# US 2019/0167359 A1 · Systems and methods for en bloc registration in navigated surgery > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2019/0167359 A1 - Document ID: US20190167359A1 - Status: Published application - Kind: A1 - Application number: 16/266,798 - Filed: 2019-02-04 - Published: 2019-06-06 - Earliest claimed: 2016-12-12 - Assignees: Medos International Sarl - Applicants: Medos International Sàrl - Inventors: Masashi Neo; John Riley Hawkins; Aniruddha Raina - Web page: https://patentgrep.com/patent/US20190167359A1 ## CPC - A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis - A61B 2017/00991: {Telescopic means} - A61B 2034/2055: {Optical tracking systems} - A61B 2090/3916: {Bone tissue} - A61B 2090/3983: {Reference marker arrangements for use with image guided surgery} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract Systems and methods for registering and tracking multiple anatomical structures, e.g., multiple vertebrae, as a single functional unit for surgical procedures are disclosed herein. In some embodiments, the system can include a bone bridge for attaching a navigation marker to multiple vertebrae and for limiting or preventing movement between the multiple vertebrae. Various ways of attaching the bone bridge are disclosed, including fasteners that extend through gaps or throughholes formed in the bridge, bridges having a jaw portion that clamps the underlying bone, and bridges formed of adhesive or cement and directly attached to the bone. Various adjustment features are also disclosed, including joints that allow the position and/or orientation of the bridge to be adjusted in one or more degrees of freedom, and bridges that include telescoping portions or other features for adjusting a length of the bridge. ## Claims ### Claim 1 A surgical navigation method, comprising: attaching a plurality of vertebrae of a patient to one another using a bridge, the bridge limiting or preventing relative movement between the plurality of vertebrae, the plurality of vertebrae defining a single functional unit once connected to the bridge, the bridge having a navigation marker; and using a surgical navigation system, guiding movement of a navigated object relative to a constituent member of the functional unit based on the navigation marker. ### Claim 2 (depends on 1) The method of claim 1, wherein the navigation maker of the bridge and a navigation marker of the navigated object are the only navigation markers used in guiding movement of the object. ### Claim 3 (depends on 1) The method of claim 1, wherein the navigated object comprises at least one of a bone anchor and a surgical instrument. ### Claim 4 (depends on 1) The method of claim 1, wherein said movement comprises driving the navigated object into the constituent member of the functional unit. ### Claim 5 (depends on 1) The method of claim 1, wherein the constituent member comprises one of the plurality of vertebrae to which the bridge is attached or a vertebra disposed between the plurality of vertebrae. ### Claim 6 (depends on 1) The method of claim 1, wherein the bridge limits or prevents relative movement between the plurality of vertebrae and any vertebrae disposed between the plurality of vertebrae. ### Claim 7 (depends on 1) The method of claim 1, further comprising determining a position and orientation of the navigated object relative to a constituent member of the functional unit. ### Claim 8 (depends on 1) The method of claim 1, wherein attaching the plurality of vertebrae comprises inserting a screw through an opening formed in the bridge and driving the screw into one of the plurality of vertebrae. ### Claim 9 (depends on 1) The method of claim 1, wherein attaching the plurality of vertebrae comprises clamping the plurality of vertebrae between first and second jaws of the bridge. ### Claim 10 (depends on 9) The method of claim 9, wherein clamping the jaws comprises tightening a screw within the bridge to move the jaws towards one another. ### Claim 11 (depends on 9) The method of claim 9, wherein clamping the jaws comprises squeezing the jaws together using at least one of a clamping tool and a bias force applied to the jaws. ### Claim 12 (depends on 1) The method of claim 1, wherein attaching the plurality of vertebrae comprises forming the bridge from a curable material in contact with the plurality of vertebrae. ### Claim 13 (depends on 1) The method of claim 1, further comprising adjusting a length of the bridge based on a length of the functional unit. ### Claim 14 (depends on 1) The method of claim 1, further comprising adjusting a position and/or orientation of the bridge relative to the plurality of vertebrae using one or more jointed arms of the bridge. ### Claim 15 (depends on 1) The method of claim 1, wherein attaching the plurality of vertebrae comprises attaching the spinous processes of the plurality of vertebrae to the bridge. ### Claim 16 A surgical navigation method, comprising: attaching spinous processes of a plurality of vertebrae of a patient to one another using a bridge, the bridge immobilizing the plurality of vertebrae relative to one another and having a navigation marker attached thereto; and registering or tracking the plurality of vertebrae as a single functional unit using the navigation marker. ### Claim 17 A surgical device, comprising: a bridge having a first end and a second end, the bridge having a length between the first and second ends sufficient to span multiple vertebrae of a patient; a securement device configured to attach the bridge to a plurality of vertebrae to connect and immobilize the vertebrae; and a navigation marker formed on or coupled to the bridge. ### Claim 18 (depends on 17) The device of claim 17, further comprising a surgical navigation system configured to track the plurality of a vertebrae as a single functional unit using the navigation marker. ### Claim 19 (depends on 17) The device of claim 17, wherein the bridge includes a continuous slot that extends substantially from the first end to the second end of the bridge and wherein the securement device comprises a plurality of screws inserted through the slot. ### Claim 20 (depends on 17) The device of claim 17, wherein the bridge includes a plurality of discrete openings and wherein the securement device comprises a plurality of screws inserted through the openings. ### Claim 21 (depends on 17) The device of claim 17, wherein the securement device comprises first and second jaws configured to clamp onto a plurality of vertebrae. ### Claim 22 (depends on 21) The device of claim 21, wherein the securement device comprises a screw configured to be tightened to force the first and second jaws towards one another. ### Claim 23 (depends on 17) The device of claim 17, wherein the securement device comprises a curable material from which at least a portion of the bridge is formed. ### Claim 24 (depends on 17) The device of claim 17, wherein the securement device comprises first and second arms extending from the bridge, the arms including at least one joint to allow adjustment of a position or orientation of the bridge. ### Claim 25 (depends on 17) The device of claim 17, wherein the length of the bridge is adjustable. ### Claim 26 (depends on 17) The device of claim 17, wherein the length of the bridge is adjustable by a telescoping portion of the bridge.