The present disclosure relates to position recognition systems, and in particular, multi-image registration for robot assisted surgery.
In the field of image guidance, registration is the quantification of the transformation between two or more coordinate systems. After successful registration, the position of a tool or other object in one coordinate system, such as an optically tracked space, can be accurately displayed in another coordinate system, such as the medical image space. In the case where image guidance or robot-assisted image guidance is to be performed using a preoperative 3D image dataset such as a computed tomography (CT) scan or magnetic resonance imaging (MRI) scan, co-registration among multiple coordinate systems may be needed, such as between a preoperatively obtained anatomical CT or MRI coordinate system, an intraoperatively obtained anatomical coordinate system, a coordinate system of the tracking cameras, and the like.
One way to achieve co-registration of multiple coordinate systems is to use 2D-3D registration, such as where a pair of 2D x-ray radiographs of the patient is taken at the time of surgery, with the position of the x-ray machine and patient tracked using tracking cameras. The coordinate system in which the x-rays are taken may then be registered to a preoperatively obtained 3D medical image coordinate system through methods of 2D-3D registration. In this method, the 3D CT or MM dataset may be used to generate 2D reconstructed planar images simulating x-ray radiographs. One way to generate 2D reconstructed simulated x-ray images from a 3D dataset is to trace and integrate the intensities along rays from a point source projected through the volumetric medical image on a 2D plane (e.g., a digitally reconstructed radiograph (DRR)). The DRRs are generated iteratively until they match the actual 2D x-ray images; that is, until the features or intensity characteristics of the bone structures on the DRRs and actual radiographs overlap within some tolerance. For instance, the iterative method could be a method such as Powell's Method, by which a cost function is minimized by starting with a guess and then adjusting parameters systematically until the error is within tolerance. As an example, the cost function could be constructed by subtracting the pixel intensities at locations within the images in the DRRs and the actual x-ray radiographs, and would be minimized when the pixel intensities agreed closest between X-ray and DRR in both views of the x-ray pair. Parameters of the cost function that could be adjusted between iterations may include the position and orientation of the 3D volumetric data, the x-ray source, angles of x-ray paths relative to the 3D volume, and the like, varied independently and/or simultaneously within the known (tracked) geometric constraint of the actual relative positions of the x-ray machine when the pair of shots were taken. Once a match is found, the position in the CT or MM coordinate system in which the x-ray machine must have been at the time the x-rays were taken is known from the parameters used in the calculation. Also, the position of the actual x-ray machine in the tracking coordinate system is known from tracking cameras. Therefore, the transformations between CT (or MRI), x-ray, and camera coordinate systems are determined.
Iterative methods as mentioned above, however, may be problematic because a large number of iterations may be required before a successful match is found. This may result in a long time delay, or worse, the iterations may fail to converge on a solution. Therefore, systems and methods are needed to improve the convergence of 2D-3D registration.
The present disclosure provides methods and systems that improve 2D-3D registration convergence by initializing the computational configuration such that the simulated and actual x-rays agree fairly well before starting iterations. Improvements may result in less iteration, decrease processing time, lower incidence of failure to converge, and the like.
In one embodiment, there is provided a system and method for registration of digital medical images. The method includes the step of storing a 3D digital medical image having a 3D anatomical feature and a first coordinate system and storing a 2D digital medical image having a 2D anatomical feature and a second coordinate system. The method further includes the steps of storing a placement of a digital medical object on the 3D digital medical image and the 2D digital medical image and generating a simulated 2D digital medical image from the 3D digital medical image, wherein the simulated 2D digital medical image comprises a simulated 2D anatomical feature corresponding to the 3D anatomical feature. The 2D anatomical feature is compared with the simulated 2D anatomical feature until a match is reached and a registration of the first coordinate system with the second coordinate system based on the match is determined.
These and other systems, methods, objects, features, and advantages of the present invention will be apparent to those skilled in the art from the following detailed description of the preferred embodiment and the drawings. All documents mentioned herein are hereby incorporated in their entirety by reference.
The invention and the following detailed description of certain embodiments thereof may be understood by reference to the following figures:
While the invention has been described in connection with certain preferred embodiments, other embodiments would be understood by one of ordinary skill in the art and are encompassed herein.
It is to be understood that the present disclosure is not limited in its application to the details of construction and the arrangement of components set forth in the description herein or illustrated in the drawings. The teachings of the present disclosure may be used and practiced in other embodiments and practiced or carried out in various ways. Also, it is to be understood that the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use of “including,” “comprising,” or “having” and variations thereof herein is meant to encompass the items listed thereafter and equivalents thereof as well as additional items. Unless specified or limited otherwise, the terms “mounted,” “connected,” “supported,” and “coupled” and variations thereof are used broadly and encompass both direct and indirect mountings, connections, supports, and couplings. Further, “connected” and “coupled” are not restricted to physical or mechanical connections or couplings.
The following discussion is presented to enable a person skilled in the art to make and use embodiments of the present disclosure. Various modifications to the illustrated embodiments will be readily apparent to those skilled in the art, and the principles herein can be applied to other embodiments and applications without departing from embodiments of the present disclosure. Thus, the embodiments are not intended to be limited to embodiments shown, but are to be accorded the widest scope consistent with the principles and features disclosed herein. The following detailed description is to be read with reference to the figures, in which like elements in different figures have like reference numerals. The figures, which are not necessarily to scale, depict selected embodiments and are not intended to limit the scope of the embodiments. Skilled artisans will recognize the examples provided herein have many useful alternatives and fall within the scope of the embodiments.
Turning now to the drawing,
With respect to the other components of the robot 102, the display 110 can be attached to the surgical robot 102 and in other exemplary embodiments, display 110 can be detached from surgical robot 102, either within a surgical room with the surgical robot 102, or in a remote location. End effector 112 may be coupled to the robot arm 104 and controlled by at least one motor. In exemplary embodiments, end effector 112 can comprise a guide tube 114, which is able to receive and orient a surgical instrument 608 (described further herein) used to perform surgery on the patient 210. As used herein, the term “end effector” is used interchangeably with the terms “end-effectuator” and “effectuator element.” Although generally shown with a guide tube 114, it will be appreciated that the end effector 112 may be replaced with any suitable instrumentation suitable for use in surgery. In some embodiments, end effector 112 can comprise any known structure for effecting the movement of the surgical instrument 608 in a desired manner.
The surgical robot 102 is able to control the translation and orientation of the end effector 112. The robot 102 is able to move end effector 112 along x-, y-, and z-axes, for example. The end effector 112 can be configured for selective rotation about one or more of the x-, y-, and z-axis, and a Z Frame axis (such that one or more of the Euler Angles (e.g., roll, pitch, and/or yaw) associated with end effector 112 can be selectively controlled). In some exemplary embodiments, selective control of the translation and orientation of end effector 112 can permit performance of medical procedures with significantly improved accuracy compared to conventional robots that utilize, for example, a six degree of freedom robot arm comprising only rotational axes. For example, the surgical robot system 100 may be used to operate on patient 210, and robot arm 104 can be positioned above the body of patient 210, with end effector 112 selectively angled relative to the z-axis toward the body of patient 210.
In some exemplary embodiments, the position of the surgical instrument 608 can be dynamically updated so that surgical robot 102 can be aware of the location of the surgical instrument 608 at all times during the procedure. Consequently, in some exemplary embodiments, surgical robot 102 can move the surgical instrument 608 to the desired position quickly without any further assistance from a physician (unless the physician so desires). In some further embodiments, surgical robot 102 can be configured to correct the path of the surgical instrument 608 if the surgical instrument 608 strays from the selected, preplanned trajectory. In some exemplary embodiments, surgical robot 102 can be configured to permit stoppage, modification, and/or manual control of the movement of end effector 112 and/or the surgical instrument 608. Thus, in use, in exemplary embodiments, a physician or other user can operate the system 100, and has the option to stop, modify, or manually control the autonomous movement of end effector 112 and/or the surgical instrument 608. Further details of surgical robot system 100 including the control and movement of a surgical instrument 608 by surgical robot 102 can be found in co-pending U.S. patent application Ser. No. 13/924,505, which is incorporated herein by reference in its entirety.
The robotic surgical system 100 can comprise one or more tracking markers 118 configured to track the movement of robot arm 104, end effector 112, patient 210, and/or the surgical instrument 608 in three dimensions. In exemplary embodiments, a plurality of tracking markers 118 can be mounted (or otherwise secured) thereon to an outer surface of the robot 102, such as, for example and without limitation, on base 106 of robot 102, on robot arm 104, or on the end effector 112. In exemplary embodiments, at least one tracking marker 118 of the plurality of tracking markers 118 can be mounted or otherwise secured to the end effector 112. One or more tracking markers 118 can further be mounted (or otherwise secured) to the patient 210. In exemplary embodiments, the plurality of tracking markers 118 can be positioned on the patient 210 spaced apart from the surgical field 208 to reduce the likelihood of being obscured by the surgeon, surgical tools, or other parts of the robot 102. Further, one or more tracking markers 118 can be further mounted (or otherwise secured) to the surgical tools 608 (e.g., a screw driver, dilator, implant inserter, or the like). Thus, the tracking markers 118 enable each of the marked objects (e.g., the end effector 112, the patient 210, and the surgical tools 608) to be tracked by the robot 102. In exemplary embodiments, system 100 can use tracking information collected from each of the marked objects to calculate the orientation and location, for example, of the end effector 112, the surgical instrument 608 (e.g., positioned in the tube 114 of the end effector 112), and the relative position of the patient 210.
In exemplary embodiments, one or more of markers 118 may be optical markers. In some embodiments, the positioning of one or more tracking markers 118 on end effector 112 can maximize the accuracy of the positional measurements by serving to check or verify the position of end effector 112. Further details of surgical robot system 100 including the control, movement and tracking of surgical robot 102 and of a surgical instrument 608 can be found in co-pending U.S. patent application Ser. No. 13/924,505, which is incorporated herein by reference in its entirety.
