JP2018509965A - 医療機器及び方法 - Google Patents
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- 238000000034 method Methods 0.000 title claims abstract description 11
- 230000000087 stabilizing effect Effects 0.000 claims abstract description 80
- 238000012545 processing Methods 0.000 claims abstract description 30
- 230000006641 stabilisation Effects 0.000 claims abstract description 25
- 238000011105 stabilization Methods 0.000 claims abstract description 25
- 238000001514 detection method Methods 0.000 claims abstract description 21
- 239000007943 implant Substances 0.000 claims description 22
- 238000005452 bending Methods 0.000 claims description 21
- 238000002407 reforming Methods 0.000 claims description 7
- 239000003826 tablet Substances 0.000 claims description 4
- 238000004891 communication Methods 0.000 claims description 3
- 238000003384 imaging method Methods 0.000 abstract 1
- 210000000988 bone and bone Anatomy 0.000 description 14
- 238000004873 anchoring Methods 0.000 description 6
- 238000011065 in-situ storage Methods 0.000 description 4
- 238000013461 design Methods 0.000 description 3
- 238000002513 implantation Methods 0.000 description 3
- 238000001356 surgical procedure Methods 0.000 description 3
- 238000005286 illumination Methods 0.000 description 2
- 230000003287 optical effect Effects 0.000 description 2
- 238000012790 confirmation Methods 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 239000012634 fragment Substances 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 230000010354 integration Effects 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
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- 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
- A61B17/7083—Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements
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- 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
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7002—Longitudinal elements, e.g. rods
-
- 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
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
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- 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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8863—Apparatus for shaping or cutting osteosynthesis equipment by medical personnel
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- 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
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
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- 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
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
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- 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
- A61B2034/108—Computer aided selection or customisation of medical implants or cutting guides
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- 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
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2055—Optical tracking systems
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- 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
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2055—Optical tracking systems
- A61B2034/2057—Details of tracking cameras
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/037—Automatic limiting or abutting means, e.g. for safety with a frangible part, e.g. by reduced diameter
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3937—Visible markers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3983—Reference marker arrangements for use with image guided surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3991—Markers, e.g. radio-opaque or breast lesions markers having specific anchoring means to fixate the marker to the tissue, e.g. hooks
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
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- Heart & Thoracic Surgery (AREA)
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Robotics (AREA)
- Surgical Instruments (AREA)
Abstract
Description
12 安定化要素
14 固定システム
16 埋込み具
18 標示装置
20 ナビゲーションシステム
22 再形成装置
24 標示装置
26 椎体
28 固着要素
