EP1482846A1 - Procede de visualisation et de controle de l'equilibre d'une colone vertebrale - Google Patents
Procede de visualisation et de controle de l'equilibre d'une colone vertebraleInfo
- Publication number
- EP1482846A1 EP1482846A1 EP03727566A EP03727566A EP1482846A1 EP 1482846 A1 EP1482846 A1 EP 1482846A1 EP 03727566 A EP03727566 A EP 03727566A EP 03727566 A EP03727566 A EP 03727566A EP 1482846 A1 EP1482846 A1 EP 1482846A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- vli
- limit
- vertebrae
- vls
- radiographs
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
Classifications
-
- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T7/00—Image analysis
- G06T7/0002—Inspection of images, e.g. flaw detection
- G06T7/0012—Biomedical image inspection
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
- G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
- G16H40/63—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/50—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for simulation or modelling of medical disorders
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16Z—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS, NOT OTHERWISE PROVIDED FOR
- G16Z99/00—Subject matter not provided for in other main groups of this subclass
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B2017/564—Methods for bone or joint treatment
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
-
- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T2207/00—Indexing scheme for image analysis or image enhancement
- G06T2207/30—Subject of image; Context of image processing
- G06T2207/30004—Biomedical image processing
- G06T2207/30008—Bone
Definitions
- the present invention relates to a method for viewing and controlling the balance of the spine of a patient.
- the visualization and control method according to the present invention is more particularly intended for visualizing and controlling the balance of the spine of a patient during an operation relating to a spinal segment corrected by means of known spinal instrumentation in itself.
- the osteosynthesis instrumentations or materials known to date consist generally of bone anchoring screws, connectors fixed by the screws on the vertebral bodies of each vertebra and connecting rods connecting the connectors together. Sometimes, the connecting rods are deformed by the surgeon to be able to restore the curvatures of the spinal segment to be corrected.
- the frontal balance of the patient's spine is obtained from the moment when the first thoracic vertebra (T1) is centered relative to the sacrum.
- T1 first thoracic vertebra
- the sagittal equilibrium it can be considered that it is obtained from the moment when the external auditory canals are located vertically from the femoral heads.
- the surgeon's objective is obviously firstly to reduce the curvatures of the spine in the case of a spinal deformation and / or to fix an area which will be called instrumented.
- the surgeon must ensure that the instrumented area allows the patient to find or regain his balance after the operation, when he adopts the standing position.
- surgeons therefore seek during the operation to assess a possible balance or imbalance post-operation in the patient.
- Radiographic means two X-rays face + profile
- the problem is that the patient is lying on the operating table, and only the vertebrae that will be fused are released by a conventional posterior approach.
- VLS instrumented limit vertebra
- VLI lower instrumented limit vertebra
- VLS first instrumented vertebra
- VLI last instrumented vertebra
- the object of the process according to the present invention is to determine the balance of the spine by looking at the two extreme vertebrae of the instrumentation (VLS and VLI).
- the method according to the present invention makes it possible to see on a control screen the virtual column of the patient in a standing position after operation.
- VLS and VLI instrumented limit vertebrae
- the present invention provides a process for visualizing and controlling the balance of the spine, a spinal segment of which is corrected by means of spinal instrumentation known per se, characterized in that it consists:
- VLS upper
- VLI lower
- VLS upper
- VLI lower
- the three-dimensional relative position of the upper (VLS) and lower (VLI) instrumented limit vertebrae of the corrected spinal segment is obtained from a first reconstruction in a three-dimensional visual space of the geometry of the 'envelope or external contour of the upper (VLS) and lower (VLI) limit vertebrae and of a second reconstruction in a three-dimensional visual space of the posterior arch surface of the upper (VLS) and lower (VLI) limit vertebrae.
- the first and second stages of reconstruction in a three-dimensional visual space make it possible to determine, in a three-dimensional visual space, the relative position of the upper (VLS) and lower (VLI) instrumented limit vertebrae of the segment. spinal column corrected.
- the visualization and control method consists in that the upper (VLS) and lower (VLI) instrumented limit vertebrae of the corrected spinal segment are projected onto the front and profile radiographs of the patient. treat.
- the visualization and control method consists in that the front and profile projection of the upper (VLS) and lower (VLI) instrumented limit vertebrae of the corrected spinal segment makes it possible to determine the position on the front and profile radiographs of the spinal segments above and below the corrected spinal segment, and to visualize on the front and profile radiographs the appearance of the reconstructed spine.
- the visualization and control method consists in identifying or digitizing for each vertebra of the spinal column, at least four points delimiting a rectangle reproducing the vertebral body.
- the visualization and control method consists in identifying or digitizing the points which correspond to the radiological landmarks used, to define the balance of the patient's head relative to the pelvis.