Exemplary embodiments include one or more markers 118 coupled to the surgical instrument 608. In exemplary embodiments, these markers 118, for example, coupled to the patient 210 and surgical instruments 608, as well as markers 118 coupled to the end effector 112 of the robot 102 can comprise conventional infrared light-emitting diodes (LEDs) or an Optotrak® diode capable of being tracked using a commercially available infrared optical tracking system such as Optotrak®. Optotrak® is a registered trademark of Northern Digital Inc., Waterloo, Ontario, Canada. In other embodiments, markers 118 can comprise conventional reflective spheres capable of being tracked using a commercially available optical tracking system such as Polaris Spectra. Polaris Spectra is also a registered trademark of Northern Digital, Inc. In an exemplary embodiment, the markers 118 coupled to the end effector 112 are active markers which comprise infrared light-emitting diodes which may be turned on and off, and the markers 118 coupled to the patient 210 and the surgical instruments 608 comprise passive reflective spheres.
In exemplary embodiments, light emitted from and/or reflected by markers 118 can be detected by camera 200 and can be used to monitor the location and movement of the marked objects. In alternative embodiments, markers 118 can comprise a radio-frequency and/or electromagnetic reflector or transceiver and the camera 200 can include or be replaced by a radio-frequency and/or electromagnetic transceiver.
Similar to surgical robot system 100,
Input power is supplied to system 300 via a power source 548 which may be provided to power distribution module 404. Power distribution module 404 receives input power and is configured to generate different power supply voltages that are provided to other modules, components, and subsystems of system 300. Power distribution module 404 may be configured to provide different voltage supplies to platform interface module 406, which may be provided to other components such as computer 408, display 304, speaker 536, driver 508 to, for example, power motors 512, 514, 516, 518 and end effector 310, motor 510, ring 324, camera converter 542, and other components for system 300 for example, fans for cooling the electrical components within cabinet 316.
Power distribution module 404 may also provide power to other components such as tablet charging station 534 that may be located within tablet drawer 318. Tablet charging station 534 may be in wireless or wired communication with tablet 546 for charging table 546. Tablet 546 may be used by a surgeon consistent with the present disclosure and described herein. Power distribution module 404 may also be connected to battery 402, which serves as temporary power source in the event that power distribution module 404 does not receive power from input power 548. At other times, power distribution module 404 may serve to charge battery 402 if necessary.
Other components of platform subsystem 502 may also include connector panel 320, control panel 322, and ring 324. Connector panel 320 may serve to connect different devices and components to system 300 and/or associated components and modules. Connector panel 320 may contain one or more ports that receive lines or connections from different components. For example, connector panel 320 may have a ground terminal port that may ground system 300 to other equipment, a port to connect foot pedal 544 to system 300, a port to connect to tracking subsystem 532, which may comprise position sensor 540, camera converter 542, and cameras 326 associated with camera stand 302. Connector panel 320 may also include other ports to allow USB, Ethernet, HDMI communications to other components, such as computer 408.
Control panel 322 may provide various buttons or indicators that control operation of system 300 and/or provide information regarding system 300. For example, control panel 322 may include buttons to power on or off system 300, lift or lower vertical column 312, and lift or lower stabilizers 520-526 that may be designed to engage casters 314 to lock system 300 from physically moving. Other buttons may stop system 300 in the event of an emergency, which may remove all motor power and apply mechanical brakes to stop all motion from occurring. Control panel 322 may also have indicators notifying the user of certain system conditions such as a line power indicator or status of charge for battery 402.
Ring 324 may be a visual indicator to notify the user of system 300 of different modes that system 300 is operating under and certain warnings to the user.
Computer subsystem 504 includes computer 408, display 304, and speaker 536. Computer 504 includes an operating system and software to operate system 300. Computer 504 may receive and process information from other components (for example, tracking subsystem 532, platform subsystem 502, and/or motion control subsystem 506) in order to display information to the user. Further, computer subsystem 504 may also include speaker 536 to provide audio to the user.
Tracking subsystem 532 may include position sensor 504 and converter 542. Tracking subsystem 532 may correspond to camera stand 302 including camera 326 as described with respect to
Moreover, system 300 may provide for automatic movement of vertical column 312, upper arm 306, and lower arm 308 through a user indicating on display 304 (which may be a touchscreen input device) the location of a surgical instrument or component on three dimensional image of the patient's anatomy on display 304. The user may initiate this automatic movement by stepping on foot pedal 544 or some other input means.
A tracking array 612 may be mounted on instrument 608 to monitor the location and orientation of instrument tool 608. The tracking array 612 may be attached to an instrument 608 and may comprise tracking markers 804. As best seen in
For example, as shown in
In addition, in exemplary embodiments, end effector 602 may be equipped with infrared (IR) receivers that can detect when an external camera 200, 326 is getting ready to read markers 702. Upon this detection, end effector 602 may then illuminate markers 702. The detection by the IR receivers that the external camera 200, 326 is ready to read markers 702 may signal the need to synchronize a duty cycle of markers 702, which may be light emitting diodes, to an external camera 200, 326. This may also allow for lower power consumption by the robotic system as a whole, whereby markers 702 would only be illuminated at the appropriate time instead of being illuminated continuously. Further, in exemplary embodiments, markers 702 may be powered off to prevent interference with other navigation tools, such as different types of surgical instruments 608.
The manner in which a surgeon 120 may place instrument 608 into guide tube 606 of the end effector 602 and adjust the instrument 608 is evident in
With respect to the locating coupling, robot arm 604 may comprise mounting plate 1216, which may be non-magnetic material, one or more depressions 1214, lip 1218, and magnets 1220. Magnet 1220 is mounted below each of depressions 1214. Portions of clamp 1204 may comprise magnetic material and be attracted by one or more magnets 1220. Through the magnetic attraction of clamp 1204 and robot arm 604, balls 1208 become seated into respective depressions 1214. For example, balls 1208 as shown in
With respect to the reinforcing coupling, portions of clamp 1204 may be configured to be a fixed ground link and as such clamp 1204 may serve as a five bar linkage. Closing clamp handle 1206 may fasten end effector 602 to robot arm 604 as lip 1212 and lip 1218 engage clamp 1204 in a manner to secure end effector 602 and robot arm 604. When clamp handle 1206 is closed, spring 1210 may be stretched or stressed while clamp 1204 is in a locked position. The locked position may be a position that provides for linkage past center. Because of a closed position that is past center, the linkage will not open absent a force applied to clamp handle 1206 to release clamp 1204. Thus, in a locked position end effector 602 may be robustly secured to robot arm 604.
Spring 1210 may be a curved beam in tension. Spring 1210 may be comprised of a material that exhibits high stiffness and high yield strain such as virgin PEEK (poly-ether-ether-ketone). The linkage between end effector 602 and robot arm 604 may provide for a sterile barrier between end effector 602 and robot arm 604 without impeding fastening of the two couplings.
The reinforcing coupling may be a linkage with multiple spring members. The reinforcing coupling may latch with a cam or friction based mechanism. The reinforcing coupling may also be a sufficiently powerful electromagnet that will support fastening end-effector 102 to robot arm 604. The reinforcing coupling may be a multi-piece collar completely separate from either end effector 602 and/or robot arm 604 that slips over an interface between end effector 602 and robot arm 604 and tightens with a screw mechanism, an over center linkage, or a cam mechanism.
Referring to
In order to track the position of the patient 210, a patient tracking device 116 may include a patient fixation instrument 1402 to be secured to a rigid anatomical structure of the patient 210 and a dynamic reference base (DRB) 1404 may be securely attached to the patient fixation instrument 1402. For example, patient fixation instrument 1402 may be inserted into opening 1406 of dynamic reference base 1404. Dynamic reference base 1404 may contain markers 1408 that are visible to tracking devices, such as tracking subsystem 532. These markers 1408 may be optical markers or reflective spheres, such as tracking markers 118, as previously discussed herein.
Patient fixation instrument 1402 is attached to a rigid anatomy of the patient 210 and may remain attached throughout the surgical procedure. In an exemplary embodiment, patient fixation instrument 1402 is attached to a rigid area of the patient 210, for example, a bone that is located away from the targeted anatomical structure subject to the surgical procedure. In order to track the targeted anatomical structure, dynamic reference base 1404 is associated with the targeted anatomical structure through the use of a registration fixture that is temporarily placed on or near the targeted anatomical structure in order to register the dynamic reference base 1404 with the location of the targeted anatomical structure.
A registration fixture 1410 is attached to patient fixation instrument 1402 through the use of a pivot arm 1412. Pivot arm 1412 is attached to patient fixation instrument 1402 by inserting patient fixation instrument 1402 through an opening 1414 of registration fixture 1410. Pivot arm 1412 is attached to registration fixture 1410 by, for example, inserting a knob 1416 through an opening 1418 of pivot arm 1412.
Using pivot arm 1412, registration fixture 1410 may be placed over the targeted anatomical structure and its location may be determined in an image space and navigation space using tracking markers 1420 and/or fiducials 1422 on registration fixture 1410. Registration fixture 1410 may contain a collection of markers 1420 that are visible in a navigational space (for example, markers 1420 may be detectable by tracking subsystem 532). Tracking markers 1420 may be optical markers visible in infrared light as previously described herein. Registration fixture 1410 may also contain a collection of fiducials 1422, for example, such as bearing balls, that are visible in an imaging space (for example, a three dimension CT image). As described in greater detail with respect to
At step 1504, an imaging pattern of fiducials 1420 is detected and registered in the imaging space and stored in computer 408. Optionally, at this time at step 1506, a graphical representation of the registration fixture 1410 may be overlaid on the images of the targeted anatomical structure.
