CN116648207A - Power drill assembly - Google Patents

Abstract

A system and method for operating components such as a power drill assembly is disclosed. The assembly may be used to provide feedback to a user regarding a selected position and/or condition of the power drill system. The power drill system may be used to power or drive a selected tool, such as a cutting or grinding tool.

Description

Power drill assembly

Cross Reference to Related Applications

The present application claims the benefits of U.S. provisional application No. 63/129,906 (attorney docket No. 5074A-000229-US-PS 1) and U.S. provisional application No. 63/129,921 (attorney docket No. 5074A-000230-US-PS 1), and the present application claims the benefits of U.S. application No. 17/555,777 (attorney docket No. 5074A-000229-US) and U.S. patent application No. 17/556,299 (attorney docket No. 5074A-000230-US). The entire disclosures of the above applications are incorporated herein by reference.

Technical Field

The present disclosure relates to power drills and, more particularly, to a power drill assembly with selected feedback.

Background

During a selected procedure, the motor may be used to power a drill motor that moves a tool, such as a tool having a tool tip or working end. For example, the tool may be rotated at a selected speed, such as about 100 Revolutions Per Minute (RPM) to about 10,000RPM. A tool interconnected with the motor may be connected to a drive shaft configured to be powered by the motor for rotation. The rotary tool tip may then be used to perform a procedure when powered by the motor.

During a selected procedure, such as a surgical procedure, a user of the tool (e.g., a surgeon) may need to rely solely on visual cues and experience to determine the position of the tool tip. During surgery, at least one working end of the tool may be hidden from direct or complete direct view by the user. Thus, open experience may be required to properly perform the procedure.

Disclosure of Invention

This section provides a general summary of the disclosure, and is not a comprehensive disclosure of its full scope or all of its features.

A power drill may be provided to perform a procedure by a user. The power drill may be powered in any suitable manner, such as pneumatically, electrically, or other suitable power system, to rotate at a selected and/or selectable speed, including from about 100RPM to about 100,000RPM, including about 75,000RPM. The power drill may provide power to the tool to perform a procedure on a selected subject, such as a human patient or other suitable subject or non-human subject. The power drill may be driven to rotate the tool, such as for drilling, forming a skull borehole, and the like.

During surgery, the subject may have a predefined location or portion for performing surgery thereon. For example, a patient's skull may be selected to form a skull burr hole therein. The position, size, etc. of the burr hole may be predefined during the planned procedure. However, the selected surgical area or volume may also be selected during surgery. The power drill may be used to form a skull burr hole in a selected portion of the subject.

The power drill may also be used to perform other procedures. For example, power drills may be used to perform spinal procedures. In various embodiments, the spinal bone may be surgically resected for fusion and/or disc replacement.

The power drill may be used and/or controlled to provide feedback to the user during use of the instrument. The navigation system may track tools such as power drills, power saws, and/or other suitable items including motors or power systems that may be altered during their use to change parameters such as cutting speed. Alternatively and/or additionally, a sensor may be provided to sense motor power and/or stress. In addition, a sensorless motor may be provided or used, and other parameters, such as the back reaction on the motor itself, e.g., the back electromotive force (EMF) on the motor coil, may be sensed to determine motor operating properties.

The motor may be operated in selected and/or different ways to provide feedback, such as tactile feedback, to the user. Thus, the system may provide feedback to the user during operation of the power drill. The feedback may be related to the position of the tool, the type of material the tool is in contact with, etc.

Further areas of applicability will become apparent from the description provided herein. The description and specific examples in this summary are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure.

Drawings

The drawings described herein are for illustrative purposes only of selected embodiments and not all possible implementations, and are not intended to limit the scope of the present disclosure.

FIG. 1 is an environmental view of a track-type motorized assembly;

FIG. 2 is a schematic view of a portion of the spinal column as seen from two directions;

FIG. 3 is a schematic diagram of a system and selected inputs and outputs according to various embodiments;

FIG. 4 is a flow chart of the operation of a system according to various embodiments;

FIGS. 5A-5E are environmental views of the operation of a system according to various embodiments; and is also provided with

FIG. 6 is a graph illustrating operation of a system based on inputs from various sensors, according to various embodiments;

fig. 7A-7D are environmental views of the operation of a system according to various embodiments.

Corresponding reference characters indicate corresponding parts throughout the several views of the drawings.

Detailed Description

Exemplary embodiments will now be described more fully with reference to the accompanying drawings.

Fig. 1 is an environmental view of an instrument (such as power drill assembly 20) being used by a user 24 to perform a procedure on a subject (e.g., patient) 28. The power drill assembly 20 may be driven to rotate the motor and/or tool at a selected and/or selectable speed, including about 100RPM to about 100,000RPM, including about 200RPM to about 75,000RPM. In various embodiments, the power drill assembly 20 may include a power dissection tool 32 for performing selected procedures, such as forming a burr hole in the skull of the patient 28, performing a procedure on a vertebra 36, or other selected procedure. However, it should be understood that power drill assembly 20 may be used to perform other procedures, such as removing material relative to and/or in the spinal bone.

For example, power drill assembly 20 may be used to remove a portion of a spinal bone during a selected procedure, including laminectomy or other suitable spinal procedures. Further, it should be appreciated that the power drill assembly 20 may be used to perform a procedure on a non-living subject, such as drilling holes in a fuselage, automobile frame, or the like. Thus, the power drill assembly 20 need not be used with a living subject, such as a human patient.

Power drill assembly 20 may include a motorized drill that tracks and/or navigates relative to subject 28 according to various systems and/or procedures. For example, as further discussed herein, the tracking system may include a tracking device 40 that may be coupled to the power drill assembly 20 to track the position of the tool relative to the subject 28 (such as the vertebra 36). Suitable tracking systems include those disclosed in U.S. patent No. 8,842,893, which is incorporated herein by reference. It should be appreciated that image data of subject 28 may be acquired to create an image, as discussed herein. To acquire image data, the imaging system 31 may be used either before the procedure is initiated or after the procedure has been initiated, which may include operation of the power drill 20. The imaging system 31 may include an O-port sold by Medun force company (Medtronic, inc.) Imaging systems and/or may include those disclosed in U.S. Pat. nos. 7,188,998, 7,108,421, 7,106,825, 7,001,045, and 6,940,941; all of these U.S. patents are incorporated herein by reference. Other possible imaging systems may include a C-arm fluoroscopic imaging system that may also generate a three-dimensional view of the patient 28.

The tracking system may be part of a navigation system to assist in performing selected procedures, such as on a subjectThe surgical procedures performed by the trial 28 and may include those known in the art. For example, navigation systems may include those disclosed in U.S. patent nos. 5,772,594, 5,913,820, 5,592,939, 5,983,126, 7,751,865 and 8,842,893, and 9,737,235, and U.S. patent application publication No. 2004/0199072, all of which are incorporated herein by reference. Due to registration of the subject or real space position with the image space, the tracked position may be displayed on or relative to the image, as also disclosed in the above-incorporated U.S. patent and publication. In addition, the tracking system may include stepth, sold entirely by the meiton force pilot company (Medtronic Navigation, inc.) Tracking system and AxiEM ^TM And (3) a tracking system.

The tracking system may include various features such as an optical tracking system, an EM tracking system, an ultrasound tracking system, and the like. However, as shown in fig. 1, for example, the tracking system may include one or more locators that may include portions with cameras and/or antennas for receiving and/or transmitting signals for tracking. The locator may include an optical locator 50 that includes one or more cameras 54 that may detect or "view" the tracking device 40 connected to the power drill 20. The locator 50, including the camera 54, may emit selected radiation, such as infrared radiation from the emitter 58, that is reflected by one or more trackable portions 62 associated with the tracking device 40. The camera 54 may observe the trackable portion 62 and signals may be transmitted to the navigation processor unit 70. The navigation processor unit 70 may include various features, such as a Navigation Probe Interface (NPI), as further discussed herein. Navigation processor unit 70 may also include a Coil Array Controller (CAC) for various types of tracking systems. Various features, such as NPI, CAC, or other portions, may be provided as separate units from navigation processor unit 70 or as separate modules for interacting with various portions of the navigation system, as is generally known in the art.

However, the locator 50 may be in communication with the navigation processor unit 70 via a selected communication line 74. The communication line 74 may be wired or wireless communication with the navigation processor unit 70. The navigation processor unit 70 may be in communication with a selected system (such as a workstation, terminal, etc.) that includes a display system or display module 80 having a display screen 84 and one or more user inputs 88. However, it should be appreciated that the display 84 may be separate from the processor unit 70 and/or otherwise such as a projection display, a head mounted display (e.g., an augmented reality system). The user input 88 may include a keyboard, mouse, touch screen, or other tactical input. Other inputs may also include foot switches, verbal inputs, visual inputs, and the like.

