RU2014143528A - Хирургический направитель, соответствующий пациенту, и способ его применения - Google Patents

Хирургический направитель, соответствующий пациенту, и способ его применения Download PDF

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RU2014143528A
RU2014143528A RU2014143528A RU2014143528A RU2014143528A RU 2014143528 A RU2014143528 A RU 2014143528A RU 2014143528 A RU2014143528 A RU 2014143528A RU 2014143528 A RU2014143528 A RU 2014143528A RU 2014143528 A RU2014143528 A RU 2014143528A
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surgical
guide
patient
anatomy
instrument
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RU2014143528A
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RU2628464C2 (ru
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Джордж ФРЕЙ
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Джордж ФРЕЙ
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  • Robotics (AREA)

Abstract

1. Способ подготовки индивидуализированного хирургического устройства или инструмента, включающий этапы:получения данных, связанных с анатомией пациента;преобразования полученных данных в трехмерный набор (наборы) данных;определения по меньшей мере одной траектории или пути для упрощения хирургической процедуры, которая должна быть выполнена в отношении конкретного пациента;определения по меньшей мере одной поверхности, связанной с анатомией пациента;генерирования трехмерного представления индивидуализированного хирургического устройства или инструмента, включающего по меньшей мере одну траекторию или путь и поверхность соответствия по меньшей мере одной поверхности, связанной с анатомией пациента;идентификации по меньшей мере одного размера и типа устройства или инструмента по меньшей мере частично на основе трехмерного сгенерированного представления; иизготовления индивидуализированного хирургического устройства или инструмента с использованием трехмерного представления.2. Индивидуализированное хирургическое устройство или инструмент, сформированный с помощью способа по п. 1.3. Индивидуализированное хирургическое устройство или инструмент по п. 2, отличающееся тем, что устройство представляет собой направитель для размещения фиксирующего устройства.4. Индивидуализированное хирургическое устройство или инструмент по п. 2, отличающееся тем, что устройство представляет собой имплантируемое устройство.5. Индивидуализированное хирургическое устройство или инструмент по п. 2, отличающееся тем, что устройство содержит направитель для разреза, при этом направитель содержит ряд плоскостей разреза в

Claims (20)