At step 1508, a navigational pattern of registration fixture 1410 is detected and registered by recognizing markers 1420. Markers 1420 may be optical markers that are recognized in the navigation space through infrared light by tracking subsystem 532 via position sensor 540. Thus, the location, orientation, and other information of the targeted anatomical structure is registered in the navigation space. Therefore, registration fixture 1410 may be recognized in both the image space through the use of fiducials 1422 and the navigation space through the use of markers 1420. At step 1510, the registration of registration fixture 1410 in the image space is transferred to the navigation space. This transferal is done, for example, by using the relative position of the imaging pattern of fiducials 1422 compared to the position of the navigation pattern of markers 1420.
At step 1512, registration of the navigation space of registration fixture 1410 (having been registered with the image space) is further transferred to the navigation space of dynamic registration array 1404 attached to patient fixture instrument 1402. Thus, registration fixture 1410 may be removed and dynamic reference base 1404 may be used to track the targeted anatomical structure in both the navigation and image space because the navigation space is associated with the image space.
At steps 1514 and 1516, the navigation space may be overlaid on the image space and objects with markers visible in the navigation space (for example, surgical instruments 608 with optical markers 804). The objects may be tracked through graphical representations of the surgical instrument 608 on the images of the targeted anatomical structure.
Robot system 300 may include an image registration facility, for example as part of computer subsystem 504 and further, for example, as part of computer 406. Registration facility may be specifically configured to perform registration by acquiring and processing patient medical images in preparation for a medical procedure (e.g., surgery). The registration may be conducted in order to position a medical object in one coordinate system relative to another coordinate system, such as between pre-operative, intra-operative, and real-time image data of a patient 210. A medical object may be a passive implant (e.g., screw, pin), electronics-based implant (e.g., artificial pacemaker, cochlear implant), bioactive implant (e.g., pharmaceutical implant), biological transplant tissue, artificial transplant material, and the like. For instance, image guidance or robot-assisted image guidance may be performed using a preoperative 3D image dataset such as a computed tomography (CT) scan or magnetic resonance imaging (MRI) scan. Co-registration of multiple coordinate systems may then be needed, such as between the preoperatively obtained anatomical CT or MM coordinate system, an intraoperatively obtained anatomical coordinate system, a coordinate system of the tracking cameras, and the like. Co-registration of multiple coordinate systems may utilize 2D-3D registration, such as where multiple 2D x-ray radiographs of the patient are taken at the time of surgery, where the position of the x-ray machine and the patient are tracked (e.g., using tracking cameras). The coordinate system in which the x-rays were taken may then be registered to the preoperatively obtained 3D medical image coordinate system through 2D-3D registration.
Co-registration of multiple coordinate systems may involve an iterative process. For example, a 3D CT or MM dataset may be used to generate 2D reconstructed planar images simulating x-ray radiographs. The generation of 2D reconstructed simulated x-ray images from a 3D dataset may comprise tracing and integrating the intensities along rays from a point source projected through the volumetric medical image on a 2D plane, such as in preparation for generating a digitally reconstructed radiograph (DRR). DRRs may then be generated iteratively until they match the actual 2D x-ray images; that is, until the features or intensity characteristics of the bone structures on the DRRs and actual radiographs overlap within some tolerance. In embodiments, initial conditions for the computational configuration may be established in order to reduce the number of iterations required in this process. For instance, a computational configuration may be initialized such that simulated and actual x-rays agree to a predetermined level before starting iterations, thus potentially reducing the number of iterations and likelihood for reaching co-registration convergence associated with registration of the multiple coordinate systems.
Initial conditions for the computational configuration for registration of multiple coordinate systems may include a step where a user (e.g., surgeon, doctor, medical technician, medical assistant, and the like), manipulates software to enable graphic objects representing surgical objects that he/she intends to implant during a surgical procedure to be superimposed over the anatomy that appears on multiple intraoperatively obtained images (e.g., x-ray images). In embodiments, when the graphic objects are applied, their appearance may be depicted as similar to the appearance of shadows that would appear on x-ray if the surgical hardware had been implanted and an x-ray then taken. Before or after placing the graphic objects on 2D images, the user may also manipulate software such that graphic objects are superimposed on 3D medical images in the same anatomical location as the graphic objects applied to the 2D images. In an example, preoperative 3D medical images may be used together with intraoperative 2D x-ray radiographs, where the user would likely first (preoperatively) plan screw placement on the 3D medical images, then intraoperatively plan the same screws on two or more 2D x-ray radiographs. For instance, before surgery, the user could use the system to plan a pedicle screw at a particular vertebra on 3D preoperative CT or MRI images and then plan the same pedicle screw on x-rays by interacting with the system in the operating room before beginning surgery.
As the user may not be able to exactly match the locations of the hardware in the 2D and 3D image sets the user may be enabled to make placement within a tolerance range (e.g., within set linear or rational dimensional limits), within predetermined placement criteria (e.g., placement constraints stored in a profile for different surgical objects, anatomical features, and the like). The system may then use the object locations in different coordinate systems (e.g., both the CT (or MM) and x-ray coordinate systems) to determine areas of interest on the images so that the iterative process starts on and focuses within this region in attempting to match simulated and actual images.
In embodiments, the system could use as little as one object planned in 2D and 3D. However, using two or more planned objects may result in an improved performance since one planned object provides limited degrees of freedom (e.g., 5 of 6 degrees of freedom). That is, with one planned object, it may not be clear what the orientation of the anatomy is in its rotational alignment of the object, such as around the shaft of a surgical screw. Using the entirety of the intended construct (e.g., multiple object placements) has the additional benefit of demarking the entire region of interest, whereas if only a portion of the surgical hardware construct is used, the algorithm may need to extrapolate outside of the indicated region to match anatomical features (e.g., bones) that may or may not need to be accurately targeted.
It may not be immediately clear to the user who has already planned the placement of objects using 3D medical images on CT or MM where the corresponding objects should go when planning on 2D planar x-ray radiographs. The reason for the difficulty in correlating the images is that the 3D medical image planning occurs while the user is looking at two or three mutually orthogonal slices through the image volume; that is, only the anatomy on the slice itself may be shown, not anatomy in front of or behind that slice. However, when planning in 2D, the user may be looking at two or more projections through the same anatomical features. Additionally, by the nature of x-rays, the projected images originate from a point source and travel through the patient to an image intensifier or collector plate through a conical beam, introducing parallax that may be difficult to reconcile mentally by the user when comparing 2D and 3D images. If the 3D medical image is already present at the time the 2D images are shot, as it would be if a preoperative CT or Mill is used, DRRs such as those that are generated in a matching algorithm may be used as a tool for the user when planning object placement on 2D images. That is, the software may be able to generate and display DRRs that the user can quickly adjust to be roughly similar in appearance to the actual x-ray radiographs (e.g., a default may be anteroposterior and lateral x-rays) where software can automatically superimpose the objects that were planned on 3D images onto these DRRs. Given this procedure it may be relatively easy for the user to plan object placement that is similarly placed on the actual 2D x-ray radiographs when side by side with the objects visible on DRRs.
Providing for initial conditions as part of registration may help an iterative matching algorithm to converge more quickly because the approximate location of object placement is known to the system, such as in both the 2D and 3D images. Although the object positions may not agree exactly because of user placement error, if placed within the constraints set by the system (or by the user through placement constraints stored in a profile) may be close enough that the algorithm can start making small instead of coarse adjustments to converge to a solution. In the alternative circumstance, where no starting position is provided, the algorithm may start varying the orientation of the simulated x-rays in the wrong direction, potentially converging on a minimum error value that exceeds tolerance (e.g., where convergence is not reached).
Another advantage of providing an initial placement on the images is that the user is able to place objects on actual imaged anatomy rather than with reference to identification of landmarks on the anatomy. Identification of landmarks on the anatomy can be challenging for medical personnel because it may be difficult to visualize, such as to which way bony curvatures travel, especially in 2D views. For example, if the user is asked to mark the outermost extension of a bony process but the bony process is oriented toward the direction of the x-ray path, it may be unclear what portion of the resulting shadow corresponds to the outermost extension of the process. However, most users of the process should be familiar with the appearance of surgical objects when optimally placed on both 2D and 3D views, and should therefore already be familiar with how the objects should appear on medical images.
Initial placement may also automatically fulfill the purpose of segmentation sometimes required by algorithms for matching 2D to 3D medical images, such as where the user must superimpose ranges (e.g., boxes) around each anatomical feature (e.g., vertebra) on 2D or 3D images, thereby indicating to the software the anatomical level of each vertebra so that the matching algorithm can be performed independently for each spinal level. The reason for independently registering each anatomical feature is that the 3D image is generally taken while the patient is lying supine and the 2D images are generally taken while the patient is lying prone, and even if the images were taken in roughly the same orientation, there could be some movement between the features, which would mean that 2D-3D registration at one level would not necessarily be valid at another level. By setting initial conditions through placement of objects prior to the registration process (e.g., iterative convergence of multiple coordinate systems), the user knows the level where an object is being planned. For example, if a surgeon intends to perform a long construct from LI to LS, he or she may plan screws in all of these levels preoperatively on a 3D image, then again intraoperatively on a 2D image. By performing these planning steps, the software would be provided similar information about the anatomical level of each part of the image. For instance, an image analysis algorithm may then check for a shift in the pixel intensity of the image while moving outward away from the objects that could be used to automatically segment the edges of each level on 3D and 2D images. Additionally, the known general shape of anatomical features (e.g., vertebra) and the known general spacing between adjacent objects (e.g., surgical screws) can be used to improve an automatic algorithm for detecting edges of the anatomical feature and the object. With reference to the preceding example, the software may then independently run the matching algorithm on each vertebra from LI to LS to give unique registration for each level.
