# US 2014/0194889 A1 · Pedicle Screw Insertion System and Method > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2014/0194889 A1 - Document ID: US20140194889A1 - Status: Published application - Kind: A1 - Application number: 14/024,741 - Filed: 2013-09-12 - Published: 2014-07-10 - Earliest claimed: 2010-04-26 - Inventors: David Chang; Nicholas R. Powley; Alan Fischer; Andrew Fischer - Web page: https://patentgrep.com/patent/US20140194889A1 ## CPC - A61B 17/1703: {using imaging means, e.g. by X-rays} - A61B 6/022: {Stereoscopic imaging} - A61B 6/4405: {the apparatus being movable or portable, e.g. handheld or mounted on a trolley} - A61B 6/4452: {the source unit and the detector unit being able to move relative to each other} - A61B 6/505: {for diagnosis of bone} - A61B 6/5211: {involving processing of medical diagnostic data} - A61B 6/547: {involving tracking of position of the device or parts of the device} - A61B 6/587: {Alignment of source unit to detector unit} - A61B 17/1671: {for the spine} - A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations - A61B 90/36: {Image-producing devices or illumination devices not otherwise provided for} - G06T 3/608: by skew deformation, e.g. two-pass or three-pass rotation - G16H 50/20: for computer-aided diagnosis, e.g. based on medical expert systems - A61B 6/12: Arrangements for detecting or locating foreign bodies - A61B 8/00: Diagnosis using ultrasonic, sonic or infrasonic waves - A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis - A61B 2090/364: {Correlation of different images or relation of image positions in respect to the body} - 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 ## Abstract Improved methods and apparatuses for inserting pedicle screws in accordance with embodiments of the present invention include an image correction algorithm. In various embodiments, an original image of a region of interest of a patient including a pedicle is created with an X-ray emitter and an X-ray detector. Due to the X-ray emitter not being aligned orthogonal to the X-ray detector, the original image will be skewed. Using a known location and orientation of the X-ray detector, a location and orientation of the X-ray emitter provided by a position monitoring system, and the original image, a processing system can execute the image correction algorithm to provide a corrected image to allow a surgeon to properly insert a pedicle screw along the axis of the pedicle while viewing an accurate corrected image in real time. ## Claims ### Claim at position 1 1-23. (canceled) ### Claim 24 A system for inserting a pedicle screw into a pedicle of a patient, comprising: a manually positionable beam emitter adjustable in more than three degrees of freedom, the emitter including a drill assembly adapted to insert a pedicle screw into a pedicle of a patient along an axis of operation; a detector that detects a beam from the emitter, the beam oriented along an axis parallel to the axis of operation of the actuator, and generates an original two-dimensional surface projection image of a three-dimensional object having a region of interest between the detector and emitter; a computer controlled position monitoring system that monitors a position and an orientation of the emitter in the more than three degrees of freedom; a processor operably connected to the position monitoring system and the detector and configured to execute an image correction algorithm, the image correction algorithm operable to provide a corrected two-dimensional surface projection image from the original two-dimensional surface projection image, the original two-dimensional surface projection image of the pedicle being skewed when the axis along which the beam is emitted is at an angle that is not perpendicular to the detector relative to an actual appearance of the pedicle and the corrected two-dimensional surface projection showing the actual appearance of the pedicle; and a video display linked to the processor to display the corrected two-dimensional surface projection image in real-time to a surgeon performing an operation to insert the pedicle screw into the pedicle of the patient. ### Claim 25 (depends on 25) The system of claim 25, wherein the image correction algorithm executed by the processor operates directly on texture coordinates of the original two-dimensional surface projection image generated by the detector using matrix transforms. ### Claim 26 (depends on 25) The system of claim 25, wherein the image correction algorithm executed by the processor utilizes rasterization to provide the corrected two-dimensional surface projection image. ### Claim 27 (depends on 25) The system of claim 25, wherein the computer controlled position monitoring system is a kinematic or mechanical tracking system. ### Claim 28 (depends on 27) The system of claim 27, wherein the emitter is connected to an arm of the kinematic or mechanical tracking system. ### Claim 29 (depends on 25) The system of claim 25, wherein the computer controlled position monitoring system is an optical tracking system. ### Claim 30 (depends on 25) The system of claim 25, wherein the computer controlled position monitoring system is at least partially located within the emitter. ### Claim 31 (depends on 25) The system of claim 25, wherein the emitter is manually positionable in at least five degrees of freedom. ### Claim 32 (depends on 25) The system of claim 25, wherein the axis of operation of the drill assembly and the axis along which the beam is emitted are coaxial. ### Claim 33 (depends on 32) The system of claim 32, wherein at least a portion of the drill assembly that is coaxial with the axis along which the beam is emitted is comprised of a material that is translucent to the beam. ### Claim 34 (depends on 25) The system of claim 25, wherein the emitter is an X-ray emitter and the detector is an X-ray detector. ### Claim 35 (depends on 25) The system of claim 25, wherein the emitter is a handheld tool having a handle and a housing at least partially containing the actuator. ### Claim 36 A system for inserting a pedicle screw into a pedicle of a patient, comprising: a manually positionable X-ray emitter including a drill assembly adapted to insert a pedicle screw into a pedicle of a patient along an axis of operation; an X-ray detector that detects the X-rays from the X-ray emitter, the X-ray emitter capable of being positioned such that the X-rays are not perpendicular to the X-ray detector, wherein the X-ray detector generates an original image of a region of interest that includes the pedicle when the pedicle is positioned between the X-ray detector and the X-ray emitter; a computer controlled position monitoring system that uses a processor to monitor a position and an orientation of the X-ray emitter, wherein the processor is operably connected to the position monitoring system and the X-ray detector and configured to execute an image correction algorithm that provides a corrected image of the original image when the original image is generated with the X-rays emitted at an angle that is not perpendicular to the X-ray detector; and a video display linked to the processor to display the corrected mage in real-time to a surgeon performing an operation to insert the pedicle screw into the pedicle of the patient.