The subject tracking device 98 may also be connected, such as fixed, with respect to the subject 28. In various embodiments, subject tracking device 96 may be secured to a vertebra. Typically, the subject tracking device is fixed relative to a selected portion of subject 28.

In various embodiments, alternative or additional tracking systems may be provided, such as electromagnetic tracking systems including an electromagnetic tracking array (such as coil array 100). The coil array 100 may include one or more coil elements 104 that transmit and/or receive electromagnetic signals from an Electromagnetic (EM) tracking device, such as a subject tracking device 98 associated with and/or connected to the patient 28 or a tracking device 40' connected to the power drill 20. The coil array 100 may communicate with the navigation processing unit 70 via a communication line 110 similar to the communication line 74 from the locator device 50 to the navigation processing unit 70. Further, each of the tracking devices may communicate with the navigation processing unit 70 via a selected communication line, such as communication line 114, such that the navigation processing unit 70 may be used to determine the location of the selected tracking device (including tracking device 40 and tracking device 98). It should be appreciated that one or more tracking systems may be used simultaneously and/or sequentially during a selected procedure.

Display 84 may display an image 120 of a portion of subject 28, such as an image of vertebra 36. As discussed above, the image 120 may be generated based on or by using image data acquired using the imaging system 31. Displayed relative to the image 120 and/or superimposed on the image 120 of the patient 28 may be a graphical representation, also referred to as an icon 124. Icon 124 may represent a position, such as a pose, of power drill assembly 20, which may include tool 32, relative to subject 28. The location represented may also be only a portion of the assembly 20. The position of the power drill assembly 20 or a portion thereof relative to the subject 28 may be determined by registering the power drill assembly 20 relative to the subject 28 and thereafter tracking the position of the power drill assembly 20 relative to the subject 28.

Registration may include various techniques, such as those disclosed in U.S. Pat. Nos. RE44,305, 7,697,972, 8,644,907, 8,238,631, and 8,842,893, and those disclosed in U.S. patent application publication 2004/0199072, all of which are incorporated herein by reference. Typically, the registration comprises a mapping between the subject space and the image space. This may be accomplished by identifying points in subject space (i.e., the reference portion) and identifying the same points in the image (i.e., the image reference). The mapping of the image space to the subject space may then be performed, such as by a navigation system. For example, points may be identified annually, automatically, or in a combination thereof in image data (such as in image 120).

Relevant points may be identified in a subject space such as defined by subject 28. For example, user 24 may identify the spinous processes in image 120, and instrumentation tracked by one or more tracking systems (including locators 50, 100) may be used to identify the spinous processes at vertebra 36. Once an appropriate number of points are identified in both the image space of image 120 and the subject space of subject 28, a mapping may be made between the two spaces. The mapping allows registration between a subject space defined by the subject (also referred to as a navigation space) and an image space defined by the image 120. Accordingly, the instrument or any suitable portion may be tracked using the selected tracking system, and the pose of the instrument may be identified or represented relative to the image 120 using the graphical representation 124.

As discussed above, registration of the power drill assembly 20 with respect to the subject 28, such as with or with respect to the subject tracking device 98, may be performed at selected points in the procedure. The image 120 may then be displayed on the display screen 84, and the tracked position of the power drill assembly 20 may be displayed as an icon 124 relative to the image 120. An icon 124 may be superimposed on the image 120 to display the pose of at least a selected portion of the power drill assembly 20, such as the distal end of the tool 32 powered by the power drill assembly 20. The pose may include a position with three spatial degrees of freedom (e.g., including at least one of XYZ positions) and a selected number (e.g., three) of degrees of freedom orientation information positions (e.g., including at least one of yaw, pitch, and roll orientations). The pose may be determined and/or calculated by the navigation processing unit 70 and communicated to the display device 80 via a selected communication line, such as the communication line 130. The communication line 130 may be a wired or wireless or other suitable communication line. Further, it should be appreciated that the navigation processor unit 70 may include various features such as a selected processor (e.g., an Application Specific Integrated Circuit (ASIC), a general purpose processor, etc.). The navigation processor unit 70 may also include a memory system (e.g., a non-transitory memory system including a rotating hard disk, non-volatile solid state memory, etc.) that includes selected instructions, such as instructions to perform tracking, registration, overlaying the icons 124 on the image 120, etc. Thus, the determined pose of power drill assembly 20 (e.g., selected portions of power drill assembly 20, as further discussed herein) may be displayed relative to subject 28 by icon 124 associated with image 120. User 24 may then be able to view display 84 to view and/or understand the particular pose of selected portions of power drill assembly 20 relative to subject 28 by viewing display 84.

In various embodiments, power drill assembly 20 may include various components, which may include motor housing 140 of motor assembly or component 143 (fig. 5A). The drilling tool 20 may include suitable motor components, such as LEGEND sold by Medun force companyAnd/or LEGEND EHS->A motor system. The motor component may comprise a power motor such as a pneumatic motor, such as LEGEND +.>A motor, but an electric motor LEGEND EHS, for example, may also be usedA motor, or other power motor or drive.

The motor assembly may have power and/or other signals transmitted to and/or from the motor assembly via a line 114 that is connected to a controller 144 that may also include a power source. The controller 144 may be any suitable controller 144, such as those sold by the Medun force companyAn integrated power system. However, it should be appreciated that the motor component may be any suitable motor assembly, such as a motor assembly powered by an electronic power source or other suitable power source. Accordingly, the pneumatic drilling tool is not intended to limit the present disclosure or pending claims. Further, motor components may include those disclosed in U.S. patent No. 7,011,661 or 7,001,391, which are incorporated herein by reference.

As discussed above, surgery may be performed on subject 28. The procedure performed on subject 28 may be performed using a drill assembly 20 having an instrument tool 32 extending therefrom. As discussed above, drill assembly 20 may be navigated relative to subject 28. In various implementations, image guided procedures or image guided navigation may occur. Accordingly, the image 120 on the display screen 84 may include an imaged portion of the subject 28. For example, as shown in FIG. 2, a medial-to-lateral (ML) (or vice versa) image portion 120a and a front-to-rear (AP) (or vice versa) image view 120b may be shown as image 120 on display screen 84. Accordingly, the image 120 may include various portions, such as a first or ML view 120a and a second or AP view 120b. However, it should be understood that additional views or images may also be viewed for various purposes, such as from bottom to top or at selected angles relative thereto.

In various embodiments, a portion of the image may be segmented for various purposes, such as planning a selected procedure. As discussed above, the drill assembly 20 may include a tool 32 for performing procedures such as laminectomy, spinal decompression, interbody fusion, or other selected procedures on the subject 28. The procedure may include moving tool 32 to remove selected portions of subject 28, such as selected portions of the anatomy of vertebra 36. As shown in fig. 2, the vertebrae 36 can include a first vertebra 36 and a second vertebra 36a. The spinal bone may include various portions, such as the facet joint 150 or edges thereof, including the spinous process 154. The vertebrae 36 can include portions included on each vertebra, such as facet joints 150, spinous processes 154, and transverse processes 158. In various embodiments, facet joints (facet/facet joint) 150 may be resected a selected amount to perform a selected procedure, as described above. However, during surgery, only the portion of tool 32 that contacts vertebra 36, such as at facet joint 150, may be selected. The vertebra 36 is typically formed of bone material and may be resected by tool 32.

Non-bone tissue or soft tissue may be adjacent or near the vertebra 36. For example, the subject's spinal cord 162 may extend through a plurality of vertebrae 36. In addition, various nerves or nerve roots 166 may extend from the spinal cord 162. The spinal cord 162 and its various nerve portions may generally be selected not to be resected during a selected procedure. In addition, one or more intervertebral discs 168 may be formed between the various vertebrae 36.

The image 120 may be segmented to segment various portions, such as the spinal portion 36, the spinal cord 162, and/or the nerve root 166. For example, as shown in fig. 2, a vertebra may be segmented into vertebrae or bone portions, and the graphical representation thereof may include illustration thereof with small dashed lines, selected colors, and the like. Soft tissue or any suitable portion (including the spinal cord 162) may be segmented and shown in large dashed lines, selected colors, etc. It should be appreciated that any suitable identification may be made, such as color, line thickness, etc. It should also be appreciated that no particular visual representation of the segmentation need be made.