Wherein the present disclosure utilizes surgical examples such as insertion of surgical screws into a spinal column (e.g., as depicted in
At step 2508, features of the simulated 2D image data are enhanced using image processing and at step 2510 an initial feature of the simulated 2D image data may be compared to an image feature of the intra-operative 2D image feature. As a starting point for the comparison, the stored digital medical image from step 2502 may be used.
At step 2512, the system may determine if a match has occurred of the current feature of the simulated 2D image data and the image feature of the intra-operative 2D image data. If a match has occurred, method 2500 goes to step 2514 which registers the 3D coordinate system (first coordinate system) with the 2D coordinate system (second coordinate system). If a match does not occur at step 2512, method 2500 goes to step 2506 to compare a next iteration or another image feature of the simulated 2D image data to the image feature of the 2D image data. This repeats until a match has occurred, sending method 2500 to step 1514 to register the first and second coordinate systems.
While the invention has been disclosed in connection with the preferred embodiments shown and described in detail, various modifications and improvements thereon will become readily apparent to those skilled in the art. Accordingly, the spirit and scope of the present invention is not to be limited by the foregoing examples, but is to be understood in the broadest sense allowable by law.
All documents referenced herein are hereby incorporated by reference.
This application is a continuation of U.S. patent application Ser. No. 15/289,537 which is a continuation-in-part of U.S. patent application Ser. No. 15/157,444 filed May 18, 2016, which is a continuation-in-part of U.S. patent application Ser. No. 15/095,883, filed Apr. 11, 2016, which is a continuation-in-part of U.S. patent application Ser. No. 14/062,707, filed on Oct. 24, 2013, which is a continuation-in-part application of U.S. patent application Ser. No. 13/924,505, filed on Jun. 21, 2013, which claims priority to provisional application No. 61/662,702 filed on Jun. 21, 2012 and claims priority to provisional application No. 61/800,527 filed on Mar. 15, 2013, all of which are incorporated by reference herein in their entireties for all purposes.
Number | Name | Date | Kind |
---|---|---|---|
4150293 | Franke | Apr 1979 | A |
5020933 | Salvestro et al. | Jun 1991 | A |
5246010 | Gazzara et al. | Sep 1993 | A |
5354314 | Hardy et al. | Oct 1994 | A |
5397323 | Taylor et al. | Mar 1995 | A |
5598453 | Baba et al. | Jan 1997 | A |
5772594 | Barrick | Jun 1998 | A |
5791908 | Gillio | Aug 1998 | A |
5820559 | Ng et al. | Oct 1998 | A |
5825982 | Wright et al. | Oct 1998 | A |
5887121 | Funda et al. | Mar 1999 | A |
5911449 | Daniele et al. | Jun 1999 | A |
5951475 | Gueziec et al. | Sep 1999 | A |
5987960 | Messner et al. | Nov 1999 | A |
6012216 | Esteves et al. | Jan 2000 | A |
6031888 | Ivan et al. | Feb 2000 | A |
6033415 | Mittelstadt et al. | Mar 2000 | A |
6080181 | Jensen et al. | Jun 2000 | A |
6106511 | Jensen | Aug 2000 | A |
6122541 | Cosman et al. | Sep 2000 | A |
6144875 | Schweikard et al. | Nov 2000 | A |
6157853 | Blume et al. | Dec 2000 | A |
6167145 | Foley et al. | Dec 2000 | A |
6167292 | Badano et al. | Dec 2000 | A |
6201984 | Funda et al. | Mar 2001 | B1 |
6203196 | Meyer et al. | Mar 2001 | B1 |
6205411 | DiGioia, III et al. | Mar 2001 | B1 |
6212419 | Blume et al. | Apr 2001 | B1 |
6231565 | Tovey et al. | May 2001 | B1 |
6236875 | Bucholz et al. | May 2001 | B1 |
6246900 | Cosman et al. | Jun 2001 | B1 |
6301495 | Gueziec et al. | Oct 2001 | B1 |
6306126 | Montezuma | Oct 2001 | B1 |
6312435 | Wallace et al. | Nov 2001 | B1 |
6314311 | Williams et al. | Nov 2001 | B1 |
6320929 | Von Der Haar | Nov 2001 | B1 |
6322567 | Mittelstadt et al. | Nov 2001 | B1 |
6325808 | Bernard et al. | Dec 2001 | B1 |
6340363 | Bolger et al. | Jan 2002 | B1 |
6377011 | Ben-Ur | Apr 2002 | B1 |
6379302 | Kessman et al. | Apr 2002 | B1 |
6402762 | Hunter et al. | Jun 2002 | B2 |
6424885 | Niemeyer et al. | Jul 2002 | B1 |
6447503 | Wynne et al. | Sep 2002 | B1 |
6451027 | Cooper et al. | Sep 2002 | B1 |
6477400 | Barrick | Nov 2002 | B1 |
6484049 | Seeley et al. | Nov 2002 | B1 |
6487267 | Wolter | Nov 2002 | B1 |
6490467 | Bucholz et al. | Dec 2002 | B1 |
6490475 | Seeley et al. | Dec 2002 | B1 |
6499488 | Hunter et al. | Dec 2002 | B1 |
6501981 | Schweikard et al. | Dec 2002 | B1 |
6507751 | Blume et al. | Jan 2003 | B2 |
6535756 | Simon et al. | Mar 2003 | B1 |
6560354 | Maurer, Jr. et al. | May 2003 | B1 |
6565554 | Niemeyer | May 2003 | B1 |
6587750 | Gerbi et al. | Jul 2003 | B2 |
6614453 | Suri et al. | Sep 2003 | B1 |
6614871 | Kobiki et al. | Sep 2003 | B1 |
6619840 | Rasche et al. | Sep 2003 | B2 |
6636757 | Jascob et al. | Oct 2003 | B1 |
6645196 | Nixon et al. | Nov 2003 | B1 |
6666579 | Jensen | Dec 2003 | B2 |
6669635 | Kessman et al. | Dec 2003 | B2 |
6701173 | Nowinski et al. | Mar 2004 | B2 |
6757068 | Foxlin | Jun 2004 | B2 |
6782287 | Grzeszczuk et al. | Aug 2004 | B2 |
6783524 | Anderson et al. | Aug 2004 | B2 |
6786896 | Madhani et al. | Sep 2004 | B1 |
6788018 | Blumenkranz | Sep 2004 | B1 |
6804581 | Wang et al. | Oct 2004 | B2 |
6823207 | Jensen et al. | Nov 2004 | B1 |
6827351 | Graziani et al. | Dec 2004 | B2 |
6837892 | Shoham | Jan 2005 | B2 |
6839612 | Sanchez et al. | Jan 2005 | B2 |
6856826 | Seeley et al. | Feb 2005 | B2 |
6856827 | Seeley et al. | Feb 2005 | B2 |
6879880 | Nowlin et al. | Apr 2005 | B2 |
6892090 | Verard et al. | May 2005 | B2 |
6920347 | Simon et al. | Jul 2005 | B2 |
6922632 | Foxlin | Jul 2005 | B2 |
6968224 | Kessman et al. | Nov 2005 | B2 |
6978166 | Foley et al. | Dec 2005 | B2 |
6988009 | Grimm et al. | Jan 2006 | B2 |
6991627 | Madhani et al. | Jan 2006 | B2 |
6996487 | Jutras et al. | Feb 2006 | B2 |
6999852 | Green | Feb 2006 | B2 |
7007699 | Martinelli et al. | Mar 2006 | B2 |
7016457 | Senzig et al. | Mar 2006 | B1 |
7043961 | Pandey et al. | May 2006 | B2 |
7062006 | Pelc et al. | Jun 2006 | B1 |
7063705 | Young et al. | Jun 2006 | B2 |
7072707 | Galloway, Jr. et al. | Jul 2006 | B2 |
7083615 | Peterson et al. | Aug 2006 | B2 |
7097640 | Wang et al. | Aug 2006 | B2 |
7099428 | Clinthorne et al. | Aug 2006 | B2 |
7108421 | Gregerson et al. | Sep 2006 | B2 |
7130676 | Barrick | Oct 2006 | B2 |
7139418 | Abovitz et al. | Nov 2006 | B2 |
7139601 | Bucholz et al. | Nov 2006 | B2 |
7155316 | Sutherland et al. | Dec 2006 | B2 |
7164968 | Treat et al. | Jan 2007 | B2 |
7167738 | Schweikard et al. | Jan 2007 | B2 |
7169141 | Brock et al. | Jan 2007 | B2 |
7172627 | Fiere et al. | Feb 2007 | B2 |
7182083 | Yanof et al. | Feb 2007 | B2 |