- the display and control method consists in identifying or digitizing for the head at least ten points making it possible to identify the external contour of the head.
- the display and control method consists in identifying or digitizing for the pelvis at least the anatomical points defining the center of each femoral head and the sacred plateau.
- the display and control method consists in identifying or digitizing for the pelvis, at least five points, one of which for the femoral head and at least three for the sacrum, in order to form a triangle.
- the display and control method consists in embedding digital points on the patient's radiographs.
- the visualization and control method consists, from sagittal and frontal radiographs of the patient, in reconstructing in three dimensions the geometric shape of the upper (VLS) and lower (VLI) limit vertebrae.
- the visualization and control method consists in determining the linear and angular geometric position of the lower limit vertebra (VLI), reconstructed with respect to the front and profile radiographs.
- the visualization and control method consists in projecting the upper limit (VLS) and lower limit (VLI) vertebrae on the front and profile radiographs.
- the visualization and control method consists in embedding in radiographs, the projection of the upper (VLS) and lower (VLI) limit vertebrae relative to each other, by performing a registration of the projection of the lower limit vertebra (VLI).
- Figure 1 shows a sagittal x-ray of a standing patient, on which anatomical points are digitized to identify the pelvis and the femoral heads.
- FIG. 2 illustrates a sagittal radiography of a patient standing in cervical flexion, on which anatomical points are digitized to identify the head, the vertebrae overlying the instrumentation and the instrumented upper limit vertebra (VLS).
- VLS instrumented upper limit vertebra
- Figure 3 shows a sagittal radiograph of a standing patient in cervical extension, on which anatomical points are digitized to identify the head, the vertebrae overlying the instrumentation and the instrumented upper limit vertebra (VLS).
- FIG. 4 represents a sagittal radiography of a patient seated in lumbar flexion, on which anatomical points are digitized to identify the pelvis, the vertebrae underlying the instrumentation and the instrumented lower limit vertebra (VLI).
- VLI instrumented lower limit vertebra
- FIG. 5 represents a sagittal radiography of a patient seated in lumbar extension, on which anatomical points are digitized to identify the pelvis, the vertebrae underlying the instrumentation and the instrumented lower limit vertebra (VLI).
- VLI instrumented lower limit vertebra
- Figure 6 illustrates a frontal x-ray of a standing patient, on which anatomical points are digitized to identify the pelvis and the femoral heads.
- Figure 7 shows a frontal x-ray of a patient lying in a lateral inflection to the left, on which anatomical points are digitized to identify the head, the vertebrae above and below the instrumentation, the upper limit (VLS) and lower vertebrae (VLI) instrumented, pelvis and femoral heads.
- VLS upper limit
- VLI lower vertebrae
- FIG. 8 represents a frontal X-ray of a patient lying in lateral inflexion on the right, on which anatomical points are digitized to identify the head, the vertebrae above and below the instrumentation, the upper limit (VLS) and lower vertebrae (VLI) instrumented, pelvis and femoral heads.
- VLS upper limit
- VLI lower vertebrae
- FIG. 9 illustrates the radiography of FIG. 1 in which the digitalized anatomical points have been embedded in the radiographs of FIGS. 4 and 5, this after matching the scales and adjustment relative to the pelvis.
- FIG. 10 shows the radiograph of FIG. 6 in which the anatomical points digitized in the radiographs of FIGS. 7 and 8 have been embedded (only those representing the pelvis, the vertebrae underlying the instrumentation, and the lower limit vertebra ( VLI) (instrumented), this after matching scales and adjusting to the pelvis.
- VLI lower limit vertebra
- FIG. 11 illustrates the radiography of FIG. 9 in which the projection of the upper (VLS) and lower (VLI) limit vertebrae has been embedded by performing a registration of the instrumented lower limit vertebra (VLI).
- FIG. 12 shows the radiography of FIG. 10 in which the projection of the upper (VLS) and lower (VLI) limit vertebrae has been embedded by performing a registration of the instrumented lower limit vertebra (VLI).
- FIG. 13 represents the radiography of FIG. 11 in which the digitalized points have been embedded on the radiography of FIGS. 2 and 3 (head, overlying vertebrae and instrumented upper limit vertebrae (VLS)), by performing a registration of the limit vertebra instrumented upper (VLS).
- FIG. 14 illustrates the radiography of FIG. 12 in which the digitized points have been embedded on the radiography of FIGS. 7 and 8 (head, overlying vertebrae and instrumented upper limit vertebrae (VLS)), by performing a registration of the limit vertebra instrumented upper (VLS).
