# US 12,178,518 B2 · Systems and methods related to robotic guidance in surgery

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- Number: US 12,178,518 B2
- Document ID: US12178518B2
- Status: Granted
- Kind: B2
- Application number: 18/487,481
- Filed: 2023-10-16
- Published: 2024-02-15
- Granted: 2024-12-31
- Earliest claimed: 2012-06-21
- Assignees: Globus Medical, Inc.
- Applicants: Globus Medical, Inc.
- Inventors: Neil R. Crawford
- Web page: https://patentgrep.com/patent/US12178518B2

## CPC

- A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations
- A61B 6/12: Arrangements for detecting or locating foreign bodies
- A61B 6/461: {Displaying means of special interest}
- A61B 6/505: {for diagnosis of bone}
- A61B 6/5217: {extracting a diagnostic or physiological parameter from medical diagnostic data}
- A61B 17/7082: {for driving, i.e. rotating, screws or screw parts specially adapted for spinal fixation, e.g. for driving polyaxial or tulip-headed screws}
- A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B 34/30: Surgical robots
- G06T 7/0012: {Biomedical image inspection}
- G06T 7/33: using feature-based methods
- G06T 19/006: {Mixed reality (object pose determination, tracking or camera calibration for mixed reality G06T7/00)}
- G06T 19/20: Editing of three-dimensional [3D] images, e.g. changing shapes or colours, aligning objects or positioning parts
- G16H 50/30: for calculating health indices; for individual health risk assessment
- A61B 6/4405: {the apparatus being movable or portable, e.g. handheld or mounted on a trolley}
- A61B 6/468: {allowing annotation or message recording}
- A61B 17/1757: {for the spine}
- A61B 17/7001: {Screws or hooks combined with longitudinal elements which do not contact vertebrae (A61B17/7058 takes precedence)}
- A61B 17/86: Pins or screws {or threaded wires; nuts therefor (A61B17/72 take precedence)}
- A61B 90/11: with guides for needles or instruments, e.g. arcuate slides or ball joints
- A61B 2017/00477: {Coupling (A61B2017/0046 takes precedence)}
- A61B 2017/00876: {magnetic}
- A61B 2034/102: {Modelling of surgical devices, implants or prosthesis}
- A61B 2034/104: {Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring}
- A61B 2034/105: {Modelling of the patient, e.g. for ligaments or bones}
- A61B 2034/107: {Visualisation of planned trajectories or target regions}
- A61B 2034/2051: {Electromagnetic tracking systems}
- A61B 2034/2055: {Optical tracking systems}
- A61B 2034/2059: {Mechanical position encoders}
- A61B 2034/2068: {using pointers, e.g. pointers having reference marks for determining coordinates of body points}
- A61B 2090/033: {Abutting means, stops, e.g. abutting on tissue or skin}
- A61B 2090/363: {Use of fiducial points}
- A61B 2090/376: {using X-rays, e.g. fluoroscopy}
- A61B 2090/3762: {using computed tomography systems [CT]}
- A61B 2090/3945: {Active visible markers, e.g. light emitting diodes}
- A61B 2090/3966: {Radiopaque markers visible in an X-ray image}
- A61B 2090/3983: {Reference marker arrangements for use with image guided surgery}
- A61F 2/4611: {of spinal prostheses}
- A61F 2002/4632: {using computer-controlled surgery, e.g. robotic surgery}
- G06T 7/20: Analysis of motion (motion estimation for coding, decoding, compressing or decompressing digital video signals H04N19/43, H04N19/51)
- G06T 7/50: Depth or shape recovery
- G06T 7/70: Determining position or orientation of objects or cameras (camera calibration G06T7/80)
- G06T 19/003: {Navigation within 3D models or images}
- G06T 2200/24: involving graphical user interfaces [GUIs]
- G06T 2207/10081: Computed x-ray tomography [CT]
- G06T 2207/10088: Magnetic resonance imaging [MRI]
- G06T 2207/10116: X-ray image
- G06T 2207/30008: Bone
- G06T 2207/30204: Marker
- G06T 2207/30241: Trajectory
- G06T 2210/41: Medical
- G06T 2219/2016: Rotation, translation, scaling
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- G06T: IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- 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 implant planning computer positions an implant device relative to a bone of a patient. An initial image of a bone is obtained. An initial location data structure is obtained that contains data defining mapping between locations on the implant device and corresponding locations relative to the bone in the initial image. A target image of the bone of the patient is obtained. A transformation matrix is generated that transforms a contour of a portion of the bone in the initial image to satisfy a defined rule for conforming to a contour of a corresponding portion of the bone in the target image. A transformed location data structure is generated based on applying the transformation matrix to the initial location data structure. A graphical representation of the implant device is displayed overlaid at locations on the target image of the bone determined based on the transformed location data structure.