7194120 | Wicker et al. | Mar 2007 | B2 |
7197107 | Arai et al. | Mar 2007 | B2 |
7207995 | Vandewalle | Apr 2007 | B1 |
7231014 | Levy | Jun 2007 | B2 |
7231063 | Naimark et al. | Jun 2007 | B2 |
7239940 | Wang et al. | Jul 2007 | B2 |
7248914 | Hastings et al. | Jul 2007 | B2 |
7301648 | Foxlin | Nov 2007 | B2 |
7302288 | Schellenberg | Nov 2007 | B1 |
7313430 | Urquhart et al. | Dec 2007 | B2 |
7318805 | Schweikard et al. | Jan 2008 | B2 |
7318827 | Leitner et al. | Jan 2008 | B2 |
7319897 | Leitner et al. | Jan 2008 | B2 |
7324623 | Heuscher et al. | Jan 2008 | B2 |
7327865 | Fu et al. | Feb 2008 | B2 |
7331967 | Lee et al. | Feb 2008 | B2 |
7333642 | Green | Feb 2008 | B2 |
7339341 | Oleynikov et al. | Mar 2008 | B2 |
7366562 | Dukesherer et al. | Apr 2008 | B2 |
7379790 | Toth et al. | May 2008 | B2 |
7386365 | Nixon | Jun 2008 | B2 |
7422592 | Morley et al. | Sep 2008 | B2 |
7435216 | Kwon et al. | Oct 2008 | B2 |
7440793 | Chauhan et al. | Oct 2008 | B2 |
7460637 | Clinthorne et al. | Dec 2008 | B2 |
7466303 | Yi et al. | Dec 2008 | B2 |
7493153 | Ahmed et al. | Feb 2009 | B2 |
7505617 | Fu et al. | Mar 2009 | B2 |
7533892 | Schena et al. | May 2009 | B2 |
7542791 | Mire et al. | Jun 2009 | B2 |
7555331 | Viswanathan | Jun 2009 | B2 |
7567834 | Clayton et al. | Jul 2009 | B2 |
7594912 | Cooper et al. | Sep 2009 | B2 |
7606613 | Simon et al. | Oct 2009 | B2 |
7607440 | Coste-Maniere et al. | Oct 2009 | B2 |
7623902 | Pacheco | Nov 2009 | B2 |
7630752 | Viswanathan | Dec 2009 | B2 |
7630753 | Simon et al. | Dec 2009 | B2 |
7643862 | Schoenefeld | Jan 2010 | B2 |
7660623 | Hunter et al. | Feb 2010 | B2 |
7661881 | Gregerson et al. | Feb 2010 | B2 |
7683331 | Chang | Mar 2010 | B2 |
7683332 | Chang | Mar 2010 | B2 |
7689320 | Prisco et al. | Mar 2010 | B2 |
7691098 | Wallace et al. | Apr 2010 | B2 |
7702379 | Avinash et al. | Apr 2010 | B2 |
7702477 | Tuemmler et al. | Apr 2010 | B2 |
7711083 | Heigl et al. | May 2010 | B2 |
7711406 | Kuhn et al. | May 2010 | B2 |
7720523 | Omernick et al. | May 2010 | B2 |
7725253 | Foxlin | May 2010 | B2 |
7726171 | Langlotz et al. | Jun 2010 | B2 |
7742801 | Neubauer et al. | Jun 2010 | B2 |
7751865 | Jascob et al. | Jul 2010 | B2 |
7760849 | Zhang | Jul 2010 | B2 |
7762825 | Burbank et al. | Jul 2010 | B2 |
7763015 | Cooper et al. | Jul 2010 | B2 |
7787699 | Mahesh et al. | Aug 2010 | B2 |
7796728 | Bergfjord | Sep 2010 | B2 |
7813838 | Sommer | Oct 2010 | B2 |
7818044 | Dukesherer et al. | Oct 2010 | B2 |
7819859 | Prisco et al. | Oct 2010 | B2 |
7824401 | Manzo et al. | Nov 2010 | B2 |
7831294 | Viswanathan | Nov 2010 | B2 |
7834484 | Sartor | Nov 2010 | B2 |
7835557 | Kendrick et al. | Nov 2010 | B2 |
7835778 | Foley et al. | Nov 2010 | B2 |
7835784 | Mire et al. | Nov 2010 | B2 |
7840253 | Tremblay et al. | Nov 2010 | B2 |
7840256 | Lakin et al. | Nov 2010 | B2 |
7843158 | Prisco | Nov 2010 | B2 |
7844320 | Shahidi | Nov 2010 | B2 |
7853305 | Simon et al. | Dec 2010 | B2 |
7853313 | Thompson | Dec 2010 | B2 |
7865269 | Prisco et al. | Jan 2011 | B2 |
D631966 | Perloff et al. | Feb 2011 | S |
7879045 | Gielen et al. | Feb 2011 | B2 |
7881767 | Strommer et al. | Feb 2011 | B2 |
7881770 | Melkent et al. | Feb 2011 | B2 |
7886743 | Cooper et al. | Feb 2011 | B2 |
RE42194 | Foley et al. | Mar 2011 | E |
RE42226 | Foley et al. | Mar 2011 | E |
7900524 | Calloway et al. | Mar 2011 | B2 |
7907166 | Lamprecht et al. | Mar 2011 | B2 |
7909122 | Schena et al. | Mar 2011 | B2 |
7925653 | Saptharishi | Apr 2011 | B2 |
7930065 | Larkin et al. | Apr 2011 | B2 |
7935130 | Williams | May 2011 | B2 |
7940999 | Liao et al. | May 2011 | B2 |
7945012 | Ye et al. | May 2011 | B2 |
7945021 | Shapiro et al. | May 2011 | B2 |
7953470 | Vetter et al. | May 2011 | B2 |
7954397 | Choi et al. | Jun 2011 | B2 |
7971341 | Dukesherer et al. | Jul 2011 | B2 |
7974674 | Hauck et al. | Jul 2011 | B2 |
7974677 | Mire et al. | Jul 2011 | B2 |
7974681 | Wallace et al. | Jul 2011 | B2 |
7979157 | Anvari | Jul 2011 | B2 |
7983733 | Viswanathan | Jul 2011 | B2 |
7988215 | Seibold | Aug 2011 | B2 |
7996110 | Lipow et al. | Aug 2011 | B2 |
8004121 | Sartor | Aug 2011 | B2 |
8004229 | Nowlin et al. | Aug 2011 | B2 |
8010177 | Csavoy et al. | Aug 2011 | B2 |
8019045 | Kato | Sep 2011 | B2 |
8021310 | Sanborn et al. | Sep 2011 | B2 |
8035685 | Jensen | Oct 2011 | B2 |
8046054 | Kim et al. | Oct 2011 | B2 |
8046057 | Clarke | Oct 2011 | B2 |
8052688 | Wolf, II | Nov 2011 | B2 |
8054184 | Cline et al. | Nov 2011 | B2 |
8054752 | Druke et al. | Nov 2011 | B2 |
8057397 | Li et al. | Nov 2011 | B2 |
8057407 | Martinelli et al. | Nov 2011 | B2 |
8062288 | Cooper et al. | Nov 2011 | B2 |
8062375 | Glerum et al. | Nov 2011 | B2 |
8066524 | Burbank et al. | Nov 2011 | B2 |
8073335 | Labonville et al. | Dec 2011 | B2 |
8079950 | Stern et al. | Dec 2011 | B2 |
8086299 | Adler et al. | Dec 2011 | B2 |
8092370 | Roberts et al. | Jan 2012 | B2 |
8098914 | Liao et al. | Jan 2012 | B2 |
8100950 | St. Clair et al. | Jan 2012 | B2 |
8105320 | Manzo | Jan 2012 | B2 |
8108025 | Csavoy et al. | Jan 2012 | B2 |
8109877 | Moctezuma de la Barrera et al. | Feb 2012 | B2 |
8112292 | Simon | Feb 2012 | B2 |
8116430 | Shapiro et al. | Feb 2012 | B1 |
8120301 | Goldberg et al. | Feb 2012 | B2 |
8121249 | Wang et al. | Feb 2012 | B2 |
8123675 | Funda et al. | Feb 2012 | B2 |
8133229 | Bonutti | Mar 2012 | B1 |
8142420 | Schena | Mar 2012 | B2 |
8147494 | Leitner et al. | Apr 2012 | B2 |
8150494 | Simon et al. | Apr 2012 | B2 |
8150497 | Gielen et al. | Apr 2012 | B2 |
8150498 | Gielen et al. | Apr 2012 | B2 |
8165658 | Waynik et al. | Apr 2012 | B2 |
8170313 | Kendrick et al. | May 2012 | B2 |
8179073 | Farritor et al. | May 2012 | B2 |
8182476 | Julian et al. | May 2012 | B2 |
8184880 | Zhao et al. | May 2012 | B2 |
8202278 | Orban, III et al. | Jun 2012 | B2 |
8208708 | Homan et al. | Jun 2012 | B2 |
8208988 | Jenser | Jun 2012 | B2 |
8219177 | Smith et al. | Jul 2012 | B2 |
8219178 | Smith et al. | Jul 2012 | B2 |
8220468 | Cooper et al. | Jul 2012 | B2 |
8224024 | Foxlin et al. | Jul 2012 | B2 |
8224484 | Swarup et al. | Jul 2012 | B2 |
8225798 | Baldwin et al. | Jul 2012 | B2 |
8228368 | Zhao et al. | Jul 2012 | B2 |
8231610 | Jo et al. | Jul 2012 | B2 |
8263933 | Hartmann et al. | Jul 2012 | B2 |
8239001 | Verard et al. | Aug 2012 | B2 |
8241271 | Millman et al. | Aug 2012 | B2 |
8248413 | Gattani et al. | Aug 2012 | B2 |
8256319 | Cooper et al. | Sep 2012 | B2 |
8271069 | Jascob et al. | Sep 2012 | B2 |
8271130 | Hourtash | Sep 2012 | B2 |
8281670 | Larkin et al. | Oct 2012 | B2 |
8282653 | Nelson et al. | Oct 2012 | B2 |
8301226 | Csavoy et al. | Oct 2012 | B2 |
8311611 | Csavoy et al. | Nov 2012 | B2 |
8313430 | Pimenta | Nov 2012 | B1 |
8320991 | Jascob et al. | Nov 2012 | B2 |
