Abstract: Systems and methods are disclosed for use in electronic guidance systems for surgical navigation. A sensor is provided with an optical sensor, to provide optical information, and a measuring sensor, to provide measurements for determining a direction of gravity. The sensor communicates optical information and measurements to an inter-operative computing unit. In an embodiment, the inter-operative computing unit receives first optical information for a registration device and a patient anatomy and a measurement to determine a direction of gravity to perform a registration step. The inter-operative computing unit receives second optical information for the patient anatomy and an object and determines and presents measurements relative to the anatomy. The measurements relative to the anatomy are determined from the second optical information, and in relation to the registration of the anatomy of the patient.

Abstract: Systems and methods are disclosed for use in electronic guidance systems for surgical navigation. A sensor is provided with an optical sensor, to provide optical information, and a measuring sensor, to provide measurements for determining a direction of gravity. The sensor communicates optical information and measurements to an inter-operative computing unit. In an embodiment, the inter-operative computing unit receives first optical information for a registration device and a patient anatomy and a measurement to determine a direction of gravity to perform a registration step. The inter-operative computing unit receives second optical information for the patient anatomy and an object and determines and presents measurements relative to the anatomy. The measurements relative to the anatomy are determined from the second optical information, and in relation to the registration of the anatomy of the patient.

Abstract: Presented are methods and systems for determining, monitoring, and displaying the relative positioning of two rigid bodies such as during a surgery. In particular, the present disclosure relates to methods and systems for positioning a prosthesis relative to a bone during a surgery as well as to systems and methods for verifying resulting relative positioning of adjacent bones.

Abstract: Methods and a kit for a navigated procedure, such as a navigated surgical procedure relate to an optical sensor system such as a sterile optical sensor system. The methods relate to using components of the optical sensor system and a processing unit, for example, performing a navigated procedure using an optical sensor as draped and using the processing unit coupled to the optical sensor. Performing the navigated procedure comprises receiving instructions for the navigated procedure from the processing unit, and using the optical sensor comprises interacting with a button on the optical sensor through the drape to provide input to the processing unit. A kit comprises optical sensor system components and instructions for performing a method.

Abstract: Systems, methods and a sensor alignment mechanism are disclosed for medical navigational guidance systems. In one example, a system to make sterile a non-sterile optical sensor for use in navigational guidance during surgery includes a sterile drape having an optically transparent window to drape the optical sensor in a sterile barrier and a sensor alignment mechanism. The alignment mechanism secures the sensor through the drape in alignment with the window without breaching the sterile barrier and facilitates adjustment of the orientation of the optical sensor. The optical sensor may be aligned to view a surgical site when the alignment mechanism, assembled with the sterile drape and optical sensor, is attached to a bone. The alignment mechanism may be a lockable ball joint and facilitate orientation of the sensor in at least two degrees of freedom. A quick connect mechanism may couple the alignment mechanism to the bone.

Abstract: Planning tools for surgery, particularly for THA, are provided. Images of musculoskeletal structure of a patient (e.g. associated with respective planes and in a same or different functional position) may be displayed together and via co-registration and spatial transformations, 3D implants or other objects may be rendered and overlaid in a same position correctly with respect to each image. The 3D implant may be fit (e.g. via handles or automatically using image processing) to an existing implant in the patient and moved to other positions, for example, to measure the existing position or plan for an initial or new position. Measures may be represented with respect to various planes associated with the respective image and/or with respect to an existing implant.

Abstract: Systems and methods are described to determine joint center of rotation during a procedure. Joint center measurements may be useful to determine other clinically relevant measurements and/or to assist with replacement surgery.

Abstract: Computing devices and methods are provided to automatically characterize a localization system tracker for a procedure. A starting tracker definition is refined until convergence using an iterative process and measured features of the tracker in images provided by a localization system camera. In each iteration, poses are determined from the measured features using a current tracker definition. The current definition is then refined using the poses and an optimization function. Tracker images may be captured passively, when performing other procedure steps. In a robotic context, command trajectories move a robot may be to respective poses where images to characterize the tracker are captured. An updated trajectory may be commanded to optimize convergence, additionally using the measured features at the updated pose in the iterative process. A robot kinematic model may be defined, refining a starting model using tracker poses from the localization system and sensor positions from the robot system.

Abstract: Systems, methods and devices are described herein for performing a navigated surgical procedure involving a patient's anatomy in sterile and non-sterile surgical environments. A camera may be used to determine a registration of the camera coordinate-frame to the patient anatomy or optionally a tracker in relation to the patient anatomy. A drape may be applied to permit use in a sterile surgical environment. The camera may be moved from its original position to enable access to patient anatomy while maintaining a registration of the camera coordinate-frame with the patient anatomy. Alternatively, the camera may be used in a hand-held or head-mounted manner. A visualization of the patient anatomy may be displayed on a computing unit, with visualization reference planes defined by the pose of an instrument or the camera. The visualization may be presented on a display of a computing unit or as part of a head mounted augmented reality system.

Abstract: Systems and methods are described herein to generate a 3D surface scan of a surface profile of a patient's anatomy. The 3D surface scan may be generated by reflections of structured light off the surface profile of the anatomy. The 3D surface scan may be used during intra-operative surgical navigation by a localization system. Optionally, a pre-operative medical image may also be registered to the localization system or used to enhance the 3D surface scan.