## Claims

### Claim 1

A method by a surgical implant planning computer for positioning a surgical implant device relative to a bone of a patient, the method comprising:
generating a transformation matrix that transforms a portion of the bone in an initial image to satisfy a defined rule for conforming to a corresponding portion of the bone in a target image;
generating a transformed location data structure based on applying the transformation matrix to an initial location data structure, wherein the initial data structure includes data defining mapping between a set of locations on the surgical implant device and a corresponding set of locations relative to the bone in the initial image; and
displaying a graphical representation of the surgical implant device overlaid at locations on the target image of the bone determined based on the transformed location data structure.

### Claim 2 (depends on 1)

The method of claim 1, wherein the surgical implant device comprises a surgical screw, and further comprising:
determining locations of a tip and a tail of the surgical screw relative to the bone in the initial image based on the data in the initial location data structure.

### Claim 3 (depends on 1)

The method of claim 1, wherein the generation of the transformation matrix comprises:
modifying a size and/or a rotational angle of the portion of the bone in the initial image to satisfy the defined rule for conforming to a size and/or a rotational angle of the corresponding portion of the bone in the target image.

### Claim 4 (depends on 3)

The method of claim 3, further comprising:
repeating the modification of the size and/or the rotational angle of a plurality of portions of the bone in the initial image to satisfy the defined rule for conforming to the size and/or the rotational angle of a corresponding plurality of portions of the bone in the target image.

### Claim 5 (depends on 3)

The method of claim 3, wherein the modification of the size and/or the rotational angle of the portion of the bone in the initial image, comprises:
applying a best fit transformation of the size and/or the rotational angle of the portion of the bone in the initial image to satisfy the defined rule for conforming to the size and/or the rotational angle of the corresponding portion of the bone in the target image.

### Claim 6 (depends on 3)

The method of claim 3, wherein the modification of the size and/or the rotational angle of the portion of the bone in the initial image, comprises:
applying an affine transformation of the size and/or the rotational angle of the portion of the bone in the initial image to satisfy the defined rule for conforming to the size and/or the rotational angle of the corresponding portion of the bone in the target image.

### Claim 7 (depends on 1)

The method of claim 1, wherein the generation of the transformed location data structure based on applying the transformation matrix to the initial location data structure, comprises:
for a first one of the locations on the surgical implant device defined in the initial location data structure, applying the transformation matrix to transform a corresponding first one of the locations defined by the initial location data structure relative to the bone in the initial image to a transformed first location defined relative to the bone in the target image; and
storing the transformed first location in the transformed location data structure with an association to the first one of the locations on the surgical implant device.

### Claim 8 (depends on 7)

The method of claim 7, further comprising:
generating another transformation matrix that transforms another portion of the bone in the initial image to satisfy the defined rule for conforming to a corresponding another portion of the bone in the target image,
wherein the generation of the transformed location data structure based on applying the transformation matrix to the initial location data structure, further comprises:
for a second one of the locations on the surgical implant device defined in the initial location data structure, applying the other transformation matrix to transform a corresponding second one of the locations defined by the initial location data structure relative to the bone in the initial image to a transformed second location defined relative to the bone in the target image; and
storing the transformed second location in the transformed location data structure with an association to the second one of the locations on the surgical implant device.

### Claim 9 (depends on 7)

The method of claim 7, wherein:
the surgical implant device comprises a surgical screw having a tip location and a tail location defined in the initial location data structure relative to the bone in the initial image; and
the generation of the transformed location data structure based on applying the transformation matrix to the initial location data structure, comprises:
generating a first transformation matrix that transforms a first portion of the bone in the initial image to satisfy the defined rule for conforming to a corresponding first portion of the bone in the target image;
for the tip location on the surgical screw defined in the initial location data structure, applying the first transformation matrix to transform a corresponding first location defined by the initial location data structure relative to the bone in the initial image to a transformed first location defined relative to the bone in the target image;
storing the transformed first location in the transformed location data structure with an association to the tip location on the surgical screw;
generating a second transformation matrix that transforms a second portion of the bone in the initial image to satisfy the defined rule for conforming to a corresponding second portion of the bone in the target image,
for the tail location on the surgical screw defined in the initial location data structure, applying the second transformation matrix to transform a corresponding second location defined by the initial location data structure relative to the bone in the initial image to a transformed second location defined relative to the bone in the target image; and
storing the transformed second location in the transformed location data structure with an association to the tail location on the surgical screw.

### Claim 10 (depends on 1)

The method of claim 1, wherein:
the surgical implant device comprises a surgical screw having a tip location and a tail location defined by the initial location data structure relative to the bone in the initial image; and
the generation of the transformed location data structure based on applying the transformation matrix to the initial location data structure, comprises scaling a distance between the tip and tail locations of the surgical screw defined relative to the bone in the target image based on the transformation matrix.