8332012 | Kienzle, III | Dec 2012 | B2 |
8333755 | Cooper et al. | Dec 2012 | B2 |
8335552 | Stiles | Dec 2012 | B2 |
8335557 | Maschke | Dec 2012 | B2 |
8348931 | Cooper et al. | Jan 2013 | B2 |
8353963 | Glerum | Jan 2013 | B2 |
8358818 | Miga et al. | Jan 2013 | B2 |
8359730 | Burg et al. | Jan 2013 | B2 |
8374673 | Adcox et al. | Feb 2013 | B2 |
8374723 | Zhao et al. | Feb 2013 | B2 |
8379791 | Forthmann et al. | Feb 2013 | B2 |
8386019 | Camus et al. | Feb 2013 | B2 |
8392022 | Ortmaier et al. | Mar 2013 | B2 |
8394099 | Patwardhan | Mar 2013 | B2 |
8395342 | Prisco | Mar 2013 | B2 |
8398634 | Manzo et al. | Mar 2013 | B2 |
8400094 | Schena | Mar 2013 | B2 |
8414957 | Enzerink et al. | Apr 2013 | B2 |
8418073 | Mohr et al. | Apr 2013 | B2 |
8450694 | Baviera et al. | May 2013 | B2 |
8452447 | Nixon | May 2013 | B2 |
RE44305 | Foley et al. | Jun 2013 | E |
8462911 | Vesel et al. | Jun 2013 | B2 |
8465476 | Rogers et al. | Jun 2013 | B2 |
8465771 | Wan et al. | Jun 2013 | B2 |
8467851 | Mire et al. | Jun 2013 | B2 |
8467852 | Csavoy et al. | Jun 2013 | B2 |
8469947 | Devengenzo et al. | Jun 2013 | B2 |
RE44392 | Hynes | Jul 2013 | E |
8483434 | Buehner et al. | Jul 2013 | B2 |
8483800 | Jensen et al. | Jul 2013 | B2 |
8486532 | Enzerink et al. | Jul 2013 | B2 |
8489235 | Moll et al. | Jul 2013 | B2 |
8500722 | Cooper | Aug 2013 | B2 |
8500728 | Newton et al. | Aug 2013 | B2 |
8504201 | Moll et al. | Aug 2013 | B2 |
8506555 | Ruiz Morales | Aug 2013 | B2 |
8506556 | Schena | Aug 2013 | B2 |
8508173 | Goldberg et al. | Aug 2013 | B2 |
8512318 | Tovey et al. | Aug 2013 | B2 |
8515576 | Lipow et al. | Aug 2013 | B2 |
8518120 | Glerum et al. | Aug 2013 | B2 |
8521331 | Itkowitz | Aug 2013 | B2 |
8526688 | Groszmann et al. | Sep 2013 | B2 |
8526700 | Isaacs | Sep 2013 | B2 |
8527094 | Kumar et al. | Sep 2013 | B2 |
8528440 | Morley et al. | Sep 2013 | B2 |
8532741 | Heruth et al. | Sep 2013 | B2 |
8541970 | Nowlin et al. | Sep 2013 | B2 |
8548563 | Simon et al. | Oct 2013 | B2 |
8549732 | Burg et al. | Oct 2013 | B2 |
8551114 | Ramos de la Pena | Oct 2013 | B2 |
8551116 | Julian et al. | Oct 2013 | B2 |
8556807 | Scott et al. | Oct 2013 | B2 |
8556979 | Glerum et al. | Oct 2013 | B2 |
8560118 | Green et al. | Oct 2013 | B2 |
8561473 | Blumenkranz | Oct 2013 | B2 |
8562594 | Cooper et al. | Oct 2013 | B2 |
8571638 | Shoham | Oct 2013 | B2 |
8571710 | Coste-Maniere et al. | Oct 2013 | B2 |
8573465 | Shelton, IV | Nov 2013 | B2 |
8574303 | Sharkey et al. | Nov 2013 | B2 |
8585420 | Burbank et al. | Nov 2013 | B2 |
8594841 | Zhao et al. | Nov 2013 | B2 |
8597198 | Sanborn et al. | Dec 2013 | B2 |
8600478 | Verard et al. | Dec 2013 | B2 |
8603077 | Cooper et al. | Dec 2013 | B2 |
8611985 | Lavallee et al. | Dec 2013 | B2 |
8613230 | Blumenkranz et al. | Dec 2013 | B2 |
8621939 | Blumenkranz et al. | Jan 2014 | B2 |
8624537 | Nowlin et al. | Jan 2014 | B2 |
8630389 | Kato | Jan 2014 | B2 |
8634897 | Simon et al. | Jan 2014 | B2 |
8634957 | Toth et al. | Jan 2014 | B2 |
8638056 | Goldberg et al. | Jan 2014 | B2 |
8638057 | Goldberg et al. | Jan 2014 | B2 |
8639000 | Zhao et al. | Jan 2014 | B2 |
8641726 | Bonutti | Feb 2014 | B2 |
8644907 | Hartmann et al. | Feb 2014 | B2 |
8657809 | Schoepp | Feb 2014 | B2 |
8660635 | Simon et al. | Feb 2014 | B2 |
8666544 | Moll et al. | Mar 2014 | B2 |
8675939 | Moctezuma de la Barrera | Mar 2014 | B2 |
8678647 | Gregerson et al. | Mar 2014 | B2 |
8679125 | Smith et al. | Mar 2014 | B2 |
8679183 | Glerum et al. | Mar 2014 | B2 |
8682413 | Lloyd | Mar 2014 | B2 |
8684253 | Giordano et al. | Apr 2014 | B2 |
8685098 | Glerum et al. | Apr 2014 | B2 |
8693730 | Umasuthan et al. | Apr 2014 | B2 |
8694075 | Groszmann et al. | Apr 2014 | B2 |
8696458 | Foxlin et al. | Apr 2014 | B2 |
8700123 | Okamura et al. | Apr 2014 | B2 |
8706086 | Glerum | Apr 2014 | B2 |
8706185 | Foley et al. | Apr 2014 | B2 |
8706301 | Zhao et al. | Apr 2014 | B2 |
8717430 | Simon et al. | May 2014 | B2 |
8727618 | Maschke et al. | May 2014 | B2 |
8734432 | Tuma et al. | May 2014 | B2 |
8738115 | Amberg et al. | May 2014 | B2 |
8738181 | Greer et al. | May 2014 | B2 |
8740882 | Jun et al. | Jun 2014 | B2 |
8746252 | McGrogan et al. | Jun 2014 | B2 |
8749189 | Nowlin et al. | Jun 2014 | B2 |
8749190 | Nowlin et al. | Jun 2014 | B2 |
8761930 | Nixon | Jun 2014 | B2 |
8764448 | Yang et al. | Jul 2014 | B2 |
8771170 | Mesallum et al. | Jul 2014 | B2 |
8781186 | Clements et al. | Jul 2014 | B2 |
8781630 | Banks et al. | Jul 2014 | B2 |
8784385 | Boyden et al. | Jul 2014 | B2 |
8786241 | Nowlin et al. | Jul 2014 | B2 |
8787520 | Baba | Jul 2014 | B2 |
8792704 | Isaacs | Jul 2014 | B2 |
8798231 | Notohara et al. | Aug 2014 | B2 |
8800838 | Shelton, IV | Aug 2014 | B2 |
8808164 | Hoffman et al. | Aug 2014 | B2 |
8812077 | Dempsey | Aug 2014 | B2 |
8814793 | Brabrand | Aug 2014 | B2 |
8816628 | Nowlin et al. | Aug 2014 | B2 |
8818105 | Myronenko et al. | Aug 2014 | B2 |
8820605 | Shelton, IV | Sep 2014 | B2 |
8821511 | Von Jako et al. | Sep 2014 | B2 |
8823308 | Nowlin et al. | Sep 2014 | B2 |
8827996 | Scott et al. | Sep 2014 | B2 |
8828024 | Farritor et al. | Sep 2014 | B2 |
8830224 | Zhao et al. | Sep 2014 | B2 |
8834489 | Cooper et al. | Sep 2014 | B2 |
8834490 | Bonutti | Sep 2014 | B2 |
8838270 | Druke et al. | Sep 2014 | B2 |
8844789 | Shelton, IV et al. | Sep 2014 | B2 |
8855822 | Bartol et al. | Oct 2014 | B2 |
8858598 | Seifert et al. | Oct 2014 | B2 |
8860753 | Bhandarkar et al. | Oct 2014 | B2 |
8864751 | Prisco et al. | Oct 2014 | B2 |
8864798 | Weiman et al. | Oct 2014 | B2 |
8864833 | Glerum et al. | Oct 2014 | B2 |
8867703 | Shapiro et al. | Oct 2014 | B2 |
8870880 | Himmelberger et al. | Oct 2014 | B2 |
8876866 | Zappacosta et al. | Nov 2014 | B2 |
8880223 | Raj et al. | Nov 2014 | B2 |
8882803 | Iott et al. | Nov 2014 | B2 |
8883210 | Truncale et al. | Nov 2014 | B1 |
8888821 | Rezach et al. | Nov 2014 | B2 |
8888853 | Glerum et al. | Nov 2014 | B2 |
8888854 | Glerum et al. | Nov 2014 | B2 |
8894652 | Seifert et al. | Nov 2014 | B2 |
8894688 | Suh | Nov 2014 | B2 |
8894691 | Iott et al. | Nov 2014 | B2 |
8906069 | Hansell et al. | Dec 2014 | B2 |
8964934 | Ein-Gal | Feb 2015 | B2 |
8992580 | Bar et al. | Mar 2015 | B2 |
8996169 | Lightcap et al. | Mar 2015 | B2 |
9001963 | Sowards-Emmerd et al. | Apr 2015 | B2 |
9002076 | Khadem et al. | Apr 2015 | B2 |
9044190 | Rubner et al. | Jun 2015 | B2 |
9107683 | Hourtash et al. | Aug 2015 | B2 |
9125556 | Zehavi et al. | Sep 2015 | B2 |
9131986 | Greer et al. | Sep 2015 | B2 |
9215968 | Schostek et al. | Dec 2015 | B2 |
9308050 | Kostrzewski et al. | Apr 2016 | B2 |
9380984 | Li et al. | Jul 2016 | B2 |
9393039 | Lechner et al. | Jul 2016 | B2 |
9398886 | Gregerson et al. | Jul 2016 | B2 |
9398890 | Dong et al. | Jul 2016 | B2 |
