configured to display one or more virtual graphical representations of tracked instruments or devices by the optical see-through head mounted display superimposed on the physical spine. 
     
     
         15 . The system of  claim 1 , wherein the stereoscopic display of the spine displayed by the optical see-through head mounted display includes images of individually rendered vertebrae registered in the common coordinate system superimposed with individual vertebra of the physical spine. 
     
     
         16 . The system of  claim 15 , wherein the at least one computing system is configured to track pose changes of the individual vertebrae in the common coordinate system, and wherein the pose changes are translated into display of a different second stereoscopic display at a location and orientation that corresponds to the location and orientation of the individual vertebrae of the patient's spine after the pose changes. 
     
     
         17 . The system of  claim 5 , wherein the tracking of the one or more instruments, the one or more devices, the physical spine, the surgeon, the optical see-through head mounted display or combinations thereof is performed using at least one attached passive optical markers, active optical markers, and/or at least one of magnetic tracking, electromagnetic tracking, ultrasonic tracking, mechanical tracking, tracking using inertial measurement units and 3D scanners. 
     
     
         18 . The system of  claim 1 , wherein the optical see-through head mounted display is configured to display at least one of a graphical representations of one or more instruments, surgical guides or techniques, or anatomical models superimposed on the physical spine. 
     
     
         19 . A system comprising:
 a stereoscopic optical see-through head mounted display;   at least one computing system configured to receive preoperative, intraoperative, or preoperative and intraoperative image information from two or more images of individual vertebrae of a patient; and   at least one marker configured to be attached to the patient,   wherein the at least one computing system is configured to register the two or more images of the individual vertebrae in a common coordinate system,   wherein the at least one computing system is configured to register the at least one markers in the common coordinate system,   wherein the at least one computing system-is configured to generate a stereoscopic display by the optical see-through head mounted display based on the two or more images of the individual vertebrae,   wherein the at least one computing system is configured to track movement from a first position to a second position of the physical spine during surgery by tracking the position of the at least one markers,   wherein the at least one computing system is configured to track the location and orientation of the optical see-through head mounted display in the common coordinate system,   wherein the at least one computing system is configured to superimpose the stereoscopic display of the two or more images of the individual vertebrae on corresponding individual vertebrae of the physical spine visible directly through the stereoscopic optical see-through head mounted display,   wherein the at least one computing system is configured to adjust in real time the stereoscopic display of the two or more images of the individual vertebrae based on the location and orientation of the optical see-through head mounted display,   wherein the at least one computing system is configured to adjust in real time the stereoscopic display of the two or more images of the individual vertebrae based on the tracked movement from the first position to the second position of the physical spine, and   wherein the first and second positions of the physical spine of the patient are different.   
     
     
         20 . A system comprising:
 a stereoscopic optical see-through head mounted display;   at least one computing system configured to receive preoperative, intraoperative, or preoperative and intraoperative image information from two or more images of two or more individual vertebrae of a patient for stereoscopic display by the optical see-through head mounted display; and   at least two markers configured to be attached to the patient,   wherein the at least one computing system is configured to register the two or more images of the two or more individual vertebrae in a common coordinate system,   wherein the at least one computing system is configured to register the at least two markers in the common coordinate system,   wherein the at least one computing system is configured to generate a stereoscopic display by the optical see-through head mounted display based on the two or more images of the two or more individual vertebrae,   wherein the at least one computing system is configured to track movement from a first position to a second position of two or more individual vertebrae of the physical spine during surgery by tracking the position of the at least two markers,   wherein the at least one computing system is configured to track the location and orientation of the optical see-through head mounted display in the common coordinate system,   wherein the at least one computing system is configured to superimpose the stereoscopic display of the two or more images of the two or more individual vertebrae on the corresponding individual vertebrae of the physical spine visible directly through the stereoscopic optical see-through head mounted display,   wherein the at least one computing system is configured to adjust in real time the stereoscopic display based on the location and orientation of the optical see-through head mounted display,   wherein the at least one computing system is configured to adjust in real time the stereoscopic display of the two or more images of the two or more individual vertebrae based on the tracked movement from the first position to the second position of the corresponding individual vertebrae of the physical spine,   and   wherein the first and second positions of the physical spine of the patient are different.   
     