Furthermore, the segmentation of the image 120 may be formed in any suitable manner, such as automatically, manually, or with manual input and thereafter automatically. For example, the user 24 may select a region or area (e.g., pixel, voxel, region, etc.), and a system such as the navigation processor 70 may execute the selected instructions to segment the image 120. It should be appreciated that any suitable type of processing unit may be used in addition to or in combination with the navigation processing unit 70. Therefore, it is not necessary to perform various imaging processes such as segmentation with the navigation processing unit 70. However, it will be appreciated that the processing unit may generally be a general purpose processor and be capable of executing selected instructions for performing various tasks from the storage medium.

The image 120, whether segmented or not, may be used to identify a plan for performing a procedure. In general, the plan may include various features or portions, such as a plan area or volume 174. The plan 174 may include a track, volume, or other portion that may be resected with the tool 32. Further, planning may include achieving a selected ablation and/or a path of an amount of ablation. The plan may also include areas to avoid or warn. For example, the spinal cord 162 may be identified as an area or region that is not in contact with, penetrated by, or accessed by the instrument 32.

A system such as one including navigation processor 70 may automatically identify selected regions to be identified as avoided regions or volumes. Thus, the system may automatically segment and identify the spinal cord 162. In addition, however, user 24 may additionally or alternatively identify segmented regions in image 120. Moreover, various regions to avoid may be identified in image 120 and saved for later access, such as during a procedure in which tool 32 is moved relative to subject 28.

In or with the images, regions to be avoided and/or regions for performing surgery may be identified in subject 28. The first instrument being tracked may be utilized to identify the region to avoid. For example, a tracking/navigation pointer probe may be tracked to identify a volume in a subject space of subject 28, such as with respect to vertebra 36. User 24 may move the tracking instrument to identify the region to avoid and/or the region on which to perform the procedure or for performing the procedure at a first time. In addition, these regions may then be saved and recalled at a second time, such as after saving them, and during the procedure for providing the selected feedback to the user 24.

Thus, during a selected procedure, a system such as a navigation system may be used to determine or provide feedback to user 24 of the position of tool 32 relative to a selected predefined or saved region (such as a region or volume to avoid). Further, as discussed above, the controller 144 for the power drill 24 may also provide selected feedback and/or receive signals from the power drill 20, and provide feedback based on saved and identified zones that may be identified in the image 120 and/or in the subject 28. Further, the saved area may be saved in a selected memory system, such as a memory system included in the navigation processing unit 70. The controller 144 of the power drill 20 may communicate with the processing unit 70 via a selected communication line, such as communication line 190. As discussed above, the communication line 190 may be of any suitable type, such as a wired, wireless, or a combination thereof communication channel. Accordingly, the navigation processing unit 70 may be in communication with the controller 144 for providing signals regarding the tracked or navigated position of the power drill 20 and/or signals from sensors associated with the power drill assembly 20.

With continued reference to fig. 1 and with additional reference to fig. 3, the drill assembly or instrument assembly 20 may be controlled by the drill controller 144, as discussed above. The drill controller 144 may include a processor module that may receive various inputs, such as input 200. As discussed further herein, the input 200 may be processed according to selected instructions to provide selected outputs to the user 24 and/or for operation of the drill assembly 20. It should be appreciated that the drill assembly 20 is an exemplary instrument and is discussed herein as an example of the operation of a selected instrument, other instruments may include a power saw or the like. However, as discussed above, the drill assembly 20 may have a drill motor to rotate the tool 32 to perform a selected procedure. As discussed above, the selected procedure may include resecting or removing a selected bone portion, such as a facet joint of vertebra 36. Accordingly, the following discussion illustratively describes the use of the drill assembly 20 controlled by the drill controller 144, which may be in communication with the navigation processing unit 70, to remove a portion or all of the facet joints 150 of the vertebra 36.

Generally, as discussed above, the selected input may be provided to the drill controller 144. Also as discussed above, the drill controller 144 may include a selected processor and/or controller to control the operation of the drill assembly 20. However, it should be understood that the navigation processing unit 70 may also be used to control the drill assembly 20, and the controller 144 may simply enable communication of selected inputs and/or outputs with the drill 20. However, the input 200 may provide an input to the controller 144 to control the drill assembly 20.

As discussed above, the identified region or area or volume to avoid may be identified as avoidance space or volume 210. The avoidance space may also include an alert zone. For example, the avoidance space may include the direct boundaries of the spinal cord 162 and the alert zone may be a distance from the spinal cord, such as 1 millimeter (mm), including about 0.5mm to about 2mm, and the like. The avoidance space may be saved and invoked, such as by navigation processing unit 70. The avoidance space or guard zone may be selected or determined to have a selected distance that may vary depending on the direction of approach and/or pose of the instrument during or at approach. For example, an anterior approach to an anatomical feature may include a 1mm avoidance space, and a posterior approach may include a 3mm avoidance space. Thus, the avoidance space relative to cc may vary depending on the direction of approach to the feature. As discussed herein, navigation may be utilized to determine the approach direction and/or pose of an instrument. Accordingly, these inputs may be provided to the controller 144 for controlling the drill assembly 20. In addition, tracking or navigation data 70i from the navigation processing unit 70 may also be input by the controller 144 during a selected procedure. The navigation data may include a determination of the pose of the drill assembly 20 and/or the tool 32 and/or the tool tip 32 t. The tool tip 32t may include a working end or distal end of the tool 32, and may be any suitable tool tip. For example, the tool tip 32t may be a drill, tap, burr, or other suitable tool tip.

In addition to the identification of navigational data 70i and avoidance space 210 from navigation processor 70 as inputs, other selected sensors may be provided to provide information regarding the operation of drill assembly 20. For example, motor sensor 220 may be included in drill assembly 20. The motor sensor 220 may comprise any suitable type of sensor and may comprise a motor position sensor, including or configured to determine a reverse voltage or EMF, etc. from a motor of the drill assembly. In various embodiments, the motor sensor 220 may include a voltage sensor for reverse voltage or a speed sensor for actual speed of the tool 32 relative to the input voltage and/or a selected input speed of the tool 32. Thus, the sensor 220 and/or signals associated therewith may provide information regarding the speed of the tool 32 relative to the selected input speed.

Additional tools or tool tip sensors 230 may also be provided. The tool tip sensor 230 may include an electrical sensor or continuity sensor 234 (see fig. 7A-7D). The electrical sensor 234, which is one of the sensors 230, may be any suitable sensor for a nerve integrity monitoring system to sense continuity or electrical signals transmitted through or through a selected nerve, such as the spinal cord 162. The electrical sensor 234 may be part of a Nerve Integrity Monitoring System (NIMS) and may provide input regarding proximity to the spinal cord 162 or other suitable nerve in the sensing. Suitable NIMS may include those sold by meiton force corporation Nerve monitoring systems, such as NIM 3.0 nerve monitor, NIM-, sold entirely by the company meiton>3.0 and NIM->3.0 monitoring system. In addition, the sensors 230 may also include vibration, sound, or ultrasonic sensors that may sense vibrations at or near the tool tip 32t, the tool 32, or other locations relative to the tool 32. According to various embodiments, the sensor 230 may also provide an indication of vibration and/or sound, force, and other parameters sensed near or at the working end 32t of the tool 32. Furthermore, more than one sensor may be provided, or several sensors may be integrated into a single unit.

All of the input information 200 may be provided to the controller 144. In addition, user 24 may enter various parameters 240. The selected operating parameters may include parameters such as selected feedback to the user 24, operation of the drill assembly 20, or other suitable feedback or notification to the user. Further, the parameters may include a distance from avoidance space 210 to provide feedback and/or other operation of drill assembly 20.

Selected determinations and/or feedback or control may be made based on the drill controller 144 of the input 200 and selected operating parameters 240. In general, the drill controller 144 may determine the proximity at block 250, determine the kinematics of the tool assembly 20 and/or the tool 32 at block 260, and determine the contact at block 270. The determination of the proximity 250 may be based on selected information, such as navigation information or input 70i from a tracking system including a navigation component or processing unit 70. The determination kinematics in block 260 may also be based at least in part on navigation data 70i, which may be used to determine the speed, direction, etc. of movement of the drill assembly 20 and/or tool 32. Further, the determined contact in block 270 may be determined or correct whether the tool 32 (including the tool tip 32 t) is contacting a selected portion of the anatomy (including a selected bone portion). The determinations determined by the drill controller 144 shown in fig. 3, discussed further herein, are merely exemplary illustrations of the determination or operation of the system.

However, the determination of the drill controller 144 may further include determining the drill operating parameters in block 280. The determined drilling parameters in block 280 may include selected operating parameters of the drilling assembly 20, as discussed further herein. The operating parameters determined in block 280 may then be used to optionally notify the user in block 284. Informing user 24 in block 284 may include visual indications, audio or audible signals on display 84, or other suitable feedback, such as providing haptic feedback using a haptic engine in drill assembly 20. Thus, feedback separate from drilling tool 20 may be provided to user 24, such as with display 84.