- the first step of the process consists in identifying or digitizing anatomical points or contours on the radiographs of the patient to be treated. So for each vertebra 2 of the spine 1, it is necessary to identify at least four points. The latter delimit a rectangle reproducing the vertebral body. For head 3, it is necessary to identify the anatomical points which usually correspond to the radiological landmarks used to define the balance of the patient's head 3 in relation to his pelvis 4.
- the head 3 it may be necessary to identify, but not limited to, at least ten points which make it possible to identify the external contour of the head.
- the second step of the process consists of embedding the digital points on the radiographs of Figures 4 and 5 in the radiography of Figure 1.
- the digital points are encrusted on the radiographs of FIGS. 7 and 8 in the radiography of FIG. 6.
- the digital points or contours relate more particularly to those representing the pelvis 4, the vertebrae 2 underlying the instrumentation, and the lower limit vertebra (VLI) instrumented. Provision is made in this step of the method for the scales to be matched and for the points or contour to be adjusted or readjusted relative to the basin 4 (FIG. 10).
- This step consists, from the sagittal ( Figure 1) and frontal radiographs ( Figure 6), in a three-dimensional reconstruction of the geometric shape of the vertebrae 2 and more particularly of the instrumented limit vertebrae, namely:
- VLS the upper limit vertebra
- This step also consists in determining the linear and angular geometrical position of the reconstructed lower limit vertebra (VLI) with respect to the front and profile radiographs (positioning of the patient relative to the films (Rx) when taking radiographic images).
- VLS upper limit vertebra
- VLI upper limit vertebra
- a two-dimensional coordinate system is associated with the projection of the geometric shape of the upper limit vertebra (VLI) on the profile radiography ( Figure 1).
- a two-dimensional coordinate system is associated with the projection of the geometric shape of the upper limit vertebra (VLI) on the face radiography ( Figure 6).
- This stage consists in reconstructing in a three-dimensional visual space the geometry of the envelope or the external contour of the upper (VLS) and lower (VLI) limit vertebrae.
- a second reconstruction is planned in a three-dimensional visual space of the posterior arch surface of the upper (VLS) and lower (VLI) limit vertebrae.
- This step consists in projecting the upper (VLS) and lower (VLI) limit vertebrae on the front and profile radiographs thanks to the relationships established between the three-dimensional and two-dimensional landmarks defined during the third step.
- This step also consists in embedding in the radiographs of FIGS. 9 and 10 the projection of the upper (VLS) and lower (VLI) limit vertebrae relative to one another by performing a registration of the projection of the lower limit vertebra ( VLI) on the two positions occupied by this vertebra in the radiographs of Figures 9 and 10.
- FIG. 11 and 12 illustrate this step.
- This step consists of embedding in the radiography of FIG. 11 the points or contours digitized on the radiographs of FIGS. 2 and 3 by adjusting the scale between the radiographs and performing a registration with respect to the limit vertebra. higher (VLS).
- VLS limit vertebra
- FIG. 13 and 14 illustrate this step.
- VLS upper
- VLI lower
- the latter can be, for example, carried out using a three-dimensional transmitter / sensor provided with a feeler pen allowing reconstruction in a three-dimensional visual space of the external contour and of the surface. of the posterior arch of the upper (VLS) and lower (VLI) limit vertebrae.
- This implementation is carried out from an image processing system to allow the visualization of the results and the relative position in front and profile projection of the upper (VLS) and lower (VLI) instrumented limit vertebrae of the segment. spinal correction through spinal instrumentation.