     
         21 . The system of  claim 1 , wherein the image information comprises a 2D image of the spine of the patient. 
     
     
         22 . The system of  claim 21 , wherein the 2D image of the spine of the patient comprises a CT image, an MRI image, an ultrasound image, an x-ray image or combinations thereof. 
     
     
         23 . The system of  claim 1 , wherein the image information comprises is a 3D image of the spine of the patient. 
     
     
         24 . The system of  claim 23 , wherein the 3D image of the spine is generated using a CT image, an MRI image, an ultrasound image, an x-ray image or combinations thereof. 
     
     
         25 . The system of  claim 1 , wherein the tracked movement from the first position to the second position of the physical spine during surgery is a rotation of one or more vertebrae. 
     
     
         26 . The system of  claim 1 , wherein the tracked movement from the first position to the second position of the physical spine during surgery is a lateralization of one or more vertebrae. 
     
     
         27 . The system of  claim 1 , wherein the tracked movement from the first position to the second position of the physical spine during surgery is a change in sagittal position of one or more vertebrae. 
     
     
         28 . The system of  claim 1 , wherein the at least one marker is configured to be attached to an exposed portion of the physical spine. 
     
     
         29 . The system of  claim 1 , wherein the intraoperative image information is obtained using a CT scan. 
     
     
         30 . The system of  claim 1 , wherein the at least one computing system comprises the computing system configured to receive preoperative, intraoperative or preoperative and intraoperative image information from the patient, the computing system configured to register the image information of the physical spine in a common coordinate system, the computing system configured to register the at least one-marker in the common coordinate system, the computing system configured to generate a stereoscopic display by the optical see-through head mounted display based on the image of the spine, the computing system configured to track movement from a first position to a second position of the physical spine during surgery, the computing system configured to track the location and orientation of the optical see-through head mounted display in the common coordinate system, the computing system configured to adjust in real time the stereoscopic display based on the location and orientation of the optical see-through head mounted display, the computing system configured to adjust in real time the stereoscopic display based on the tracked movement from the first position to the second position of the physical spine, the computing system configured to superimpose the stereoscopic display on the target portion of the physical spine visible directly through the stereoscopic optical see-through head mounted display, and wherein one or more of the at least one computing system are the same. 
     
     
         31 . The system of  claim 1 , wherein the at least one computing system comprises the computing system configured to receive preoperative, intraoperative or preoperative and intraoperative image information from the patient, the computing system configured to register the image information of the physical spine in a common coordinate system, the computing system configured to register the at least one-marker in the common coordinate system, the computing system configured to generate a stereoscopic display by the optical see-through head mounted display based on the image of the spine, the computing system configured to track movement from a first position to a second position of the physical spine during surgery, the computing system configured to track the location and orientation of the optical see-through head mounted display in the common coordinate system, the computing system configured to adjust in real time the stereoscopic display based on the location and orientation of the optical see-through head mounted display, the computing system configured to adjust in real time the stereoscopic display based on the tracked movement from the first position to the second position of the physical spine, the computing system configured to superimpose the stereoscopic display on the target portion of the physical spine visible directly through the stereoscopic optical see-through head mounted display, and wherein one or more of the at least one computing system are different. 
     
     
         32 . The system of  claim 19 , wherein the at least one computing system is configured to reconstruct one or more preoperative, intraoperative or preoperative and intraoperative two-dimensional images into three-dimensional images using 2D to 3D reconstruction. 
     
     
         33 . The system of  claim 19 , wherein the at least one computing system is configured to track movement from the first position to the second position of the physical spine by tracking the position of the at least one marker in real time. 
     
     
         34 . The system of  claim 19 , wherein the at least one computing system is configured to compare tracking data of one or more instruments and/or one or more devices to the tracked position of the physical spine during surgery in real time. 
     