Abstract: Systems, methods and a sensor alignment mechanism are disclosed for medical navigational guidance systems. In one example, a system to make sterile a non-sterile optical sensor for use in navigational guidance during surgery includes a sterile drape having an optically transparent window to drape the optical sensor in a sterile barrier and a sensor alignment mechanism. The alignment mechanism secures the sensor through the drape in alignment with the window without breaching the sterile barrier and facilitates adjustment of the orientation of the optical sensor. The optical sensor may be aligned to view a surgical site when the alignment mechanism, assembled with the sterile drape and optical sensor, is attached to a bone. The alignment mechanism may be a lockable ball joint and facilitate orientation of the sensor in at least two degrees of freedom. A quick connect mechanism may couple the alignment mechanism to the bone.

Abstract: Systems, methods and devices for use in tracking are described, using optical modalities to detect spatial attributes or natural features of objects, such as, tools and patient anatomy. Spatial attributes or natural features may be known or may be detected by the tracking system. The system, methods and devices can further be used to verify a calibration of a tool either by a computing unit or by a user. Further, the disclosure relates to detection of spatial attributes, including depth information, of the anatomy for purposes of registration or to create a 3D surface profile of the anatomy.

Abstract: Cutting tools, systems and methods for navigated procedures are provided. A cutting tool (e.g. oscillating blade, etc.) for a power tool has an optically trackable feature in a defined positional relationship relative to a cutting feature of the cutting tool. The trackable feature may include reflective material applied to a surface (e.g. a recessed blade surface). The trackable feature is be imaged by a camera integral with or attached to the power tool and provided to a computing unit of a navigation system to determine a relative pose of the cutting feature and camera. The camera may also track a patient's bone such that the computing unit may determine a relative position of the bone and camera. The unit then computes a relative pose of the cutting feature with respect to the patient's bone and provides same for determining display information and/or to a robotic controller for procedural control.

Abstract: Preoperative planning techniques are described such as for hip surgery. Rather than pre-operatively planning by reorienting a model of the boundaries of the acetabulum derived from a 3D medical image, the proposed solution reorients portions of the 3D medical image itself and simulates one or more x-ray images using the reoriented 3D data. Optionally, simulated x-ray(s) of the un-modified CT scan may also be generated for comparison purposes. The user then measures acetabular metrics on the simulated x-ray(s) in order to determine the radiographic outcomes that a given magnitude and direction of reorientation would achieve. By iteratively selecting a reorientation and measuring the simulated x-ray(s), an optimal reorientation plan is determined by the user.

Abstract: Systems and methods are described herein to generate a 3D surface scan of a surface profile of a patient's anatomy. The 3D surface scan may be generated by reflections of structured light off the surface profile of the anatomy. The 3D surface scan may be used during intra-operative surgical navigation by a localization system. Optionally, a pre-operative medical image may also be registered to the localization system or used to enhance the 3D surface scan.

Abstract: There is provided a tracing platform configured to rigidly attach to an anatomy of a patient that has at least one surface configured to provide a defined path (represented by path definition data) for tracing by a surgical instrument. An intra-operative computing unit receives pose data for the instrument when tracing the path and calculates a location of the defined path using the pose data and the path definition data. A change in location may be determined from pose data of different traces. Tracing the defined path generates a plurality of pose data which may increase accuracy of the location calculations. Redundant trace data may be received to eliminate bias. A geometric feature (e.g. V-groove), shape and/or magnetic properties of the platform may assist with tracing. The platform may rigidly attach to a bone using at least one of spikes, a bone screw, a cerclage wire, and a bone clamp.

Abstract: A system and method perform a registration such as for a surgical navigation system by fitting a plurality of anatomical points as received to a digital model and developing a map having a corresponding confidence level indicating a degree of certainty. As additional anatomical points are received, they are continually matched to the digital model and the confidence level continually updated. The confidence level is output in any form, such as a score, a color code, or other metric. The output may include a graphical representation e.g. overlaid on an image from the digital model. The output may be a heat map overlaid on the image. The heat map may indicate an overall confidence level, and/or may indicate a plurality of confidence levels at various locations on the digital model. The overlay may provide an indication as to one or more suggested probe points to increase the level.

Abstract: The present application relates to systems and methods used to characterize or verify the accuracy of a tracker comprising optically detectable features. The tracker may be used in spatial localization using an optical sensor. Characterization results in the calculation of a Tracker Definition that includes geometrical characteristics of the tracker. Verification results in an assessment of accuracy of a tracker against an existing Tracker Definition.

Abstract: Planning tools for surgery, particularly for THA, are provided. Images of musculoskeletal structure of a patient (e.g. associated with respective planes and in a same or different functional position) may be displayed together and via co-registration and spatial transformations, 3D implants or other objects may be rendered and overlaid in a same position correctly with respect to each image. The 3D implant may be fit (e.g. via handles or automatically using image processing) to an existing implant in the patient and moved to other positions, for example, to measure the existing position or plan for an initial or new position. Measures may be represented with respect to various planes associated with the respective image and/or with respect to an existing implant.

Abstract: There is provided a surgical instrument for navigated surgeries and systems and methods using such a surgical instrument. The surgical tool comprises a tip; a tool interface, separate from the tip; and an optically trackable target. The tip is configured to probe positions in a space and identify the positions using optical information from the optically trackable target. The tool interface is configured to mate with a surgical tool such that the optical trackable target then provides optical information with which to determine positional information for the surgical tool in the space. In one example, the system provides navigational information during surgery using the surgical instrument, namely, a single integrated tracker instrument with two or more mechanical interfaces for coupling the tracker instrument with anatomical features and/or surgical tools.