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Medical Informatics (AREA)
- Orthopedic Medicine & Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Public Health (AREA)
- Neurology (AREA)
- Surgery (AREA)
- Epidemiology (AREA)
- Primary Health Care (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Life Sciences & Earth Sciences (AREA)
- General Business, Economics & Management (AREA)
- Databases & Information Systems (AREA)
- Physics & Mathematics (AREA)
- General Physics & Mathematics (AREA)
- Theoretical Computer Science (AREA)
- Business, Economics & Management (AREA)
- Quality & Reliability (AREA)
- Pathology (AREA)
- Data Mining & Analysis (AREA)
- Computer Vision & Pattern Recognition (AREA)
- Radiology & Medical Imaging (AREA)
- Heart & Thoracic Surgery (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Apparatus For Radiation Diagnosis (AREA)
- Measuring And Recording Apparatus For Diagnosis (AREA)
Abstract
Description
Claims
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR0202754A FR2836818B1 (fr) | 2002-03-05 | 2002-03-05 | Procede de visualisation et de controle de l'equilibre d'une colonne vertebrale |
FR0202754 | 2002-03-05 | ||
PCT/FR2003/000694 WO2003073946A1 (fr) | 2002-03-05 | 2003-03-04 | Procédé de visualisation et de contrôle de l'équilibre d'une colonne vertébrale |
Publications (1)
Publication Number | Publication Date |
---|---|
EP1482846A1 true EP1482846A1 (fr) | 2004-12-08 |
Family
ID=27763538
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP03727566A Withdrawn EP1482846A1 (fr) | 2002-03-05 | 2003-03-04 | Procede de visualisation et de controle de l'equilibre d'une colone vertebrale |
Country Status (5)
Country | Link |
---|---|
US (1) | US20050119593A1 (fr) |
EP (1) | EP1482846A1 (fr) |
AU (1) | AU2003233358A1 (fr) |
FR (1) | FR2836818B1 (fr) |
WO (1) | WO2003073946A1 (fr) |
Families Citing this family (13)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20080161680A1 (en) * | 2006-12-29 | 2008-07-03 | General Electric Company | System and method for surgical navigation of motion preservation prosthesis |
US8549888B2 (en) | 2008-04-04 | 2013-10-08 | Nuvasive, Inc. | System and device for designing and forming a surgical implant |
EP2164042B1 (fr) * | 2008-09-10 | 2017-11-08 | Brainlab AG | Procédé de vérification de la position relative de structures osseuses |
CA2788445C (fr) * | 2010-01-28 | 2017-11-21 | Pecsi Tudomanyegyetem | Procede et systeme pour la visualisation multidimensionnelle de la colonne vertebrale par des vecteurs de vertebres, le vecteur du sacrum et des vecteurs du bassin |
US11207132B2 (en) | 2012-03-12 | 2021-12-28 | Nuvasive, Inc. | Systems and methods for performing spinal surgery |
US9848922B2 (en) | 2013-10-09 | 2017-12-26 | Nuvasive, Inc. | Systems and methods for performing spine surgery |
DE102014102398A1 (de) * | 2014-02-25 | 2015-08-27 | Aesculap Ag | Medizinisches Instrumentarium und Verfahren |
US10524723B2 (en) | 2014-07-23 | 2020-01-07 | Alphatec Spine, Inc. | Method for measuring the displacements of a vertebral column |
US10433893B1 (en) | 2014-10-17 | 2019-10-08 | Nuvasive, Inc. | Systems and methods for performing spine surgery |
EP3361958B1 (fr) | 2015-10-13 | 2023-01-25 | Mazor Robotics Ltd. | Procédé de planification d'alignement vertébral global |
US11141221B2 (en) * | 2015-11-19 | 2021-10-12 | Eos Imaging | Method of preoperative planning to correct spine misalignment of a patient |
ES2877761T3 (es) | 2016-03-02 | 2021-11-17 | Nuvasive Inc | Sistemas y procedimientos para la planificación quirúrgica de corrección de la columna |
JP6744614B1 (ja) * | 2018-09-10 | 2020-08-19 | 京セラ株式会社 | 推定装置、推定システム及び推定プログラム |
Family Cites Families (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5228068A (en) * | 1992-09-14 | 1993-07-13 | Lunar Corporation | Device and method for automated determination and analysis of bone density and vertebral morphology |
US5582186A (en) * | 1994-05-04 | 1996-12-10 | Wiegand; Raymond A. | Spinal analysis system |
EP1046133B1 (fr) * | 1998-10-09 | 2004-01-14 | Koninklijke Philips Electronics N.V. | Obtention de donnees geometriques d'une structure a partir d'une image |
US6301495B1 (en) * | 1999-04-27 | 2001-10-09 | International Business Machines Corporation | System and method for intra-operative, image-based, interactive verification of a pre-operative surgical plan |
JP2004509722A (ja) * | 2000-09-29 | 2004-04-02 | コーニンクレッカ フィリップス エレクトロニクス エヌ ヴィ | 椎骨の椎弓根の位置を含む脊椎の正面幾何学データを抽出する方法及びシステム |
-
2002
- 2002-03-05 FR FR0202754A patent/FR2836818B1/fr not_active Expired - Fee Related
-
2003
- 2003-03-04 US US10/506,564 patent/US20050119593A1/en not_active Abandoned
- 2003-03-04 AU AU2003233358A patent/AU2003233358A1/en not_active Abandoned
- 2003-03-04 WO PCT/FR2003/000694 patent/WO2003073946A1/fr not_active Application Discontinuation
- 2003-03-04 EP EP03727566A patent/EP1482846A1/fr not_active Withdrawn
Non-Patent Citations (1)
Title |
---|
See references of WO03073946A1 * |
Also Published As
Publication number | Publication date |
---|---|
FR2836818B1 (fr) | 2004-07-02 |
US20050119593A1 (en) | 2005-06-02 |
WO2003073946A1 (fr) | 2003-09-12 |
AU2003233358A1 (en) | 2003-09-16 |
FR2836818A1 (fr) | 2003-09-12 |
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