9414859 | Ballard et al. | Aug 2016 | B2 |
9420975 | Gutfleisch et al. | Aug 2016 | B2 |
9492235 | Hourtash et al. | Nov 2016 | B2 |
9592096 | Maillet et al. | Mar 2017 | B2 |
9750465 | Engel et al. | Sep 2017 | B2 |
9757203 | Hourtash et al. | Sep 2017 | B2 |
9795354 | Menegaz et al. | Oct 2017 | B2 |
9814535 | Bar et al. | Nov 2017 | B2 |
9820783 | Donner et al. | Nov 2017 | B2 |
9833265 | Donner et al. | Nov 2017 | B2 |
9848922 | Tohmeh et al. | Dec 2017 | B2 |
9925011 | Gombert et al. | Mar 2018 | B2 |
9931025 | Graetzel et al. | Apr 2018 | B1 |
10034717 | Miller et al. | Jul 2018 | B2 |
10575906 | Wu | Mar 2020 | B2 |
20010036302 | Miller | Nov 2001 | A1 |
20020035321 | Bucholz et al. | Mar 2002 | A1 |
20030125622 | Schweikard et al. | Jul 2003 | A1 |
20030161442 | Zeiss | Aug 2003 | A1 |
20040068172 | Nowinski et al. | Apr 2004 | A1 |
20040076259 | Jensen et al. | Apr 2004 | A1 |
20040097952 | Sarin et al. | May 2004 | A1 |
20040111024 | Zheng | Jun 2004 | A1 |
20040153191 | Grimm et al. | Aug 2004 | A1 |
20040215071 | Frank et al. | Oct 2004 | A1 |
20050085714 | Foley et al. | Apr 2005 | A1 |
20050096502 | Khalili | May 2005 | A1 |
20050143651 | Verard et al. | Jun 2005 | A1 |
20050149045 | Elliott | Jul 2005 | A1 |
20050171558 | Abovitz et al. | Aug 2005 | A1 |
20050215888 | Grimm et al. | Sep 2005 | A1 |
20060100610 | Wallace et al. | May 2006 | A1 |
20060142657 | Quaid et al. | Jun 2006 | A1 |
20060173329 | Marquart et al. | Aug 2006 | A1 |
20060178559 | Kumar et al. | Aug 2006 | A1 |
20060184396 | Dennis et al. | Aug 2006 | A1 |
20060241416 | Marquart et al. | Oct 2006 | A1 |
20060264963 | Reed et al. | Nov 2006 | A1 |
20060291612 | Nishide et al. | Dec 2006 | A1 |
20070015987 | Benlloch Baviera et al. | Jan 2007 | A1 |
20070021738 | Hasser et al. | Jan 2007 | A1 |
20070038059 | Sheffer et al. | Feb 2007 | A1 |
20070073133 | Schoenefeld | Mar 2007 | A1 |
20070078475 | Bodduluri et al. | Apr 2007 | A1 |
20070122020 | Claus et al. | May 2007 | A1 |
20070156121 | Millman et al. | Jul 2007 | A1 |
20070156157 | Nahum et al. | Jul 2007 | A1 |
20070167712 | Keglovich et al. | Jul 2007 | A1 |
20070233238 | Huynh et al. | Oct 2007 | A1 |
20070238985 | Smith et al. | Oct 2007 | A1 |
20080004523 | Jensen | Jan 2008 | A1 |
20080010706 | Moses et al. | Jan 2008 | A1 |
20080013809 | Zhu et al. | Jan 2008 | A1 |
20080033283 | Dellaca et al. | Feb 2008 | A1 |
20080046122 | Manzo et al. | Feb 2008 | A1 |
20080082109 | Moll et al. | Apr 2008 | A1 |
20080108912 | Node-Langlois | May 2008 | A1 |
20080108991 | Von Jako | May 2008 | A1 |
20080109012 | Falco et al. | May 2008 | A1 |
20080119725 | Loyd | May 2008 | A1 |
20080144906 | Allred et al. | Jun 2008 | A1 |
20080154389 | Smith et al. | Jun 2008 | A1 |
20080161680 | Von Jako et al. | Jul 2008 | A1 |
20080161682 | Kendrick et al. | Jul 2008 | A1 |
20080177203 | von Jako | Jul 2008 | A1 |
20080188934 | Moser et al. | Aug 2008 | A1 |
20080200794 | Techman et al. | Aug 2008 | A1 |
20080214922 | Hartmann et al. | Sep 2008 | A1 |
20080228068 | Viswanathan et al. | Sep 2008 | A1 |
20080228195 | von Jako et al. | Sep 2008 | A1 |
20080228196 | Wang et al. | Sep 2008 | A1 |
20080235052 | Node-Langlois et al. | Sep 2008 | A1 |
20080269596 | Revie et al. | Oct 2008 | A1 |
20080287771 | Anderson | Nov 2008 | A1 |
20080287781 | Revie et al. | Nov 2008 | A1 |
20080300477 | Lloyd et al. | Dec 2008 | A1 |
20080300478 | Zuhars et al. | Dec 2008 | A1 |
20080302950 | Park et al. | Dec 2008 | A1 |
20080306490 | Lakin et al. | Dec 2008 | A1 |
20080319311 | Hamadeh | Dec 2008 | A1 |
20090012509 | Csavoy et al. | Jan 2009 | A1 |
20090030428 | Omori et al. | Jan 2009 | A1 |
20090080737 | Battle et al. | Mar 2009 | A1 |
20090099445 | Burger | Apr 2009 | A1 |
20090185655 | Koken et al. | Jul 2009 | A1 |
20090198121 | Hoheisel | Aug 2009 | A1 |
20090216113 | Meier et al. | Aug 2009 | A1 |
20090228019 | Gross et al. | Sep 2009 | A1 |
20090234217 | Mire et al. | Sep 2009 | A1 |
20090259123 | Navab et al. | Oct 2009 | A1 |
20090259230 | Khadem et al. | Oct 2009 | A1 |
20090264899 | Appenrodt et al. | Oct 2009 | A1 |
20090281417 | Hartmann et al. | Nov 2009 | A1 |
20090306480 | Protopsaltis | Dec 2009 | A1 |
20090306499 | Van Vorhis et al. | Dec 2009 | A1 |
20100022874 | Wang et al. | Jan 2010 | A1 |
20100039506 | Sarvestani et al. | Feb 2010 | A1 |
20100046718 | Weiser et al. | Feb 2010 | A1 |
20100076305 | Maier-Hein et al. | Mar 2010 | A1 |
20100114288 | Haller et al. | May 2010 | A1 |
20100125286 | Wang et al. | May 2010 | A1 |
20100130986 | Mailloux et al. | May 2010 | A1 |
20100174410 | Greer et al. | Jul 2010 | A1 |
20100228117 | Hartmann | Sep 2010 | A1 |
20100228265 | Prisco | Sep 2010 | A1 |
20100228340 | Erbel et al. | Sep 2010 | A1 |
20100249571 | Jensen et al. | Sep 2010 | A1 |
20100274120 | Heuscher | Oct 2010 | A1 |
20100280363 | Skarda et al. | Nov 2010 | A1 |
20100331858 | Simaan et al. | Dec 2010 | A1 |
20110019884 | Blau | Jan 2011 | A1 |
20110020084 | Brett et al. | Jan 2011 | A1 |
20110022229 | Jang et al. | Jan 2011 | A1 |
20110040305 | Gomez et al. | Feb 2011 | A1 |
20110077504 | Fischer et al. | Mar 2011 | A1 |
20110098553 | Robbins et al. | Apr 2011 | A1 |
20110137152 | Li | Jun 2011 | A1 |
20110184245 | Xia et al. | Jul 2011 | A1 |
20110188639 | Cooke | Aug 2011 | A1 |
20110190588 | McKay | Aug 2011 | A1 |
20110213379 | Blau et al. | Sep 2011 | A1 |
20110213384 | Jeong | Sep 2011 | A1 |
20110224684 | Larkin et al. | Sep 2011 | A1 |
20110224685 | Larkin et al. | Sep 2011 | A1 |
20110224686 | Larkin et al. | Sep 2011 | A1 |
20110224687 | Larkin et al. | Sep 2011 | A1 |
20110224688 | Larkin et al. | Sep 2011 | A1 |
20110224689 | Larkin et al. | Sep 2011 | A1 |
20110224825 | Larkin et al. | Sep 2011 | A1 |
20110230967 | O'Halloran et al. | Sep 2011 | A1 |
20110238080 | Ranjit et al. | Sep 2011 | A1 |
20110276058 | Choi et al. | Nov 2011 | A1 |
20110282189 | Graumann | Nov 2011 | A1 |
20110286573 | Schretter et al. | Nov 2011 | A1 |
20110295062 | Gratacos Solsona et al. | Dec 2011 | A1 |
20110295370 | Suh et al. | Dec 2011 | A1 |
20110306873 | Shenai et al. | Dec 2011 | A1 |
20110306986 | Lee et al. | Dec 2011 | A1 |
20120035507 | George et al. | Feb 2012 | A1 |
20120046668 | Gantes | Feb 2012 | A1 |
20120051498 | Koishi | Mar 2012 | A1 |
20120053597 | Anvari et al. | Mar 2012 | A1 |
20120059248 | Holsing et al. | Mar 2012 | A1 |
20120071753 | Hunter et al. | Mar 2012 | A1 |
20120108954 | Schulhauser et al. | May 2012 | A1 |
20120136372 | Amat Girbau et al. | May 2012 | A1 |
20120143084 | Shoham | Jun 2012 | A1 |
20120179026 | Simon | Jul 2012 | A1 |
20120184839 | Woerlein | Jul 2012 | A1 |
20120197182 | Millman et al. | Aug 2012 | A1 |
20120226145 | Chang et al. | Sep 2012 | A1 |
20120235909 | Birkenbach et al. | Sep 2012 | A1 |
20120245596 | Meenink | Sep 2012 | A1 |