1. Способ подготовки индивидуализированного хирургического устройства или инструмента, включающий этапы:
получения данных, связанных с анатомией пациента;
преобразования полученных данных в трехмерный набор (наборы) данных;
определения по меньшей мере одной траектории или пути для упрощения хирургической процедуры, которая должна быть выполнена в отношении конкретного пациента;
определения по меньшей мере одной поверхности, связанной с анатомией пациента;
генерирования трехмерного представления индивидуализированного хирургического устройства или инструмента, включающего по меньшей мере одну траекторию или путь и поверхность соответствия по меньшей мере одной поверхности, связанной с анатомией пациента;
идентификации по меньшей мере одного размера и типа устройства или инструмента по меньшей мере частично на основе трехмерного сгенерированного представления; и
изготовления индивидуализированного хирургического устройства или инструмента с использованием трехмерного представления.
2. Индивидуализированное хирургическое устройство или инструмент, сформированный с помощью способа по п. 1.
3. Индивидуализированное хирургическое устройство или инструмент по п. 2, отличающееся тем, что устройство представляет собой направитель для размещения фиксирующего устройства.
4. Индивидуализированное хирургическое устройство или инструмент по п. 2, отличающееся тем, что устройство представляет собой имплантируемое устройство.
5. Индивидуализированное хирургическое устройство или инструмент по п. 2, отличающееся тем, что устройство содержит направитель для разреза, при этом направитель содержит ряд плоскостей разреза внутри костных анатомических структур, так что режущий инструмент ориентирован на разрез через ряд плоскостей разреза, и последующее удаление костной анатомии приводит к исправлению по меньшей мере одного анатомического нарушения.
6. Способ по п. 1, отличающийся тем, что этап получения данных, связанных с анатомией пациента, выполняют с помощью получения данных посредством устройства сканирования КТ, устройства сканирования МРТ, сверхзвукового устройства сканирования, устройства рентгенографии, устройства рентгеноскопии или устройства сканирования медицинской радиологии.
7. Способ по п. 1, также включающий этапы:
определения данных биосигнала для пациента, реагирующего на электрический сигнал от устройства наблюдения, связанного с индивидуализированным хирургическим устройством или инструментом; и
сравнения данных биосигнала для пациента для предопределения данных биосигнала в соответствии с по меньшей мере одной мышечной областью, нервной областью, сосудистой областью и костной областью.
8. Способ по п. 7, отличающийся тем, что этап определения данных биосигнала включает определение одной из групп, состоящих из данных электромиографии (EMG), данных соматосенсорного вызванного потенциала (SSEP) и данных моторного вызванного потенциала (МЕР).
9. Хирургический направитель для использования при выполнении пациенту хирургической процедуры, содержащий
по меньшей мере одну поверхность, определенную из анатомии пациента и являющуюся дополнением к ней;
по меньшей мере одну траекторию или путь, определенные из анатомии пациента для упрощения хирургической процедуры; и
при этом по меньшей мере одна поверхность, которая является дополнением к анатомии пациента, изготовлена с помощью получения по меньшей мере одного первого набора анатомических данных от пациента и включает анатомические данные от пациента в по меньшей мере одной поверхности, при этом по меньшей мере одну траекторию или путь для упрощения хирургической процедуры определяют из по меньшей мере одного второго набора полученных анатомических данных.
10. Хирургический направитель по п. 9, отличающийся тем, что хирургический направитель состоит из пластины, которая содержит ряд контуров или характеристик поверхности в соответствии с костной анатомией пациента.
11. Хирургический направитель по п. 10, отличающийся тем, что пластину настраивают на охватывание множества позвонков пациента.
12. Хирургический направитель по п. 9, отличающийся тем, что направитель содержит один или несколько путей для направления по меньшей мере одного хирургического режущего инструмента.
13. Хирургический направитель по п. 12, отличающийся тем, что направитель выбран из группы, состоящей из направителя для ламинэктомии, направителя для корпэктомии, направителя для остеотомии по удалению ножки, направителя для остеотомии по Смит-Петерсону, направителя для резекции позвоночного столба и направителя для ассиметричной остеотомии.
14. Хирургический направитель по п. 13, отличающийся тем, что направитель состоит из ряда направителей, которые могут быть вложены друг в друга для достижения множества слоев или траекторий разрезов в последующих этапах.
15. Хирургический направитель по п. 13, отличающийся тем, что направитель состоит из ряда направителей, которые могут быть расположены в монолитной или многоуровневой конфигурации, такой как различные уровни позвоночника пациента.
16. Хирургический направитель по п. 9, отличающийся тем, что хирургический направитель производят посредством процесса, осуществляемого посредством выбранного из группы, состоящей из машины быстрого прототипирования, машины стереолитографии (SLA), машины избирательного лазерного спекания (SLS), машины избирательного теплового спекания (SHM), машины моделирования (FDM) методом наплавления, машины прямого лазерного спекания (DMLS) металлов, печатной (РР) машины с порошковым основанием, машины цифровой оптической обработки (DLP), струйной смоляной машины для печати фотографий, машины электронно-лучевого плавления (ЕВМ).
17. Хирургический направитель по п. 16, отличающийся тем, что направитель производят в местоположении, выбранном из группы, состоящей из местоположения вне производственной площадки, на месте производственной площадки, в клинике, хирургическом центре, кабинетах хирурга, государственной больнице или частной больнице.
18. Система для выполнения пациенту хирургической процедуры, содержащая
хирургический направитель;
при этом хирургический направитель содержит ряд поверхностей, определенных посредством сканированных данных от пациента, ряд поверхностей, сформированных в соответствии с костной анатомией пациента;
хирургический направитель дополнительно содержит по меньшей мере одну траекторию или путь, определенный посредством костной анатомии пациента, для упрощения хирургической процедуры;
хирургический направитель дополнительно содержит по меньшей мере одну муфту, при этом муфта состоит из проводящего материала и имеет первый конец и второй конец;
инструмент, содержащий по меньшей первую часть, состоящую из проводящего материала и предназначенную для приема внутрь по меньшей мере одной муфты посредством введения по меньшей мере первой части в первый конец по меньшей мере одной муфты и соприкосновения с проводящим материалом по меньшей мере одной муфты;
при этом по меньшей мере первая часть инструмента предназначена для прохождения через по меньшей мере одну муфту и выход через второй конец по меньшей мере одной муфты; и
при этом хирургический направитель может быть подвержен электрическому току для предоставления интраоперационного наблюдения (IOМ) за инструментом во время соприкосновения с хирургическим направителем и анатомией пациента.
19. Система по п. 18, отличающаяся тем, что хирургический направитель подвергают воздействию электрического тока посредством обеспечения по меньшей мере одного электрода на проводящем материале хирургического направителя и подачи электрического тока на по меньшей мере один электрод.
20. Система по п. 19, отличающаяся тем, что инструмент является режущим инструментом, сверлящим инструментом или маршрутизирующим инструментом.
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