In block 290, the drill controller 144 may also control the drill 20 according to the determined parameters. For example, the drill controller 144 may control the drill assembly 20, such as a motor of the drill assembly 20, in a selected manner as determined in the operating parameters from block 280. As discussed further herein, operation of the drill motor may include rotating the drill motor and associated tool 32 at a selected speed, oscillating the tool 32 at a selected amount and/or a selected speed, and/or stopping operation of the drill motor on the tool 32. Feedback may also be provided to user 24 based on the operation of instrument assembly 20 controlled by controller 144. Accordingly, notification to user 24 may also be based on operation of drill assembly 20 and related operation of tool 32.

The selected input 200 may be used to make a selected determination in a drill controller for operation of the drill assembly 20. The drill assembly 20 may then be operated based on the output from the drill controller 144 to control the operation of the motor of the drill assembly 20 and thus the operation of the tool 32.

The controller, including the drill controller 144, may receive various inputs, such as inputs from the user 24 and/or from various sensors, as discussed above. With continued reference to fig. 1 and 2 and further reference to fig. 4-7D, operation of the instrument 20, which may include a drill motor, will be discussed. It should be understood that the discussion herein is in terms of various embodiments, and that various disclosed features and inputs may be combined as appropriate and/or used for operation of instrument 20 without selected inputs. All of the various sensors and inputs are discussed herein for the sake of completeness of the present discussion, and it will be understood by those skilled in the art that the various inputs and sensors may not be provided for operation of the instrument 20 with the controller 144.

Referring first to FIG. 4, a process or method 310 is shown. Process 310 may be performed by a processor, such as by processor system 70 and/or a processor included in drilling tool controller 144. The processor may be designed as a general purpose processor that executes specific instructions and/or that is used to execute specific instructions that are saved and called from the memory system. However, process 310 may be used to facilitate operation of drill assembly 20 for controlling tool 32 and/or informing user 24, as discussed further herein.

Generally, process 310 begins at start block 320. Process 310 may then define or invoke the avoidance space in block 324. As discussed above, the avoidance space may be identified by user 24, invoked according to a predetermined limit or selection, or other suitable mechanism. As discussed above, in various embodiments, the image data and the image may be segmented. The user 24 may then identify various portions of the segmented image and/or assist in segmentation. For example, the user 34 may identify the spinal cord 162 and/or other portions, such as roots or nerves 166 extending from the spinal cord. These portions may be visually identified in image 120 and/or in a navigational space relative to subject 28.

Definition or invocation of avoidance space may be used to determine operation of drilling tool 20, as discussed further herein. The system may also define or invoke instrument operating parameters in block 328. The instrument operating parameters may include operation of the drill motor 20 for operating the tool 32. In various embodiments, the tool 32 may be rotated continuously in a single direction, such as about the axis 420. Typically, the tool 32 may be rotated about its axis or rotated about its axis at a selected speed. Thus, the selection of successive rotations and speeds may be determined and invoked based on various inputs, as further discussed herein.

Alternatively, the tool 32 may be oscillated. That is, the tool will rotate a selected amount in a first direction, then stop, and then rotate in the other direction. For example, the tool 32 may be rotated about 90 degrees in a first direction from the starting point, then stopped, and rotated a selected amount, such as about 90 degrees to about 180 degrees in the direction from which it was originally derived. Tool 32 may then be operated or controlled to continue oscillating about its axis a selected amount, such as about 90 degrees to about 180 degrees. It should also be appreciated that the amount of oscillation may be varied and/or selected within a selected range of oscillation, such as from about 1 degree to about 1500 degrees, including from about 30 degrees to about 240 degrees, and the like. In various embodiments, the amount of oscillation may include a full rotation, such as one or even two full rotations (360 degrees or 720 degrees) in one direction, and then a selected (such as the same) amount in the opposite direction. The amount of oscillation may be selected for various purposes in order to reduce the drilling or material removal rate (e.g., moving, drilling, or moving through bone). Oscillation may also reduce the likelihood and/or amount of tissue encapsulation, particularly as compared to continuous one-way rotation. In addition, the oscillation speed may be selected and used for operation of tool 32. Further, the tool 32 may be stopped and/or started in order to start or stop any other parameter of the drill motor 20 used to operate the tool 32. As discussed further herein, instrument operating parameters may be selected by the user 24 based on or for when certain conditions are met. Accordingly, user 24 may select inputs for parameters for operating drilling tool 20 in block 240. In various embodiments, the motor controller 144 may include preset or default parameters selectable by the user 24 and/or a menu of operating parameters selectable by the user 24. However, in various embodiments, the parameters may be entirely customized by the user 24 for various purposes.

The definition or invocation of the avoidance space in block 324 and the definition or invocation of the instrument operation in block 328 may be based on an initial operation or "setting" of the operation of drilling tool 20 and may be understood as a preparation or invocation of stage block 332. Then, in operation block 340, the operation of the drilling tool 20 may be performed by the motor controller 144. Operation block 340 may include operating drilling tool 20 according to parameters and receiving input to determine which parameters apply to the drilling operation of the drilling tool and associated tool 32.

In operation block 340, the motor controller 144 may receive input regarding the instrument 20 and/or the tool 32 in block 344. As discussed above, receiving input may include input from block 200. Thus, the input may include the predetermined avoidance space in block 210 that may be invoked in block 324 and/or the navigation data in block 70 i. Other inputs may include an attachment or tool sensor in block 230 and a motor sensor in block 220. Regardless of the operation of the drilling tool 20 based on the input received in block 344, the operation of the drilling tool 20 may be changed or selected when the user 24 has selected to power on or power the drilling tool 20. Accordingly, the operations in block 340 may be performed after the user 24 has selected to operate or power the drilling tool 20.

Based on the received input or after receiving the input in block 344, the operating parameter inputs in block 332 may be compared. The operating parameters may include avoidance spaces and guard zones as discussed above, which are related to the operation of the drill motors and tools in block 324 and in block 328. Comparing the received inputs to the operating parameters may be determining whether the tool 32 is near or in avoidance space, determining whether the drilling tool is in full rotation or oscillation mode, and/or other comparisons. As further discussed herein, for example, tool 32 may operate at a selected distance from the avoidance space at full rotation and at a second distance (e.g., guard zone) relative to the avoidance space at oscillating operation. Thus, the comparison of the input received in block 348 with the operating parameters from block 332 may be performed in block 348. After the comparison in block 348, the operation of the drilling tool 20 may be determined in block 352. As discussed above, operation of drilling tool 20 may be based on selected inputs relative to or in comparison to defined parameters or other rotations, as discussed above. Drilling tool 20 may be determined to operate at full rotation, oscillation, or other suitable operating parameters as defined in block 328.

After the drilling tool operation is determined in block 352, a comparison of the determined operation to the current operation is made in block 358. The current operation may be a selected operation of the drilling tool, such as a full rotation due to a previous input in the comparison. In various embodiments, the frequency update or check input may be selected, such as once per second, ten times per second, once per millisecond, or any suitable rate. Furthermore, the update rate may be changed based on the speed of the drilling tool, such as based on a rotational speed and/or a travel speed determined by navigation. However, the determined operation block 352 may be compared to the current operation in block 358.

Following the comparison in block 358, a determination may be made in block 362 as to whether the operation of the drilling tool needs to be changed. For example, if the comparison in block 358 finds a match between the determined operation and the current operation (determination block 362), then a determination is made that no change is required and a "no" path 366 may be followed. However, if the comparison in block 358 finds that there is no match between the determined operation and the current operation, the determination in block 362 may be that the operation of the drilling tool does need to be changed and follows the "yes" path 370.

In operation, a determination may be made in block 362 by executing selected instructions and/or algorithms. In various embodiments, physical properties regarding motion and pose of the instrument may be considered and/or machine learning algorithms may be used to integrate several data sources and inputs to make the determination. Various conditions may be detected via multiple sensors and using machine learning to determine shave and bone penetration. Thus, multiple data streams from the input or sensor 200 may be used and/or used to determine drill operation. The navigation data 70i includes both tracking data (e.g., current and recent tool positions and orientations) and imaging data (e.g., relative to and tools within the patient anatomy). One example is to use the navigation data 70i to determine kinematics via a physics-based algorithm 260 and to use the navigation data 70i and avoidance space 210 data to determine proximity 250 via a physics and/or machine learning based algorithm. Further, all of these and system parameters 240 may be used to determine drilling tool parameters via optimization and/or machine learning based algorithms 280. In addition, the use of navigation data 70i and motor sensing 220 and/or other sensing data 230 may be used to determine contact 270 via physical, statistical, or machine learning algorithms. Further, as such, all of these and system parameters may be used to determine the drilling tool parameters 280 via optimization or machine learning algorithms.

