# US 11,992,274 B2 · Systems and methods for automatic oblique lateral interbody fusion (OLIF) corridor planning > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 11,992,274 B2 - Document ID: US11992274B2 - Status: Granted - Kind: B2 - Application number: 17/370,176 - Filed: 2021-07-08 - Published: 2023-01-12 - Granted: 2024-05-28 - Earliest claimed: 2021-07-08 - Assignees: Medtronic Navigation, Inc. - Applicants: Medtronic Navigation, Inc. - Inventors: Rowena O. Vigh; Nikhil Mahendra; Andrew J. Wald - Web page: https://patentgrep.com/patent/US11992274B2 ## CPC - A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis - A61B 6/12: Arrangements for detecting or locating foreign bodies - A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations - A61B 34/25: {User interfaces for surgical systems} - A61B 2034/107: {Visualisation of planned trajectories or target regions} - A61B 2034/2051: {Electromagnetic tracking systems} - A61B 2034/2055: {Optical tracking systems} - A61B 2090/3762: {using computed tomography systems [CT]} - A61F 2/4455: {for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages (intervertebral discs A61F2/442)} - A61F 2002/4632: {using computer-controlled surgery, e.g. robotic surgery} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C) ## Abstract A surgical navigation and planning system is disclosed. The system may include at least one processor, and a storage medium storing programming instructions. The programming instructions may cause the processor to receive patient-specific vertebrae information include at least one image which may be acquired by an X-ray. The system may perform segmentation of objects in the at least one image and automatically select a set of objects for planning an optimal trajectory to a location proximal the vertebrae level. The system may determine boundary dimensions of an interbody implant, a first entry incision location and a first path for the interbody implant from the first entry incision location to the location proximal the vertebrae level. The system may calculate a plurality of clearance distances between the boundary dimensions and the set of objects. The set of objects may include the psoas muscle, Aorta, and/or Vena Cava. ## Claims ### Claim 1 A surgical navigation and planning system, comprising: a display; at least one processor; a non-transitory and tangible computer readable storage medium having programming instructions stored thereon, which when executed by the at least one processor cause the at least one processor to: receive patient-specific vertebrae information associated with a vertebrae level for treatment, the patient-specific vertebrae information comprising at least one image; perform segmentation of a plurality of objects in the at least one image; automatically select a set of objects from the plurality of objects for automatic planning of a trajectory to a location proximal the vertebrae level; determine boundary dimensions of an interbody implant, determine a first entry incision location; determine a first path and orientation for the interbody implant from the first entry incision location to the location proximal the vertebrae level; locate a psoas muscle for the vertebrae level; locate patient vessels proximate to the psoas muscle; calculate, a distance between the psoas muscle and the patient vessels proximate to the psoas muscle; and calculate, on the basis of the first path, a first plurality of clearance distances between the boundary dimensions of the interbody implant and the set of objects, wherein the at least one processor causes the display to display an optimal surgical plan provided the first entry incision location and the first path navigate around the set of objects. ### Claim 2 (depends on 1) The surgical navigation and planning system of claim 1, wherein the computer readable storage medium further comprises one or more programming instructions that, when executed by the at least one processor cause the at least one processor to determine, on the basis of the first plurality of clearance distances, whether the first entry incision location and the first path navigate around the set of objects within a programmable margin of error. ### Claim 3 (depends on 2) The surgical navigation and planning system of claim 2, wherein the set of objects comprises at risk patient tissue adjacent the trajectory, wherein the at risk patient tissue comprises a patient Aorta and/or Vena Cava. ### Claim 4 (depends on 1) The surgical navigation and planning system of claim 1, wherein the computer readable storage medium further comprises one or more programming instructions that, when executed by the at least one processor cause the at least one processor to: determine a second entry incision location; determine a second path for the interbody implant from the second entry incision location to the location proximal the vertebrae level; and calculate, on the basis of the second path, a second plurality of clearance distances between the boundary dimensions of the interbody implant and the set of objects. ### Claim 5 (depends on 4) The surgical navigation and planning system of claim 4, wherein the computer readable storage medium further comprises one or more programming instructions that, when executed by the at least one processor cause the at least one processor to: compare the first plurality of clearance distances to the second plurality of clearance distances; and rank the first path and second path on the basis of the comparison of the first plurality of clearance distances and the second plurality of clearance distances. ### Claim 6 (depends on 5) The surgical navigation and planning system of claim 5, wherein the computer readable storage medium further comprises one or more programming instructions that, when executed by the at least one processor cause the at least one processor to cause the display to display the ranking of the first path and second path. ### Claim 7 (depends on 5) The surgical navigation and planning system of claim 5, wherein the computer readable storage medium further comprises one or more programming instructions that, when executed by the at least one processor cause the at least one processor to cause the display to display the comparison of the first plurality of clearance distances