### Claim 11 (depends on 10)

The method of claim 10, wherein the generation of the transformed location data structure based on applying the transformation matrix to the initial location data structure, further comprises:
scaling a diameter of the surgical screw based on the scaling of the distance between the tip and tail locations of the surgical screw.

### Claim 12 (depends on 1)

The method of claim 1, further comprising:
providing the transformed location data structure to a surgical robotic system to control positioning of a surgical end-effector of the surgical robotic system relative to a location on the bone of the patient based on data of the transformed location data structure.

### Claim 13 (depends on 12)

The method of claim 12, further comprising:
transforming locations that are defined by the transformed location data structure in a reference coordinate system of the target image of the bone to another reference coordinate system of the surgical end-effector;
controlling movement by the surgical robotic system of the surgical end-effector to position the surgical end-effector relative to the location on the bone of the patient based on the transformed locations to facilitate implantation of the surgical implant device in the bone of the patient.

### Claim 14 (depends on 1)

The method of claim 1, further comprising:
determining distances between locations on the surgical implant device defined by the transformed location data structure and adjacent surfaces of the bone in the target image; and
responsive to the determined distances, adjusting where the graphical representation of the surgical implant device is displayed as an overlay on the target image of the bone.

### Claim 15 (depends on 1)

The method of claim 1, further comprising:
obtaining a set of rules defining depth of penetration of the surgical implant device and angle of the penetration relative to a surface of the bone in the target image; and
responsive to the set of rules, adjusting where the graphical representation of the surgical implant device is displayed as an overlay on the target image of the bone.

### Claim 16

A surgical implant planning computer comprising:
at least one network interface connected to at least one networked server;
a display device;
at least one processor connected to the at least one network interface and the display device; and
at least one memory storing program instructions executed by the at least one processor to perform operations comprising:
generating a transformation matrix that transforms a portion of the bone in an initial image to satisfy a defined rule for conforming to a corresponding portion of the bone in a target image;
generating a transformed location data structure based on applying the transformation matrix to an initial location data structure, wherein the initial data structure includes data defining mapping between a set of locations on the surgical implant device and a corresponding set of locations relative to the bone in the initial image; and
displaying a graphical representation of the surgical implant device overlaid at locations on the target image of the bone determined based on the transformed location data structure.

### Claim 17 (depends on 16)

The surgical implant planning computer of claim 16, wherein:
the surgical implant device comprises a surgical screw having a tip location and a tail location defined by the initial location data structure relative to the bone in the initial image; and
the generation of the transformed location data structure based on applying the transformation matrix to the initial location data structure, comprises scaling a distance between the tip and tail locations of the surgical screw defined relative to the bone in the target image based on the transformation matrix.

### Claim 18 (depends on 16)

The surgical implant planning computer of claim 16, wherein the operations further comprise:
providing the transformed location data structure through the at least one network interface to a surgical robotic system to control positioning of a surgical end-effector of the surgical robotic system relative to a location on the bone of the patient based on data of the transformed location data structure.

### Claim 19

A surgical system comprising:
a surgical implant planning computer comprising:
at least one network interface connected to at least one networked server;
a display device;
at least one processor connected to the at least one network interface and the display device; and
at least one memory storing program instructions executed by the at least one processor to perform operations comprising:
generating a transformation matrix that transforms a portion of the bone in an initial image to satisfy a defined rule for conforming to a corresponding portion of the bone in a target image;
generating a transformed location data structure based on applying the transformation matrix to an initial location data structure, wherein the initial data structure includes data defining mapping between a set of locations on the surgical implant device and a corresponding set of locations relative to the bone in the initial image; and
displaying a graphical representation of the surgical implant device overlaid at locations on the target image of the bone determined based on the transformed location data structure; and
a surgical robotic system comprising:
a robotic arm configured to position a surgical end-effector; and
a controller connected to the robotic arm, wherein the controller is configured to perform operations comprising:
transforming locations that are defined by the transformed location data structure in a reference coordinate system of the target image of the bone to another reference coordinate system of the surgical end-effector; and
controlling movement of the surgical end-effector to position the surgical end-effector relative to a location on the bone of the patient based on the transformed locations to facilitate implantation of the surgical implant device in the bone of the patient.

### Claim 20 (depends on 19)

The surgical system of claim 19, wherein:
the surgical implant device comprises a surgical screw having a tip location and a tail location defined by the initial location data structure relative to the bone in the initial image;
the operation of generating the transformed location data structure based on applying the transformation matrix to the initial location data structure, comprises scaling a distance between the tip and tail locations of the surgical screw defined relative to the bone in the target image based on the transformation matrix; and
the operation of controlling movement of the surgical end-effector to position the surgical end-effector relative to a location on the bone of the patient based on the transformed locations to facilitate implantation of the surgical implant device in the bone of the patient.