Thus, if the "no" path 366 is followed, a determination may be made in block 374 as to whether a close signal is received. If a shut down signal is not received (i.e., operation of the drilling tool 20 is stopped), a "no" path 378 may be followed to again receive input in block 344. Thus, operation of the drilling tool may be cycled until a shut-off signal is received as determined at block 374. Thus, if the received shut down signal is received in block 374, the "yes" path 382 may be followed and the operation of the drilling tool may be stopped or the drilling tool may be shut down in block 386.

As discussed above, the determination block 362 may be that the determined operation does not match the current operation. Thereafter, a "yes" path 370 may be followed. While following the yes path 370, the user 24 may optionally be notified that the operation of the drilling tool 20 will change in block 390. Informing user 24 that the operation of drilling tool 20 will change may be a visual indication (such as displayed on display screen 84), an audible notification, a tactile or haptic feedback, or other suitable notification. The notification user in block 390 may identify or indicate to user 24 that the operation of drilling tool 20 is to be changed at a selected time, such as immediately, after a selected period of time, and the like.

The operation of the instrument or drill may then be changed in block 394. As discussed above, drilling tool 20 may be selected or operated according to selected operating parameters, such as those invoked in block 328. Accordingly, if it is determined that the determined operation does not match the comparison of the current operation, the "yes" path 370 may cause the instrument operation to be changed in block 394. In various embodiments, as further discussed herein, the change in operation may be from full rotation to oscillation, a change in speed (e.g., an increase or decrease in speed), or other change in operation of the instrument or drill in block 394. After altering the operation of the drilling tool in block 394, the operational procedure 340 may again loop to receive input in block 344.

Thus, the drilling tool 20 may be operated in a generally cyclical manner according to process 340 until a signal to shut down the drilling tool is received. The signal may be a manual signal from the user 24, such as generated using a foot switch, a manual switch, or other suitable switch. Other shut-off signals may also include shut-off signals that cease operation of the drilling tool after a selected period of time, a selected distance of travel, etc.

With continued reference to fig. 3 and 4 and with additional reference to fig. 5A, 5B, 5C, 5D, and 5E, in various embodiments, the drilling tool 20 may be operated to operate or move a tool 32 (such as a tip 32t of the tool) relative to various portions of the subject 28 (such as the vertebra 36). The drilling tool 20 or any suitable portion of the instrument 20 may be held by the user 24. However, it should be understood that the drilling tool 20 may also be held or positioned with a selected mechanism, such as a robotic system (e.g., mazor X Stealth sold by Medun force Co., ltd.) A robotic-assisted surgery system) that may hold, control, and/or move the drilling tool 20 in a selected direction, e.g., generally axially along the axis 400 of the tool 32. However, the tool 32 (such as with the drill 20) may also be held with a substantially rigid member or the like for manipulating or moving or holding the tool 32. As discussed herein, the tool 32 may rotate about the axis 400 (and/or a line substantially parallel to the axis) and/or oscillate about the axis 400 (and/or a line substantially parallel to the axis).

As discussed above, tool 32 may be operated according to selected operating parameters for performing selected procedures. For example, the tool 32 may include a tool tip that may be used to remove a selected portion of the vertebra 36, such as a portion or all of the facet joint 150. The vertebra 36 may include various types of bone portions, such as cortical bone portions 404 formed at or near the exterior of the bone facet joint 150 and cancellous bone portions 408 that may be formed in bone relative to the cortical bone 404 (such as near the interior of the bone 36). Accordingly, the cortical bone portion 404 may include a first cortical bone portion 404a and a second cortical bone portion 404b. As shown in fig. 5A, first cortical bone portion 404a is adjacent to spinous process 412 of vertebra 36 and generally posterior relative to subject 28. Thus, the second cortical bone portion 404b is closer to the spinal cord 162 and more anterior than the subject 28. However, it should be understood that cortical bone portion 404 may enclose cancellous bone portion 408 in bone, such as vertebra 36.

In general, cortical bone 404 is denser than cancellous bone portion 408. Thus, a greater force (such as a greater torque) may be required to remove or drill through cortical bone 404 than cancellous bone 408. Thus, as further discussed herein, the motor sensor 220 may sense operation of the motor 143 for operating the tool 32, which may vary due to different bone portions or bone types (such as cortical bone 404 and cancellous bone 408). Considering the differences in bone, moving slowly through cortical bone may require less torque, while moving more quickly through cancellous bone may require more torque. These conditions and operating parameters may be used for operation. For example, the combined navigation and motor data may determine the contact type more reliably than the navigation or motor data alone.

The navigation system may track the tracking devices 98, 98' relative to the tool 32 and/or the drilling tool 20 during movement of the tool 32 relative to the vertebra 36, such as during movement through the cortical bone 404 and/or cancellous bone 408 toward and/or relative to the spinal cord 162. During operation of tool 32, drilling tool 20, including motor 143, may provide power to tool 32 and move tool 32 relative to vertebra 36. Tracking devices 98, 98' may be used to determine the position of tool 32 relative to vertebra 36 and/or spinal cord 162. As discussed above, the boundaries of the spinal cord 162 and/or the boundaries of the spinal bone 36 may be used to define various avoidance spaces or volumes.

During a selected position of the tool 32 relative to the selected avoidance space, such as at or near the spinal cord 162, the tool 32 may be operated by the motor 20 in a substantially full rotation, as indicated by circle 420, generally or substantially about the axis 400 or about a line generally parallel to the axis. Upon full rotation at a selected speed (such as maximum speed), the tool tip 32t may move through the bone, such as the facet joint 150, at a selected maximum rate. Accordingly, the cortical bone 404a and cancellous bone 408 may be drilled through at a selected rate. In addition, the tracking devices 98, 98' may be used to determine the position of the tool tip 32t relative to any suitable portion of the image data, such as the spinal cord 162. Thus, as discussed above, during a selected determined (e.g., navigated) position of the tool tip 32t that may include the boundary of the spinal cord 162 (such as at a distance away from the avoidance space), the drilling tool 20 may be operated at a maximum rotational speed for efficient and rapid drilling or movement through the facet joint 150.

During operation of the drill 20, the tool 32 having the tool tip 32t may engage cortical bone 404 and cancellous bone 408. Cortical bone 404 may cause greater resistance on tool tip 32t due to its stiffer nature. Thus, the motor sensor 220 may sense a first reverse voltage from the motor regarding additional force required to rotate the tool 32 at a selected or determined speed or rotation of the tool 32. The motor sensor 220 may also sense a second reverse voltage when the tool encounters cancellous bone 408, which may not be as dense as cortical bone 404, and the speed of the tool 32 may be easier to achieve. Thus, at least two or different reverse voltages may be sensed, possibly because the tool 32 encounters different bones. As discussed above, the motor may also operate in a sensorless manner, wherein the motor itself may be used to determine the back EMF for controlling the motor.

In addition, the position of the tool 32 and tool tip 32t may be tracked and determined with selected tracking devices 98, 98'. As will be generally understood by those skilled in the art, the tool tip 32t may have a known distance from the tracking devices 98, 98' that may be connected to the drilling tool 20. Thus, as the drill 20 moves, the tracking devices 98, 98' may move and the position of the tool tip 32t may be known.

As shown in fig. 5A, the tool tip 32t may be positioned at a distance from the facet joint 150. However, as shown in fig. 5B, the tool tip 32 may engage the facet joint 150. When the tool tip 32t engages the facet joint 150, the tool tip may first engage the cortical bone 404a. Tracking devices 98, 98' may track the position of tool tip 32t and the navigation system may determine and/or display the position of tool tip 32 t. Because the tool tip 32t is located at the cortical bone 404a and at a selected distance from the spinal cord 162, the tool 32 may be selected to rotate in a selected direction and/or speed, as discussed above. Thus, when the tool tip 32t is distant from the spinal cord 162 or other selected avoidance area or region by a selected distance, the tool 32 and associated tool tip may be rotated at a selected speed, which may be selected by the user 24.

Further, the tool 32 may be rotated at a selected speed without changing the speed as long as the tool 32 is in the selected planned position. As shown in fig. 5A and 5B, the plane 430 may be identified with respect to the facet joint 150. The plane 430 may include the geometry or volume or trajectory of the tool 32 (including the tool tip 32 t). Thus, as long as the tool 32 is in a selected position, such as within the planned volume or region 430, and a selected distance from the avoidance region (including the spinal cord 162), the tool 32 may be rotated, such as in direction 420, at a selected speed and/or direction or type. Thus, while navigating at the selected portion of the plan, tool 32 may continue to operate at full rotation and at the selected speed. In addition, the sensor 220 may sense a reverse voltage of the motor to help determine that the tool tip 32t is in or passing through the cortical bone 404 a.

