Stereotactic Computer Assisted Surgery Method and System

Abstract

A computer assisted surgical system that includes an apparatus for imaging a region of interest of a portion of an anatomy of a subject; a memory containing executable instructions; and a processor programmed using the instructions to receive two or more two-dimensional images of the region of interest taken at different angles from the apparatus and process the two or more two-dimensional images to produce three dimensional information associated with the region of interest.

1 . A system for stereotactic surgery, comprising:
 a first implant coupled to a reference body implantable in a portion of a patient, the reference body having a plurality of fiducial markers detectable by a fluoroscopic imaging system;   a fluoroscopic imaging system;   a processor in communication with the fluoroscopic imaging system, the processor configured to:   acquire first and second two-dimensional fluoroscopic images of the reference body together with the portion of the patient;   register the first and second images using the reference body;   process the first and second images to produce a three dimensional reconstruction of the portion of the patient using a location of the fiducial markers in the reference body;   determine a position of the first implant in the portion of the patient from the first and second images;   generate a virtual representation of a second implant with the portion of the patient and the reference body before the second implant is implanted based on the three dimensional reconstruction of the portion of the patient, the first implant and the second implant having a fixed predefined spatial relationship to one another upon implantation, and   display a virtual representation of the second implant superimposed on the reconstructed portion of the patient such that the second implant is displayed as having a virtual fixed predefined spatial relationship to the first implant before the second implant is implanted, the virtual fixed predefined spatial relationship being the same as the fixed predefined spatial relationship between the first implant and the second implant upon implantation.   
     
     
         2 . The system of  claim 1 , wherein the virtual representation of the second implant superimposed on the reconstructed portion of the patient includes a location and a length of the second implant before the second implant is implanted. 
     
     
         3 . The system of  claim 2 , wherein the virtual representation of the second implant superimposed on the reconstructed portion of the patient includes virtual tick marks that indicate the length of the second implant before the second implant is implanted, the virtual tick marks being located adjacent the virtual representation of the second implant. 
     
     
         4 . The system of  claim 1 , wherein the first implant is locking nail and the second implant is a screw. 
     
     
         5 . The system of  claim 1 , wherein the first implant is an intracapsular plate and the second implant is a screw. 
     
     
         6 . The system of  claim 1 , wherein the reference body is attachable to any of the first implant, second implant and a targeting device, the reference body defining a characteristic two-dimensional projection. 
     
     
         7 . The system of  claim 1 , wherein the processor is configured to processes the first and second two-dimensional fluoroscopic images by outlining contours of a region of interest in a portion of the patient in two dimensions and creates a three dimensional object representing the region of interest. 
     
     
         8 . The system of  claim 7 , wherein the three dimensional object comprises a sphere. 
     
     
         9 . The system of  claim 8 , wherein the three dimensional object is derived from a database and based on age and gender of the patient. 
     
     
         10 . The system of  claim 7 , wherein the three dimensional object is determined based on landmarks associated with the region of interest. 
     
     
         11 . The system of  claim 1 , wherein the system is adapted for automatically detecting a status of an operation and determining next operative steps to be performed so as to provide a reactive system. 
     
     
         12 . The system of  claim 1 , wherein the system is configured to provide suggestions to a surgeon with respect to any of a specific type, a specific size, and a shape of a best-fit first and second implant based on a detected geometry of a fracture. 
     
     
         13 . The system of  claim 12 , wherein the system is adapted to modify a previous suggestion based on additional information determined during the surgery. 
     
     
         14 . A method of implanting first and second implants, the method comprising the steps of:
 positioning a first implant and a reference body in a target surgical site of a patient using fluoroscopic images taken along at least two dimensions;   generating an image showing a position of a virtual first implant and an associated virtual second implant relative to the target surgical site based on the fluoroscopic images and the position of the reference body, the virtual first implant corresponding to the first implant and the virtual second implant corresponding to a second implant;   affixing the first implant to the target surgical site using the second implant, and   performing a quality check by detecting and displaying the actual location of the first and second implants relative to their desired position.   
     
     
         15 . The method of  claim 14 , further including a step of repositioning any of the first and second implants based on the step of performing the quality check. 
     
     
         16 . The method of  claim 14 , wherein the first implant is a locking nail and the second implant is a screw. 
     
     
         17 . The method of  claim 14 , wherein the first implant is an intracapsular plate and the second implant is a screw. 
     
     
         18 . The method of  claim 14 , wherein the reference body is attachable to any of the first implant, second implant and a targeting device. 
     
     
         19 . The method of  claim 18 , wherein the reference body defines a characteristic two-dimensional projection. 
     
     
         20 . The method of  claim 18 , wherein the reference body includes fiducial markers.