     
         35 . The system of  claim 19 , wherein the at least one computing system is configured to track the location and/or orientation of one or more instruments, one or more devices, the physical spine, the surgeon, the optical see-through head mounted display or combinations thereof in real time. 
     
     
         36 . The system of  claim 19 , wherein the image information of the two or more images of individual vertebrae is registered with one or more structures of the physical spine using a navigation system. 
     
     
         37 . The system of  claim 19 , wherein the at least one computing system is configured to provide for adjustment of transparency, color and contrast of the stereoscopic display displayed by the optical see-through head mounted display superimposed on the physical spine. 
     
     
         38 . The system of  claim 19 , wherein the at least one computing system is configured to display one or more virtual graphical representations of tracked instruments or devices by the optical see-through head mounted display superimposed on the individual vertebrae of the physical spine. 
     
     
         39 . The system of  claim 19 , wherein the at least one computing system is configured to track pose changes of the individual vertebrae in the common coordinate system and wherein the pose changes are translated into display of a different second stereoscopic display at a location and orientation that corresponds to the location and orientation of the individual vertebrae of the spine of the patient after the pose changes. 
     
     
         40 . The system of  claim 35 , wherein the tracking of the one or more instruments, one or more devices, the physical spine, the surgeon, the optical see-through head mounted display or combinations thereof is performed using at least one attached passive optical marker, active optical marker, and/or at least one of magnetic tracking, electromagnetic tracking, ultrasonic tracking, mechanical tracking, tracking using inertial measurement units and 3D scanners. 
     
     
         41 . The system of  claim 19 , wherein the optical see-through head mounted display is configured to display at least one of a graphical representation of one or more instruments, surgical guides or techniques, or anatomical models superimposed on the physical spine. 
     
     
         42 . The system of  claim 19 , wherein the two or more images comprise at least one 2D image of the individual vertebrae of the patient. 
     
     
         43 . The system of  claim 42 , wherein the 2D image of the spine of the patient comprises a CT image, an MRI image, an ultrasound image, an x-ray image, or combinations thereof. 
     
     
         44 . The system of  claim 19 , wherein the two or more images comprise at least one 3D image of the spine of the patient. 
     
     
         45 . The system of  claim 44 , wherein the 3D image of the spine is generated using a CT image, an MRI image, an ultrasound image, an x-ray image, or combinations thereof. 
     
     
         46 . The system of  claim 19 , wherein the tracked movement from the first position to the second position of the physical spine during surgery is a rotation of one or more vertebrae. 
     
     
         47 . The system of  claim 19 , wherein the tracked movement from the first position to the second position of the physical spine during surgery is a lateralization of one or more vertebrae. 
     
     
         48 . The system of  claim 19 , wherein the tracked movement from the first position to the second position of the physical spine during surgery is a change in sagittal position of one or more vertebrae. 
     
     
         49 . The system of  claim 19 , wherein the at least one marker is configured to be attached to an exposed portion of the physical spine. 
     
     
         50 . The system of  claim 19 , wherein the intraoperative image information is obtained from the patient using a CT scan. 
     
     
         51 . The system of  claim 19 , wherein the at least one computing system comprises the computing system configured to receive preoperative, intraoperative, or preoperative and intraoperative image information from two or more images of individual vertebrae of the patient, the computing system configured to register the two or more images of the individual vertebrae in the common coordinate system, the computing system configured to register the at least one marker in the common coordinate system, the computing system configured to generate the stereoscopic display by the optical see-through head mounted display based on the two or more images of the individual vertebrae, the computing system configured to track movement from a first position to a second position of the physical spine during surgery by tracking the position of the at least one marker, the computing system configured to track the location and orientation of the optical see-through head mounted display in the common coordinate system, the computing system configured to adjust in real time the stereoscopic display of the two or more images of the individual vertebrae based on the location and orientation of the optical see-through head mounted display, the computing system configured to adjust in real time the stereoscopic display of the two or more images of the individual vertebrae based on the tracked movement from the first position to the second position of the physical spine, the computing system configured to superimpose the stereoscopic display of the two or more images of the individual vertebrae on corresponding individual vertebrae of the physical spine visible directly through the stereoscopic optical see-through head mounted display, and wherein one or more of the at least one computing system are the same. 
     