and the second plurality of clearance distances in a customizable graphical user interface. ### Claim 8 (depends on 1) The surgical navigation and planning system of claim 1, wherein the computer readable storage medium further comprises one or more programming instructions that, when executed by the at least one processor cause the at least one processor to receive aggregated historical data comprising clinical outcomes of completed surgeries utilizing a substantially similar interbody device. ### Claim 9 (depends on 1) The surgical navigation and planning system of claim 1, wherein the computer readable storage medium further comprises one or more programming instructions that, when executed by the at least one processor cause the at least one processor to receive individual surgeon preferences. ### Claim 10 (depends on 1) The surgical navigation and planning system of claim 1, further comprising an imaging system including a source for generating X-rays and a detector for detecting X-rays that pass through a patient. ### Claim 11 (depends on 10) The surgical navigation and planning system of claim 10, wherein the computer readable storage medium further comprises one or more programming instructions that, when executed by the at least one processor cause the at least one processor to receive the patient-specific vertebrae information comprising the at least one image from the imaging system. ### Claim 12 (depends on 1) The surgical navigation and planning system of claim 1, wherein the trajectory comprises an oblique trajectory with respect to a patient. ### Claim 13 (depends on 1) The surgical navigation and planning system of claim 1, wherein the trajectory comprises a lateral trajectory with respect to a patient. ### Claim 14 (depends on 1) The surgical navigation and planning system of claim 1, wherein the trajectory comprises an oblique lateral trajectory with respect to a patient for performing an interbody fusion to the vertebrae level. ### Claim 15 (depends on 1) The surgical navigation and planning system of claim 1, wherein the set of objects includes a psoas muscle. ### Claim 16 (depends on 1) The surgical navigation and planning system of claim 1, wherein the patient vessels comprise an Aorta of a patient and/or a Vena Cava of a patient. ### Claim 17 A method for determining an optimal oblique corridor for inserting an interbody implant, comprising: providing a surgical navigation and planning system, comprising: a display; at least one processor; and a non-transitory and tangible computer readable storage medium having programming instructions stored thereon; receiving patient-specific vertebrae information associated with a vertebrae level for treatment, the patient-specific vertebrae information comprising at least one image acquired from an imaging system; performing segmentation of objects in the at least one image; selecting, automatically, a set of objects for planning a trajectory to a location proximal the vertebrae level; determining boundary dimensions of an interbody implant, the interbody implant being used for inserting along the trajectory; determining a first entry incision location; determining a first path for the interbody implant from the first entry incision location to the location proximal the vertebrae level; locating a psoas muscle for the vertebrae level; locating patient vessels proximate to the psoas muscle; and calculating, a distance between the psoas muscle and the patient vessels proximate to the psoas muscle; calculating, on the basis of the first path, a first plurality of clearance distances between the determined boundary dimensions of the interbody implant and the set of objects; and displaying, by the display, a viable surgical plan provided the first entry incision location and the first path navigate around delicate patient tissue within a pre-determined margin of error. ### Claim 18 (depends on 17) The method of claim 17, wherein the patient vessels comprise an Aorta of a patient and/or a Vena Cava of a patient. ### Claim 19 A surgical navigation and planning system, comprising: a display; at least one processor; a non-transitory and tangible computer readable storage medium having programming instructions stored thereon, which when executed by the at least one processor cause the at least one processor to: receive patient-specific vertebrae information associated with a vertebrae level for treatment, the patient-specific vertebrae information comprising at least one image; perform segmentation of a plurality of objects in the at least one image; automatically select a set of objects from the plurality of objects for automatic planning of a trajectory to a location proximal the vertebrae level; determine boundary dimensions of an interbody implant, determine a first entry incision location; determine a second entry incision location; determine a first path and orientation for the interbody implant from the first entry incision location to the location proximal the vertebrae level; determine a second path for the interbody implant from the second entry incision location to the location proximal the vertebrae level; calculate, on the basis of the first path, a first plurality of clearance distances between the boundary dimensions of the interbody implant and the set of objects; calculate, on the basis of the second path, a second plurality of clearance distances between the boundary dimensions of the interbody implant and the set of objects; compare the first plurality of clearance distances to the second plurality of clearance distances; rank the first path and second path on the basis of the comparison of the first plurality of clearance distances and the second plurality of clearance distances; and display an optimal surgical plan provided the first entry incision location and the first path navigate around the set of objects or the second entry incision location and the second path navigate around the set of objects. ### Claim 20 (depends on 19) The surgical navigation and planning system of claim 19, wherein the computer readable storage medium further comprises one or more programming instructions that, when executed by the at least one processor cause the at least one processor to cause the display to display the ranking of the first path and second path.