Referring to fig. 5C, tracking devices 98, 98' may be used to determine or navigate the position of tool tip 32 t. As shown in fig. 5C, tool tip 32 may be within planned trajectory 430 or may be a selected or determined distance 450 from spinal cord 162, which may be determined as an avoidance space. Thus, the drilling tool 20 may be used to oscillate the tool 32 generally or substantially about the axis 400 or about a line generally parallel to the axis. Upon oscillating the tool, the tool 32 may be rotated a first distance in the direction of arrow 454, stopped, and then rotated a second distance in the direction of arrow 458. As shown in fig. 5C, the two arrows may be opposite each other to illustrate the oscillation of the tool 32.

Distance 450 may be a selected distance from spinal cord 162 such that the operating parameters as discussed above may allow for greater oscillation. As shown in fig. 5C, the oscillation about the axis 400 of the tool 32 may be about 280 degrees to about 360 degrees. Thus, a larger oscillation may still enable an effective or quick cut of the vertebra 36, yet provide more control and/or feedback to the user regarding the tracked position of the tool 32.

Further, as shown in fig. 5C, the tool tip 32 may be positioned within cancellous bone 408. Thus, the motor sensor 220 may sense a reverse voltage for motor operation. The motor sensor 220 may be used to sense torque applied to the tool tip 32t to move through bone and further assist in determining the position of the tool tip 32 relative to the vertebra 36 and/or spinal cord 162. As discussed above, various portions of the anatomy may be determined and/or segmented, and thus the type of bone relative to the spinal cord 162 may be determined and known. In addition to and/or as an alternative to other sensors, such as motor sensor 220, the tracked position of drilling tool 20 and associated tool 32 may be used to determine a position relative to the avoidance space, and other sensors may be used to help determine or sense the type of bone counted.

Referring to fig. 5D, the tool tip 32t has been moved to a closer distance 462 from the spinal cord 162. The tracked or navigated position of tool tip 32t may be determined using tracking devices 98, 98'. Distance 462 may be a selected distance that further alters the operation or rotation of tool 32. As shown in fig. 5D, the tool tip may continue to oscillate in the direction indicated by arrows 454, 458, but less, generally or substantially about axis 400 or about a line generally parallel to the axis. For example, as shown in fig. 5D, the oscillations of the tool may include an arc equal to or less than the total arc shown in fig. 5C. For example, oscillations in the direction of arrow 454 may follow an arc 470 of about 50 degrees to about 120 degrees (including about 90 degrees). Further, oscillations in the direction of arrow 458 may follow an arc 474, which may be a selected distance, such as about 50 degrees to about 120 degrees, and include about 90 degrees. Thus, the oscillations shown in fig. 5D when tool tip 32t is a distance 462 from an avoidance space (such as spinal cord 162) may be less than the oscillations when tool tip 32t is a distance 450 from the avoidance space. For example, as shown in fig. 5D, as the tool tip 32 approaches the avoidance space, the oscillations of the tool 32 may decrease. Furthermore, the speed of oscillation can be reduced. Accordingly, user 24 may receive feedback regarding the position of tool tip 32t relative to the avoidance space as a result of operation of drilling tool 20.

Referring to fig. 5D, tool tip 32 may be entering or being entering cortical bone 404b. As discussed above, the motor sensor 220 may sense a high voltage of the motor when the tool tip 32t encounters cortical bone 404b. The change from cancellous bone 408 to cortical bone 404b can be determined or sensed with motor sensor 220. Thus, both the position tracked with the tracking device 98, 98' and the sensing of motor operation by the motor sensor 220 may be used to help determine the position of the tool tip 32t relative to the avoidance space (such as the spinal cord 162).

Finally, as shown in fig. 5E, tool tip 32 may be passed through vertebra 36. Thus, the tool tip 32t may be a distance 480 from the spinal cord 162, which may be an avoidance space. In this position, the tool 32 may be stopped such that the tool 32 is no longer rotating. The position of the tool tip 32t may be determined based on tracking of the tracking devices 98, 98'. In addition, motor sensor 220 may be used to sense that the tool is no longer engaged or is no longer experiencing as much resistance as tool tip 32 is traversing or partially traversing the vertebra. Thus, the sensor 220 may also provide sensing of the operation of the motor 143 to help determine the position of the tool tip 32 t.

Thus, tool 32 may be used to perform surgery. The tracked position of the tracking devices 98, 98' may be used to determine the position of the tool tip 32 t. Based on the tracked position of the tool tip 32t, the motor of the drilling tool 20 may be used to achieve full rotation of the motor and tool 32 at a selected speed, to oscillate a selected amount, to reduce oscillations, and/or to stop operation. This may provide feedback to the user regarding the position of tool tip 32t and/or help drill efficiently or effectively through selected portions of vertebra 36 or subject 24 while having feedback and operation of tool 32 based on a predetermined selected space or volume.

As discussed and illustrated in fig. 5A-5E, exemplary applications of the inputs and operations of the drilling tool 20 shown in fig. 3 and the process 310 shown in fig. 4 are included according to various embodiments. As discussed above, various operating parameters of drilling tool 20 may be initially entered or invoked. Based on tracking and determining the position of tool 32 and/or tool tip 32t, drilling tool 20 may be used to change speed, direction, rotation, and/or oscillation, or stop. Accordingly, drilling tool 20 may be operated according to predetermined and/or invoked tool operating parameters based on tracking or determining the position of drilling tool 20 and/or tool 32 and/or tool tip 32 t. Additionally, sensors, such as motor sensor 220, may be provided to include or provide additional inputs for operation of the drilling tool 20. Thus, the drilling tool 20 may be operated based on the input parameters and tracking position and/or sensed motor operation.

For example, as shown in fig. 6, the drilling tool 20 may include an electric motor 143 that operates based on the position of the tool tip 32t relative to the subject. Fig. 6 shows a graph 500 of the operation of drilling tool 20 relative to tool 32 and vertebra 36. The Y-axis represents the voltage sensed by the motor sensor 220, and the X-axis represents time. In addition, top bar 504 shows the change in the type of rotation or movement of tool 32 over time. Thus, as discussed above, tool 32 may have an initial stop or start at 508, rotate at time 510, such as in the direction of arrow 420, oscillate as discussed above at time 512, and again stop at 516. The graph shows the voltage change sensed by the motor sensor 220, which may be related to different types of rotation as shown in row 504.

Bottom bar 520 along the Y-axis shows the types of bone that may be associated with various changes in sensed voltage. The variation or different voltages may be predetermined. As discussed above, the bone of the vertebra 36 may include a cortical portion 404a, a cancellous portion 408, and a second cortical portion 404b. When tool tip 32t engages a different type of bone, as shown in row 520, the voltage sensed at motor sensor 220 may change as shown in graph 500. The sensor 220 may send a signal to the motor controller 144 to help determine or alter the operation of the motor drilling tool 20. Thus, the voltage sensed at motor sensor 220 may assist in operating or determining the operation of drilling tool 20.

Referring to fig. 7A, 7B, 7C, and 7D, drilling tool 20 may again be used to engage or interact with a selected portion of a subject, such as vertebra 36, including facet joint 150. Likewise, the spinal cord 162 may generally be adjacent to or at the vertebra 36. For example, the spinal cord 162 may again be identified as avoiding a space or region. In addition, various nerve bundles 166 may extend from the spinal cord 162. Nerve bundles 166 may also be defined as avoidance spaces or volumes in a manner similar to that discussed above with respect to spinal cord 162. In addition, avoidance space may be identified and displayed on display screen 82 and/or sent and invoked for various purposes, such as operating drilling tool 20.

Thus, as discussed above, the avoidance space may be defined relative to or by the spinal cord 162 and/or the nerve 166 in the vicinity thereof, and may be used to select operation of the drilling tool 20. Tracking devices 98, 98' may be associated with, such as connected to, drilling tool 20. Thus, the navigation system or tracking system may track and determine the position of the drilling tool 20 and the tool 32 associated therewith. Tool 32 may include a selected tool, such as a burr or router portion, to remove a selected portion of an anatomy, such as a portion of facet joint 150. The tool 132 may remove facet joint material generally by moving in the direction of arrow 540. By moving in the direction of arrow 540, tool 32, including tool tip 32t, may remove a selected portion of facet joint 150.