     
         52 . The system  claim 19 , wherein the at least one computing system comprises the computing system configured to receive preoperative, intraoperative, or preoperative and intraoperative image information from two or more images of individual vertebrae of the patient, the computing system configured to register the two or more images of the individual vertebrae in the common coordinate system, the computing system configured to register the at least one marker in the common coordinate system, the computing system configured to generate the stereoscopic display by the optical see-through head mounted display based on the two or more images of the individual vertebrae, the computing system configured to track movement from a first position to a second position of the physical spine during surgery by tracking the position of the at least one marker, the computing system configured to track the location and orientation of the optical see-through head mounted display in the common coordinate system, the computing system configured to adjust in real time the stereoscopic display of the two or more images of the individual vertebrae based on the location and orientation of the optical see-through head mounted display, the computing system configured to adjust in real time the stereoscopic display of the two or more images of the individual vertebrae based on the tracked movement from the first position to the second position of the physical spine, the computing system configured to superimpose the stereoscopic display of the two or more images of the individual vertebrae on corresponding individual vertebrae of the physical spine visible directly through the stereoscopic optical see-through head mounted display, and wherein one or more of the at least one computing system are different. 
     
     
         53 . The system of  claim 20 , wherein the at least one computing system is configured to reconstruct one or more preoperative, intraoperative or preoperative and intraoperative two-dimensional images into three-dimensional images using 2D to 3D reconstruction. 
     
     
         54 . The system of  claim 20 , wherein the at least one computing system is configured to track movement from the first position to the second position of the two or more individual vertebrae of the physical spine during surgery by tracking the position of the at least two markers in real time. 
     
     
         55 . The system of  claim 20 , wherein the at least one computing system is configured to compare tracking data of one or more instruments and/or one or more devices to the tracked position of the two or more individual vertebrae of the physical spine during surgery in real time. 
     
     
         56 . The system of  claim 20 , wherein the at least one computing system is configured to track the location and/or orientation of one or more instruments, one or more devices, the physical spine, the surgeon, the optical see-through head mounted display in real time or combinations thereof. 
     
     
         57 . The system of  claim 20 , wherein the image information of two or more individual vertebrae of the patient is registered with one or more structures of the two or more individual vertebrae of the physical spine using a navigation system. 
     
     
         58 . The system of  claim 20 , wherein the at least one computing system is configured to provide for adjustment of transparency, color and contrast of the stereoscopic display displayed by the optical see-through head mounted display superimposed on the physical spine. 
     
     
         59 . The system of  claim 20 , wherein the at least one computing system is configured to display one or more virtual graphical representations of tracked instruments or devices by the optical see-through head mounted display superimposed on the two or more individual vertebrae. 
     
     
         60 . The system of  claim 20 , wherein the at least one computing system is configured to track pose changes of the individual vertebrae in the common coordinate system, and wherein the pose changes are translated into display of a different second stereoscopic display at a location and orientation that corresponds to the location and orientation of the individual vertebrae of the spine of the patient after the pose changes. 
     
     
         61 . The system of  claim 56 , wherein the tracking of the one or more instruments, one or more devices, the patient's spine, the surgeon, or the optical see-through head mounted display or combinations thereof is performed using at least one attached passive optical marker, active optical marker, and/or at least one of magnetic tracking, electromagnetic tracking, ultrasonic tracking, mechanical tracking, tracking using inertial measurement units and 3D scanners. 
     
     
         62 . The system of  claim 20 , wherein the optical see-through head mounted display is configured to display at least one of a graphical representation of one or more instruments, surgical guides or techniques, or anatomical models superimposed on the physical spine. 
     