30 骨ねじ
32 ロッド
34 剛体
36 標示要素
38 ホルダ
40 遠位端
42 把持要素
44 スマートフォン
46 ハウジング
48 データ処理ユニット
50 カメラ
52 検出ユニット
54 ディスプレイユニット
56 照明ユニット
62 曲げ装置
64 分岐部
66 遠位端
68 接触要素
Claims (17)
- カメラ(50)を含む光検出ユニット(52)、及び前記検出ユニットに連結されたデータ処理ユニット(48)を含むナビゲーションシステム(20)と、
外科用固定システム(14)の安定化要素(12)と、
前記安定化要素(12)上で規定の空間的配置にて保持される、又は前記安定化要素(12)に含まれる、又は前記安定化要素(12)により形成される医療用標示装置(18)と
を備えた医療機器(10)であって、
前記標示装置(18)の空間における場所及び配向が、前記ナビゲーションシステム(20)を用いて決定可能であり、
前記安定化要素(12)及び前記標示装置(18)の少なくとも2つの画像が、前記検出ユニット(52)により、異なる配向から撮影されることが可能であり、かつ、前記安定化要素(12)の形状が、前記2つ以上の画像に基づいて前記データ処理ユニット(48)により決定されることが可能である、
医療機器。 - 請求項1に記載の機器であって、前記安定化要素(12)がロッド(32)であること、を特徴とする機器。
- 請求項1又は2に記載の機器であって、前記安定化要素(12)及び前記標示装置の3つ以上の画像が撮影されることが可能であり、該画像に基づいて前記安定化要素(12)の形状が決定可能であり、互いに相違する前記配向及び画像が対を成すこと、を特徴とする機器。
- 請求項1〜3のいずれか1項に記載の機器であって、前記ナビゲーションシステム(20)が、手持ち式の統合ナビゲーションシステム(20)であること、を特徴とする機器。
- 請求項4に記載の機器であって、前記ナビゲーションシステム(20)が、スマートフォン(44)又はタブレットコンピュータであること、を特徴とする機器。
- 請求項1〜5のいずれか1項に記載の機器であって、前記ナビゲーションシステム(20)がディスプレイユニット(54)を含み、該ディスプレイユニット(54)は前記データ処理ユニット(48)に連結され、該ディスプレイユニット(54)上に、前記安定化要素(12)の画像、及び/又は前記画像を撮影するための操作者に対する命令、及び/又は前記画像に基づいて決定された前記安定化要素(12)の描写を示すことが可能であること、を特徴とする機器。
- 請求項1〜6のいずれか1項に記載の機器であって、前記安定化要素が、例えば前記安定化要素上の点又は線として構成された、前記標示装置の標示要素を含む又は形成すること、を特徴とする機器。
- 請求項1〜7のいずれか1項に記載の機器であって、前記標示装置が、前記安定化要素に解放可能に固定される又は固定可能であること、を特徴とする機器。
- 請求項1〜8のいずれか1項に記載の機器であって、前記標示装置が、前記安定化要素に一体的に接続されること、を特徴とする機器。
- 請求項9に記載の機器であって、所定の切断点が、前記安定化要素から前記標示装置を分離するために設けられること、を特徴とする機器。
- 請求項1〜10のいずれか1項に記載の機器であって、前記機器(10)が、前記安定化要素(12)用の埋込み具(16)を含み、該埋込み具(16)上で、前記安定化要素及び前記標示装置(18)が保持されること、を特徴とする機器。
- 請求項1〜11のいずれか1項に記載の機器であって、前記機器(10)が再形成装置(22)を含み、該再形成装置(22)を用いて、前記安定化要素(12)の形状が変更可能であること、を特徴とする機器。
- 請求項12に記載の機器であって、前記再形成装置(22)は、ロッド(32)を曲げるための曲げ装置(62)であり、該ロッド(32)として前記安定化要素(12)が構成されること、を特徴とする機器。
- 請求項12又は13に記載の機器であって、前記安定化要素(12)を決定された形状から指定可能な形状へと変換するために、前記データ処理ユニット(48)により、前記再形成装置(22)を取り扱うための形状変更情報が、前記ナビゲーションシステム(20)の表示ユニット、例えばディスプレイユニット(54)上で操作者に提供されることが可能であること、を特徴とする機器。
- 請求項12〜14のいずれか1項に記載の機器であって、前記安定化要素(12)を決定された形状から指定可能な形状へと変換するために、形状変更情報が、前記ナビゲーションシステム(20)から通信インタフェースを介して前記再形成装置(22)に転送可能であること、を特徴とする機器。
- 請求項12〜15のいずれか1項に記載の機器であって、
前記機器(10)が、前記再形成装置(22)上で規定の空間的配置にて保持される、又は前記再形成装置(22)に含まれる、又は前記再形成装置(22)により形成される更なる医療用標示装置(24)を含むこと、
前記更なる標示装置(24)の場所及び配向が、前記ナビゲーションシステム(20)を用いて決定可能であること、及び
前記データ処理ユニット(48)により、前記再形成装置(22)を案内するための命令が、前記ナビゲーションシステム(20)の表示ユニット、例えばディスプレイユニット(54)上で操作者に提供されることが可能であること、
を特徴とする機器。 - カメラを含む光検出ユニット、及び前記検出ユニットに連結されたデータ処理ユニットを含むナビゲーションシステムと、
外科用固定システムの安定化要素と、
前記安定化要素上で規定の空間的配置にて保持される、又は前記安定化要素に含まれる、又は前記安定化要素により形成される医療用標示装置と
を備えた請求項1〜16のいずれか1項に記載の機器を使用して、外科用安定化要素の形状を決定するための方法であって、
前記標示装置の空間における場所及び配向が、前記ナビゲーションシステムを用いて決定可能であり、
前記安定化要素及び前記標示装置の少なくとも2つの画像が、前記検出ユニットにより、異なる配向から撮影され、
前記安定化要素の形状が、前記2つ以上の画像に基づいて前記データ処理ユニットにより決定される、
方法。
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DE102015102776.3 | 2015-02-26 | ||
DE102015102776.3A DE102015102776A1 (de) | 2015-02-26 | 2015-02-26 | Medizinisches Instrumentarium und Verfahren |
PCT/EP2016/051671 WO2016134911A1 (de) | 2015-02-26 | 2016-01-27 | Medizinisches instrumentarium und verfahren |
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JP2018509965A true JP2018509965A (ja) | 2018-04-12 |
JP6736570B2 JP6736570B2 (ja) | 2020-08-05 |
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US (1) | US10786287B2 (ja) |
EP (1) | EP3261564B1 (ja) |
JP (1) | JP6736570B2 (ja) |
DE (1) | DE102015102776A1 (ja) |
WO (1) | WO2016134911A1 (ja) |
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DE102015102776A1 (de) | 2015-02-26 | 2016-09-01 | Aesculap Ag | Medizinisches Instrumentarium und Verfahren |
DE102015102768A1 (de) | 2015-02-26 | 2016-09-01 | Aesculap Ag | Medizinisches Instrumentarium |
DE102016115605A1 (de) | 2016-08-23 | 2018-03-01 | Aesculap Ag | Medizinisches Instrumentarium und Verfahren |
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US10779893B2 (en) * | 2018-10-18 | 2020-09-22 | Warsaw Orthopedic, Inc. | Spinal implant system and method |
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DE102015102776A1 (de) | 2016-09-01 |
US20170340367A1 (en) | 2017-11-30 |
JP6736570B2 (ja) | 2020-08-05 |
EP3261564A1 (de) | 2018-01-03 |
US10786287B2 (en) | 2020-09-29 |
WO2016134911A1 (de) | 2016-09-01 |
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