In addition to tracking devices 98, 98' associated with drilling tool 20, additional sensors may also be associated with drilling tool 20. As discussed above, the motor sensor 220 may be configured to sense the operation or voltage applied by the motor and/or feedback to the motor. In addition to the sensors, or as an alternative to the motor sensors 220 and/or tracking devices 98, 98', conductivity or integrity sensors 234 may be disposed near the tool 32. Conductivity sensor 234 may include a nerve integrity monitoring device sensor that may sense signals provided through spinal cord 162 and/or other neural pathways such as nerve 166. The conductivity sensor 234 may comprise a sensor sold by meiton force corporationThose sensors included in the monitoring system or similar to those sensors included therein. Accordingly, the integrity sensor 234 may sense the signal and transmit the signal to an appropriate location for processing, such as the drill motor controller 144.

As shown in fig. 7A, for example, a tool 32 associated with the drilling tool 20 may utilize tracking devices 98, 98' to track and determine the position of the tool. At the initial position 550, the tool 32 may be rotated at a selected speed, such as generally in the direction of arrow 560, generally or substantially about the axis 400, or about a line generally parallel to the axis. Drilling tool 20 may be moved generally in the direction of arrow 540 to activate or remove selected portions of bone, such as vertebra 36. Tool 32 may continue to move generally in the direction of arrow 540, which may move tool 32 closer to nerve 166. Further, the position of tool 32 may be tracked or determined based on tracking devices 98, 98'.

At a selected second distance (such as distance 564), tool 32 may still rotate substantially in the entire rotational direction shown by arrow 560, but may have a varying speed based on the operation of the drilling tool according to various invoked parameters, such as those discussed above in operation subroutine 340 and motor controller 144. Further, the operation of the drilling tool 20 and associated tool 32 may be based on various determinations. The predetermined operating parameter may be based on the determined proximity (such as proximity to nerve 16), the determined kinematics (such as the kinematics determined in block 260), and so forth. This may be determined based on tracking the tracking device 98 over time. Thus, if the tool 32 is moved at a selected speed (such as greater than 1mm or 1 centimeter per minute) at a distance 564, the rotational speed in the direction of arrow 560 may be changed, such as decreased. Thus, the speed and direction of movement of the tool 32 may be used to assist in selecting parameters for controlling the drilling tool 20 at selected times.

Referring to fig. 7C, the integrity sensor 234 may be in proximity to the nerve 166. At selected proximity, the integrity sensor 234 may sense a signal through the nerve 166. The integrity sensor signal from the integrity sensor 234 and/or the position determined using the tracking devices 98, 98' may be used to determine changes in the operating parameters of the drilling tool 20. At the signal sensing of the selected distance and/or integrity sensor 234, the operation of the tool 32 may become oscillated, such as shown by the two arrows 580 and 584, generally or substantially about the axis 400 or about a line generally parallel to the axis. Further, the oscillations may be any selected oscillation, such as an arc generally in a selected direction, such as an arc of about 50 degrees to about 140 degrees, such as including arcs 586 and 588. Accordingly, various inputs including the proximity determined in block 250, the kinematics determined in block 260, and the contact determined in block 270 may be used to help determine or select the operation of tool 32 by drilling tool 20. Further, the drilling tool 20 may be operated based on user selected inputs and various inputs from one or more of the sensors discussed above.

As shown in fig. 7D, the integrity sensor 234 may sense contact with or generate contact with the nerve 166. Accordingly, the integrity sensor 234 may transmit a signal based thereon and may determine that the determination of the tool 32 should be stopped. Thus, rotation of the tool 32 may be eliminated. Further, the integrity sensor 234 may sense contact or substantially near contact with the nerve 166. In addition, as discussed above, tracking devices 98, 98' may be utilized to track the position of the drilling tool 20. Various inputs may be used to determine operation of the drilling tool 20 according to the process 310 (including the operational process portion 340) and various inputs based on execution of the controller 144, as also discussed above.

Accordingly, various sensors may be provided to sense the operation of the drilling tool 20 and/or the movement of the drilling tool 20 or tool 32. Various inputs may be used to determine various parameters associated with tool 32, such as contact, proximity, and kinematics, to aid in selecting and/or determining the operation of drilling tool 20. The operating parameters may be based on a location determined with a navigation system (such as with tracking devices 98, 98'), and one or more other sensor inputs may also be provided. As discussed above, motor sensors 220, integrity sensors 234, and other suitable sensors may be provided to provide inputs for executing selected instructions to operate drilling tool 20.

The exemplary embodiments are provided so that this disclosure will be thorough, and will fully convey the scope of the disclosure to those skilled in the art. Numerous specific details are set forth, such as examples of specific components, devices, and methods, in order to provide a thorough understanding of embodiments of the present disclosure. It will be apparent to one skilled in the art that the exemplary embodiments may be embodied in many different forms without the use of specific details and should not be construed as limiting the scope of the disclosure. In some exemplary embodiments, well known processes, well known device structures, and well known techniques have not been described in detail.

The instructions may be executed by a processor and may include software, firmware, and/or microcode, and may refer to programs, routines, functions, classes, data structures, and/or subjects. The term shared processor circuit encompasses a single processor circuit that executes some or all code from multiple modules. The term ganged processor circuit encompasses processor circuits that execute some or all code from one or more modules in conjunction with additional processor circuits. References to multiple processor circuits encompass multiple processor circuits on a discrete die, multiple processor circuits on a single die, multiple cores of a single processor circuit, multiple threads of a single processor circuit, or combinations thereof. The term shared memory circuit encompasses a single memory circuit that stores some or all code from multiple modules. The term set of memory circuits encompasses memory circuits that store some or all code from one or more modules in combination with additional memory.

The apparatus and methods described in this application can be implemented, in part or in whole, by special purpose computers created by configuring a general purpose computer to perform one or more specific functions that are implemented in computer programs. The computer program includes processor-executable instructions stored on at least one non-transitory, tangible computer-readable medium. The computer program may also include or be dependent on stored data. The computer program may include a basic input/output system (BIOS) that interacts with the hardware of a special purpose computer, a device driver that interacts with a particular device of a special purpose computer, one or more operating systems, user applications, background services, background applications, and the like.

The computer program may include: (i) assembly code; (ii) object code generated by a compiler from source code; (iii) source code for execution by the interpreter; (iv) Source code for compilation and execution by a just-in-time compiler, (v) descriptive text for parsing, such as hypertext markup language (HTML) or extensible markup language (XMT), and the like. By way of example only, source code may C, C++、C#、Objective-C、Haskell、Go、SQL、Lisp、ASP、Perl、/>HTML5, ada, active Server Page (ASP), perl, scala, erlang, ruby, +. >Visual/>Lua or->Is written.

The communications may include wireless communications described in this disclosure, which may be conducted in whole or in part in compliance with IEEE standard 802.11-2012, IEEE standard 802.16-2009, and/or IEEE standard 802.20-2008. In various embodiments, IEEE 802.11-2012 may be supplemented by draft IEEE standard 802.11ac, draft IEEE standard 802.11ad, and/or draft IEEE standard 802.11 ah.

The processor or module or "controller" may be replaced with the term "circuit". The term "module" may refer to, be part of, or include an Application Specific Integrated Circuit (ASIC); digital, analog, or hybrid analog/digital discrete circuits; digital, analog, or hybrid analog/digital integrated circuits; a combinational logic circuit; a Field Programmable Gate Array (FPGA); processor circuitry (shared, dedicated, or group) that executes code; a memory circuit (shared, dedicated, or group) that stores code executed by the processor circuit; other suitable hardware components that provide the described functionality; or a combination of some or all of the above, such as in a system-on-chip.

The foregoing description of the embodiments has been presented for purposes of illustration and description. The above description is not intended to be exhaustive or to limit the invention. Individual elements or features of a particular embodiment are generally not limited to that particular embodiment, but, where applicable, are interchangeable and can also be used in selected embodiments, even if not specifically shown or described. The same element or feature may be varied in many ways. Such variations are not to be regarded as a departure from the invention, and all such modifications are intended to be included within the scope of the invention.

Claims (47)

1. A system for controlling operation of an instrument, the system comprising:

a tracking device configured to be associated with the instrument;

a navigation system configured to determine a pose of the instrument based on tracking the tracking device; and

an instrument controller configured to operate the instrument according to a selected operating parameter, wherein the instrument controller comprises a processor module configured to execute instructions to change the operating parameter of the instrument based at least on the determined pose of the instrument;

wherein the operating parameters include at least a full rotation parameter and an oscillation parameter.

2. The system of any of claims 1 or 2, wherein the instrument is a drilling tool configured to rotate a tool, and the controller is configured to change operation of the drilling tool to change rotation of the tool.

