Neutar, LLC

Frederick C Haer

Ronald J Franklin

Joel I Franck

John B Clayton

Kurt R Smith

Richard D Bucholz

Kevin J Frank

Catalina J Carroll

Jaimie Henderson

Provided herein are methods and apparatuses for performing precise medical procedures. Provided are methods of providing unitary positioning interfaces for stereotactic devices or medical devices. The methods include implanting emitters in a patient, scanning the patient using any suitable scanning technique, determining orientation and location data of the emitters and any suitable anatomic structures, generating a digital image, and fabricating a solid physical model from the digital image. Also provided herein are methods of verifying medical treatments and systems for performing medical procedures.

Patient and procedure customized fixation and targeting devices for stereotactic frames

A customized surgical fixture ( ) is formed by scanning a body to form a three-dimensional image of the body, and then identifying in the image a target ( ) in the body, and mounting points or structures ( ) on the body. A model, such as a computer solid model, of the fixture ( ) is specified in accordance with the locations of the target ( ) and mounting structures ( ) or points. The fixture ( ) is formed in accordance with the model of the fixture ( ), for example using a rapid prototyping and tooling machine. When attached to the body, the fixture ( ) can be used to guide a surgical instrument ( ) into the body, for example, by using a mechanical guide ( ) attached to the fixture ( ) or using a remote sensing device ( ) that tracks the relative position of the customized fixture ( ) and the surgical instrument.

Customized surgical fixture

A method and apparatus for positioning a surgical instrument during stereotactic surgery on a body, for example, during spinal surgery or general surgery. A mounting device is attached to a bone structure of the body, for example, by attaching a rail to the spine for spinal surgery. In spinal surgery, the rail is attached to the spine by clamping the rail to two spinous processes and adjusting the separation of the two spinous processes to match the separation of the two processes in three-dimensional scanned image, thereby matching a curvature of the spine with a corresponding curvature of the spine in the image. Multiple of fiducial points are located on the body in relation to the mounting device. An adjustable guidance fixture that includes an instrument guide for guiding the surgical instrument along a constrained trajectory relative to the instrument guide is attached to the mounting device.

Instrument guidance system for spinal and other surgery

A method and apparatus for stereotactic surgery on a body, such as surgery on the brain or spine. A guidance fixture is used that includes a mounting base having a central axis, a controllable instrument drive for moving a surgical instrument along a constrained trajectory in response to a drive control signal, an actuated adjustment mechanism coupled between the mounting base and the controllable instrument drive, and a sensor system coupled to the adjustment mechanism. The mounting base of the guidance fixture is attached to the body and a location of the mounting base in a three-dimensional image of the body is determined, for example, using a remote sensing device, such as a camera, and tracking markers, such as LEDs, attached to the guidance fixture. Sensor signals encoding the orientation of the constrained trajectory and encoding a position of the surgical instrument along the constrained trajectory are generated and transmitted from the guidance fixture. An adjustment control signal is received and the orientation of the constrained trajectory relative to the mounting base is adjusted in response to the received adjustment control signal.

Instrumented and actuated guidance fixture for sterotactic surgery

A customized positioning fixture is fabricated specifically for a patient the purpose of positioning a portion, or all, of the patient's body relative to a medical apparatus. The customized positioning fixture is fabricated such that the relative position of the patent to the medical apparatus is predetermined before a procedure is performed on the patient using the apparatus. The positioning fixture is fabricated using a computer-aided or an automated computer-controlled process according to data determined for that patient, for example, using a rapid prototyping and tooling (RPT) technique. In some embodiments, the positioning fixture is designed to be repeatedly removed and reattached to the patient, thereby allowing the patient to be repeatedly precisely re-positioned in the medical device is separated sessions. A second positioning fixture can also be fabricated so that the patient can be positioned relative to a second apparatus in a way that the patient's position in the two different apparatuses is related in a desired manner.

Customizable fixture for patient positioning

A method for determining a mapping between coordinates relative to a body and corresponding coordinates in a three-dimensional image of the body in stereotactic surgery. The method includes attaching an instrumented pointing device to the body, for example, attaching the pointing device directly to a skull. The pointing device includes an arm and an instrumented joint for coupling the arm to the body and for generating a position signal encoding a position of the arm relative to the joint. The method includes positioning the arm at each of a plurality of known points on the body, each of the known points corresponding to a known location in the three-dimensional image, and generating the position signal when the arm is positioned at each of the known points. The method then includes determining from the position signals and the known locations of the points in the three-dimensional image a mapping between a coordinate system that is fixed relative to the anchor and a coordinate system of the three-dimensional image.

Movable arm locator for stereotactic surgery

A surgical fixture is formed by scanning a body to form a three-dimensional image of the body, and then identifying in the image a target point in the body, and mounting structures on the body. A model, such as a computer solid model, of the fixture is specified in accordance with the locations of the target point and mounting structures. The fixture is formed in accordance with the model of the fixture, for example using a rapid prototyping and tooling machine.

A method and apparatus for positioning a surgical instrument during stereotactic surgery using a guidance fixture. The guidance fixture includes an upper portion, which includes an instrument guide for moving the surgical instrument along a constrained trajectory relative to the upper portion, and includes an adjustable base supporting the upper portion, which includes a mounting base and an adjustment mechanism. The adjustable base can include a rotating collar attached to the mounting base and a pivoting collar coupling the rotating collar to the upper portion. A remote sensing device, such as a camera array sensing LEDs on the fixture, is used to determine the orientation of the upper portion of the guidance assembly in relation to the body.

Instrument guidance for stereotactic surgery

A method for tracking an instrument during image-guided stereotactic surgery on a body, for instance during stereotactic brain surgery. The method includes attaching multiple bone anchors to the body, attaching scanning markers to each of the bone anchors, and scanning the body to form a three-dimensional image of the body. Images of the scanning markers are formed in the three-dimensional image and the locations of the images of the scanning markers in the three-dimensional image are determined, for example, by a human operator identifying the locations on a computer display of the image. The method then involves attaching a number of sensing devices, such as cameras, or microphones, to the bone anchors. For example, a mounting rod is attached to each of the bone anchors and each mounting rod supports one of the sensing devices. The mounted sensing devices are in a predetermined geometric relationship with the bone anchors. The instrument, which includes a tracking marker, is positioned in the field of view of the sensing devices. The location of the tracking marker in relation to the bone anchors is determined using signal provided by the sensing devices, such as camera images, and using the known geometric relationship between the cameras and the bone anchors, and can be continuously displaying the location of the instrument in conjunction with a view of three-dimensional image.

Body-mounted sensing system for stereotactic surgery

A marking and tracking apparatus for stereotactic surgery on a body. The apparatus includes a rigid scanning frame. The scanning frame includes a set of scanning markers for making corresponding images in a scanned image of the body, and multiple mounting points, such that when the scanning frame is attached to the body, each of the mounting points mates with a corresponding one of multiples anchors, such as threaded inserts, embedded in the body. The apparatus can also include a rigid tracking frame. The tracking frame includes a set of tracking markers for tracking a position of the frame using a remote sensing device, and multiple mounting points, such that when the tracking frame is attached to the body, each of the mounting points mates with a corresponding one of the anchors embedded in the body.

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Brunswick, ME, United States of America

Frederick C Haer