     
         63 . The system of  claim 20 , wherein the two or more images comprise at least one 2D image of the individual vertebrae of the patient. 
     
     
         64 . The system of  claim 63 , wherein the 2D image of the individual vertebrae of the patient comprises a CT image, an MM image, an ultrasound image, an x-ray image or combinations thereof. 
     
     
         65 . The system of  claim 20 , wherein the two or more images of the individual vertebrae comprise at least one 3D image of the spine of the patient. 
     
     
         66 . The system of  claim 65 , wherein the 3D image of the individual vertebrae is generated using a CT image, an MRI image, an ultrasound image, an x-ray image or combinations thereof. 
     
     
         67 . The system of  claim 20 , wherein the tracked movement from the first position to the second position of the two or more individual vertebrae of the physical spine during surgery is a rotation of one or more vertebrae. 
     
     
         68 . The system of  claim 20 , wherein the tracked movement from the first position to the second position of the two or more individual vertebrae of the physical spine during surgery is a lateralization of one or more vertebrae. 
     
     
         69 . The system of  claim 20 , wherein the tracked movement from the first position to the second position of the two or more individual vertebrae of the physical spine during surgery is a change in sagittal position of one or more vertebrae. 
     
     
         70 . The system of  claim 20 , wherein the at least two markers are configured to be attached to an exposed portion of the physical spine. 
     
     
         71 . The system of  claim 20 , wherein the intraoperative image information is obtained from the patient using a CT scan. 
     
     
         72 . The system of  claim 20 , wherein the at least one computing system comprises the computing system configured to receive preoperative, intraoperative, or preoperative and intraoperative image information from two or more images of two or more individual vertebrae of a patient for stereoscopic display by the optical see-through head mounted display, the computing system configured to register the two or more images of the two or more individual vertebrae in a common coordinate system, the computing system configured to register the at least two markers in the common coordinate system, the computing system configured to generate the stereoscopic display by the optical see-through head mounted display based on the two or more images of the two or more individual vertebrae, the computing system configured to track movement from a first position to a second position of two or more individual vertebrae of the physical spine during surgery by tracking the position of the at least two markers, the computing system configured to track the location and orientation of the optical see-through head mounted display in the common coordinate system, the computing system configured to adjust in real time the stereoscopic display based on the location and orientation of the optical see-through head mounted display, the computing system configured to adjust in real time the stereoscopic display of the two or more images of the two or more individual vertebrae based on the tracked movement from the first position to the second position of the corresponding individual vertebrae of the physical spine, the computing system configured to superimpose the stereoscopic display of the two or more images of the two or more individual vertebrae on the corresponding individual vertebrae of the physical spine visible directly through the stereoscopic optical see-through head mounted display, and wherein one or more of the at least one computing system are the same. 
     
     
         73 . The system of  claim 20 , wherein the at least one computing system comprises the computing system configured to receive preoperative, intraoperative, or preoperative and intraoperative image information from two or more images of two or more individual vertebrae of a patient for stereoscopic display by the optical see-through head mounted display, the computing system configured to register the two or more images of the two or more individual vertebrae in a common coordinate system, the computing system configured to register the at least two markers in the common coordinate system, the computing system configured to generate the stereoscopic display by the optical see-through head mounted display based on the two or more images of the two or more individual vertebrae, the computing system configured to track movement from a first position to a second position of two or more individual vertebrae of the physical spine during surgery by tracking the position of the at least two markers, the computing system configured to track the location and orientation of the optical see-through head mounted display in the common coordinate system, the computing system configured to adjust in real time the stereoscopic display based on the location and orientation of the optical see-through head mounted display, the computing system configured to adjust in real time the stereoscopic display of the two or more images of the two or more individual vertebrae based on the tracked movement from the first position to the second position of the corresponding individual vertebrae of the physical spine, the computing system configured to superimpose the stereoscopic display of the two or more images of the two or more individual vertebrae on the corresponding individual vertebrae of the physical spine visible directly through the stereoscopic optical see-through head mounted display, and wherein one or more of the at least one computing system are different.