3. The system of claim 1, the system further comprising:

a boundary determination system configured to determine a boundary in an image;

wherein the operating parameter is changed based on the determined pose of the instrument relative to the boundary.

4. The system of claim 3, wherein the boundary determination system comprises:

a display device configured to display an image; and

an input system configured to allow user input regarding a boundary of at least a portion of a display in the image.

5. The system of claim 3, wherein the boundary determination system comprises an image segmentation system configured to segment an image of a subject.

6. The system of any one of claims 1 or 6, further comprising:

a boundary determination system configured to determine a boundary;

an operating parameter input system configured to input and store operating parameters;

wherein a boundary is determined within the image of the subject and operating parameters relating to the operation of the instrument are stored when the instrument is in a selected pose relative to the boundary.

7. The system of any one of claims 1 to 6, further comprising:

an imaging system configured to image the subject; and

a boundary determination system configured to determine a boundary within the image.

8. The system of claim 7, wherein the boundary determination system comprises a user input to select at least a seed portion.

9. The system of claim 7, wherein the oscillation parameter is selected at a distance relative to a boundary in the image.

10. The system of claim 7, wherein the boundary determination system comprises an image segmentation system configured to segment the image of the subject.

11. The system of any of claims 1 to 10, wherein the oscillation parameter is selected at a distance relative to a boundary in the image.

12. The system of any one of claims 1 to 11, wherein the processor module is configured to execute further instructions to change the operating parameter of the instrument based at least on a machine learning based algorithm.

13. A method of controlling operation of an instrument, the method comprising:

determining a location of the instrument using a navigation system configured to determine the location of the instrument; and

controlling operation of the instrument according to a selected operating parameter, wherein controlling the operation includes executing instructions with a processor module to change the operating parameter of the instrument based on the determined position of the instrument;

Wherein the operating parameters include at least a full rotation parameter and an oscillation parameter.

14. The method of claim 13, the method further comprising:

tracking a tracking device associated with the instrument;

wherein the determined position is based on tracking the tracking device.

15. The method of any one of claims 13 or 14, the method further comprising:

the instrument is configured as a drilling tool configured to rotate a tool or oscillate the tool.

16. The method of any one of claims 13 to 15, the method further comprising:

determining boundaries in the image;

wherein the operation of the instrument is controlled based on the determined position of the instrument relative to the boundary.

17. The method of any one of claims 13 to 16, the method further comprising:

displaying the image; and

a user selection of the boundary for at least a portion of the display in the image is entered.

18. The method of claim 14, the method further comprising:

determining boundaries in the image;

wherein the operation of controlling the instrument includes rotating the tool a first distance from the determined boundary and oscillating the tool a second distance from the boundary.

19. The method of claim 18, wherein the second distance is less than the first distance.

20. The method of claim 13, the method further comprising:

acquiring an image using an imaging system; and

boundaries within the image are determined.

21. The method of claim 20, wherein determining the boundary within the image comprises receiving user input to select at least a seed portion.

22. The method of claim 21, wherein the oscillation parameter is selected at a distance relative to a determined boundary in the image.

23. A method of controlling operation of a drilling tool, the method comprising:

determining a boundary within the image;

determining a position of the instrument relative to the boundary using a navigation system; and

controlling operation of the instrument according to the selected operating parameter, including executing instructions with a processor module to change operation of the instrument based on the determined position of the instrument relative to the determined boundary;

wherein the operations include at least full rotation of a tool driven by the instrument at a first position relative to the boundary and oscillation of the tool driven by the instrument at a second position relative to the boundary.

24. A system for controlling operation of a drilling tool, the system comprising:

a sensor configured to sense at least one operation of a motor of the drilling tool and transmit a sensor signal based on the at least one operation;

a processor module configured to receive the sensor signals and execute instructions to operate the drilling tool and to change an operating parameter of the drilling tool based at least on the sensor signals;

wherein the sensor signal comprises at least a first signal and a second signal;

wherein the operation of the drilling tool comprises at least a full rotation when the first signal is received and an oscillation when the second signal is received.

25. The system of claim 24, wherein the sensor comprises a voltage sensor configured to sense a reverse voltage of a motor of the drilling tool;

wherein the first signal is a first reverse voltage and the second signal is a second reverse voltage.

26. The system of any one of claims 24 or 25, further comprising:

a tracking device configured to be associated with the drilling tool;

A navigation system configured to determine a pose of the drilling tool based on tracking the tracking device; and is also provided with

Wherein the processor module is configured to execute further instructions to change the operating parameter based on the determined pose of the drilling tool;

wherein the operating parameters of the drilling tool are selected based on both: (i) a first sensor signal or a second sensor signal; and (ii) the determined pose.

27. The system of claim 26, the system further comprising:

a boundary determination system configured to determine a boundary in an image;

wherein the operating parameter is changed based on the determined position of the drilling tool relative to the boundary.

28. The system of claim 27, wherein the boundary determination system comprises:

a display device configured to display an image; and

an input system configured to allow user input regarding a boundary of at least a portion of a display in the image.

29. The system of claim 26, the system further comprising:

an imaging system configured to image the subject; and

A boundary determination system configured to determine a boundary within the image.

30. The system of claim 26, wherein the boundary determination system comprises a user input to select at least a seed portion.

31. The system of any of claims 24 to 30, wherein oscillation parameters are selected at a distance relative to boundaries in the image.

32. The system of any one of claims 24 to 31, further comprising:

an auxiliary sensor operable to sense an electrical signal transmitted through a nerve;

wherein the processor module is further configured to receive an auxiliary sensor signal from the auxiliary sensor.

33. The system of claim 26, wherein the boundary determination system comprises an image segmentation system configured to segment an image of the subject.

34. A system for controlling operation of a drilling tool, the system comprising:

a sensor configured to sense an electrical signal transmitted through a nerve in a subject and transmit a sensor signal based on the electrical signal;

a processor module configured to receive the sensor signals and execute instructions to operate the drilling tool and to change an operating parameter of the drilling tool based on the sensor signals;

Wherein the sensor signal comprises at least a first signal and a second signal;

wherein the operation of the drilling tool comprises at least a full rotation when the first signal is received and an oscillation when the second signal is received.

35. The system of claim 34, wherein the first signal does not include a neural signal and the second signal includes a neural signal.

36. The system of claim 35, the system further comprising:

a tracking device configured to be associated with the drilling tool;

a navigation system configured to determine a pose of the drilling tool based on tracking the tracking device; and is also provided with

Wherein the processor module is configured to execute further instructions to change the operating parameter based on the determined pose of the drilling tool;

wherein the operating parameters of the drilling tool are selected based on both: (i) a first sensor signal or a second sensor signal; and (ii) the determined pose.

37. The system of claim 36, the system further comprising:

a boundary determination system configured to determine a boundary in an image;

Wherein the operating parameter is changed based on the determined pose of the drilling tool relative to the boundary.

38. The system of claim 37, wherein the boundary determination system comprises:

a display device configured to display an image; and

an input system configured to allow user input regarding a boundary of at least a portion of a display in the image.

39. The system of claim 38, the system further comprising:

an imaging system configured to image the subject; and

a boundary determination system configured to determine a boundary within the image.

40. The system of claim 39, wherein the boundary determination system comprises user input to select at least a seed portion.

41. The system of claim 40, wherein oscillation parameters are selected at a distance relative to the boundary in the image.

42. A method of controlling operation of a drilling tool, the method comprising:

determining a sensor signal from a sensor configured to sense a condition associated with the drilling tool;

Determining a pose of the drilling tool using a navigation system configured to determine a pose of the drilling tool; and

controlling operation of the drilling tool according to the selected operating parameters, wherein controlling the operation includes executing instructions with a processor module to change the operating parameters of the drilling tool based on both: (i) the determined pose of the drilling tool; and (ii) the sensor signal;

wherein controlling the operation of the drilling tool comprises at least full rotation of the drilling tool and oscillation of the drilling tool.

43. The method of claim 42, wherein determining the sensor signal comprises at least one of:

an electrical signal and transmitting a sensor signal based on the electrical signal, or

At least one operation of a motor of the drilling tool.

44. The method of claim 43, the method further comprising:

determining boundaries in the image;

wherein the operation of the instrument is controlled based on both: (i) The determined pose of the instrument relative to the boundary; and (ii) the sensor signal.

45. The method of claim 44, the method further comprising:

displaying the image; and

A user selection of the boundary for at least a portion of the display in the image is entered.

46. The method of claim 45, wherein determining the boundary within the image comprises receiving user input to select at least a seed portion.

47. The method of claim 44, wherein the oscillation of the drilling tool is selected at a distance relative to the determined boundary in the image.