20120253332 | Moll | Oct 2012 | A1 |
20120253360 | White et al. | Oct 2012 | A1 |
20120256092 | Zingerman | Oct 2012 | A1 |
20120289820 | Rohling | Nov 2012 | A1 |
20120294498 | Popovic | Nov 2012 | A1 |
20120296203 | Hartmann et al. | Nov 2012 | A1 |
20130006267 | Odermatt et al. | Jan 2013 | A1 |
20130016889 | Myronenko et al. | Jan 2013 | A1 |
20130018384 | Kappel | Jan 2013 | A1 |
20130030571 | Ruiz Morales et al. | Jan 2013 | A1 |
20130035583 | Park et al. | Feb 2013 | A1 |
20130051647 | Miao | Feb 2013 | A1 |
20130060146 | Yang et al. | Mar 2013 | A1 |
20130060337 | Petersheim et al. | Mar 2013 | A1 |
20130064427 | Picard et al. | Mar 2013 | A1 |
20130094742 | Feilkas | Apr 2013 | A1 |
20130096574 | Kang et al. | Apr 2013 | A1 |
20130113791 | Isaacs et al. | May 2013 | A1 |
20130116706 | Lee et al. | May 2013 | A1 |
20130131695 | Scarfogliero et al. | May 2013 | A1 |
20130144307 | Jeong et al. | Jun 2013 | A1 |
20130158542 | Manzo et al. | Jun 2013 | A1 |
20130165937 | Patwardhan | Jun 2013 | A1 |
20130178867 | Farritor et al. | Jul 2013 | A1 |
20130178868 | Roh | Jul 2013 | A1 |
20130178870 | Schena | Jul 2013 | A1 |
20130184873 | Namiki | Jul 2013 | A1 |
20130204271 | Brisson et al. | Aug 2013 | A1 |
20130211419 | Jensen | Aug 2013 | A1 |
20130211420 | Jensen | Aug 2013 | A1 |
20130218142 | Tuma et al. | Aug 2013 | A1 |
20130223702 | Holsing et al. | Aug 2013 | A1 |
20130225942 | Holsing et al. | Aug 2013 | A1 |
20130225943 | Holsing et al. | Aug 2013 | A1 |
20130231556 | Holsing et al. | Sep 2013 | A1 |
20130237995 | Lee et al. | Sep 2013 | A1 |
20130245375 | DiMaio et al. | Sep 2013 | A1 |
20130261640 | Kim et al. | Oct 2013 | A1 |
20130268007 | Rezach et al. | Oct 2013 | A1 |
20130272488 | Bailey et al. | Oct 2013 | A1 |
20130272489 | Dickman et al. | Oct 2013 | A1 |
20130274761 | Devengenzo et al. | Oct 2013 | A1 |
20130281821 | Liu et al. | Oct 2013 | A1 |
20130296884 | Taylor et al. | Nov 2013 | A1 |
20130303887 | Holsing et al. | Nov 2013 | A1 |
20130307955 | Deitz et al. | Nov 2013 | A1 |
20130317521 | Choi et al. | Nov 2013 | A1 |
20130325033 | Schena et al. | Dec 2013 | A1 |
20130325035 | Hauck et al. | Dec 2013 | A1 |
20130331686 | Freysinger et al. | Dec 2013 | A1 |
20130331858 | Devengenzo et al. | Dec 2013 | A1 |
20130331861 | Yoon | Dec 2013 | A1 |
20130342578 | Isaacs | Dec 2013 | A1 |
20130345717 | Markvicka et al. | Dec 2013 | A1 |
20130345757 | Stad | Dec 2013 | A1 |
20140001235 | Shelton, IV | Jan 2014 | A1 |
20140012131 | Heruth et al. | Jan 2014 | A1 |
20140031664 | Kang et al. | Jan 2014 | A1 |
20140046128 | Lee et al. | Feb 2014 | A1 |
20140046132 | Hoeg et al. | Feb 2014 | A1 |
20140046340 | Wilson et al. | Feb 2014 | A1 |
20140049629 | Siewerdsen et al. | Feb 2014 | A1 |
20140052150 | Taylor et al. | Feb 2014 | A1 |
20140058406 | Tsekos | Feb 2014 | A1 |
20140067343 | Yamagata | Mar 2014 | A1 |
20140073914 | Lavallee et al. | Mar 2014 | A1 |
20140080086 | Chen | Mar 2014 | A1 |
20140081128 | Verard et al. | Mar 2014 | A1 |
20140088410 | Wu | Mar 2014 | A1 |
20140088612 | Bartol et al. | Mar 2014 | A1 |
20140094694 | Moctezuma de la Barrera | Apr 2014 | A1 |
20140094851 | Gordon | Apr 2014 | A1 |
20140096369 | Matsumoto et al. | Apr 2014 | A1 |
20140100587 | Farritor et al. | Apr 2014 | A1 |
20140121676 | Kostrzewski et al. | May 2014 | A1 |
20140128882 | Kwak et al. | May 2014 | A1 |
20140135744 | Stein et al. | May 2014 | A1 |
20140135796 | Simon et al. | May 2014 | A1 |
20140142591 | Alvarez et al. | May 2014 | A1 |
20140142592 | Moon et al. | May 2014 | A1 |
20140148692 | Hartmann et al. | May 2014 | A1 |
20140163581 | Devengenzo et al. | Jun 2014 | A1 |
20140171781 | Stiles | Jun 2014 | A1 |
20140171900 | Stiles | Jun 2014 | A1 |
20140171965 | Loh et al. | Jun 2014 | A1 |
20140180308 | von Grunberg | Jun 2014 | A1 |
20140180309 | Seeber et al. | Jun 2014 | A1 |
20140187915 | Yaroshenko et al. | Jul 2014 | A1 |
20140188132 | Kang | Jul 2014 | A1 |
20140194699 | Roh et al. | Jul 2014 | A1 |
20140200587 | Pompee et al. | Jul 2014 | A1 |
20140130810 | Azizian et al. | Aug 2014 | A1 |
20140221819 | Sarment | Aug 2014 | A1 |
20140221822 | Ehlers et al. | Aug 2014 | A1 |
20140222023 | Kim et al. | Aug 2014 | A1 |
20140228631 | Kwak et al. | Aug 2014 | A1 |
20140234804 | Huang et al. | Aug 2014 | A1 |
20140257328 | Kim et al. | Sep 2014 | A1 |
20140257329 | Jang et al. | Sep 2014 | A1 |
20140257330 | Choi et al. | Sep 2014 | A1 |
20140275760 | Lee et al. | Sep 2014 | A1 |
20140275955 | Crawford et al. | Sep 2014 | A1 |
20140275985 | Walker et al. | Sep 2014 | A1 |
20140276931 | Parihar et al. | Sep 2014 | A1 |
20140276940 | Seo | Sep 2014 | A1 |
20140276944 | Farritor et al. | Sep 2014 | A1 |
20140288413 | Hwang et al. | Sep 2014 | A1 |
20140299648 | Shelton, IV et al. | Oct 2014 | A1 |
20140303434 | Farritor et al. | Oct 2014 | A1 |
20140303643 | Ha et al. | Oct 2014 | A1 |
20140305995 | Shelton, IV et al. | Oct 2014 | A1 |
20140309659 | Roh et al. | Oct 2014 | A1 |
20140316436 | Bar et al. | Oct 2014 | A1 |
20140323803 | Hoffman et al. | Oct 2014 | A1 |
20140324070 | Min et al. | Oct 2014 | A1 |
20140330288 | Date et al. | Nov 2014 | A1 |
20140336669 | Park | Nov 2014 | A1 |
20140343416 | Panescu et al. | Nov 2014 | A1 |
20140364720 | Darrow et al. | Dec 2014 | A1 |
20140371577 | Maillet et al. | Dec 2014 | A1 |
20150032164 | Crawford et al. | Jan 2015 | A1 |
20150039034 | Frankel et al. | Feb 2015 | A1 |
20150049174 | Lee et al. | Feb 2015 | A1 |
20150085970 | Bouhnik et al. | Mar 2015 | A1 |
20150100066 | Kostrzewski | Apr 2015 | A1 |
20150100067 | Cavanagh et al. | Apr 2015 | A1 |
20150146847 | Liu | May 2015 | A1 |
20150150524 | Yorkston et al. | Jun 2015 | A1 |
20150157416 | Andersson | Jun 2015 | A1 |
20150157468 | Wakayama et al. | Jun 2015 | A1 |
20150173810 | Biedermann et al. | Jun 2015 | A1 |
20150196261 | Funk | Jul 2015 | A1 |
20150196365 | Kostrzewski et al. | Jul 2015 | A1 |
20150209056 | Shoham et al. | Jul 2015 | A1 |
20150213633 | Chang et al. | Jul 2015 | A1 |
20150335480 | Alvarez et al. | Nov 2015 | A1 |
20150342647 | Frankel et al. | Dec 2015 | A1 |
20160005194 | Schretter et al. | Jan 2016 | A1 |
20160030129 | Christian et al. | Feb 2016 | A1 |
20160033284 | Sato | Feb 2016 | A1 |
20160063707 | Masumoto | Mar 2016 | A1 |
20160166329 | Langan et al. | Jun 2016 | A1 |
20160220320 | Crawford et al. | Aug 2016 | A1 |
20160235480 | Scholl et al. | Aug 2016 | A1 |
20160235492 | Morard et al. | Aug 2016 | A1 |
20160235493 | LeBoeuf et al. | Aug 2016 | A1 |
20160249990 | Glozman et al. | Sep 2016 | A1 |
20160256225 | Crawford et al. | Sep 2016 | A1 |
20160296266 | Chandanson et al. | Oct 2016 | A1 |
20160302871 | Gregerson et al. | Oct 2016 | A1 |
20160320322 | Suzuki | Nov 2016 | A1 |
20160331335 | Gregerson et al. | Nov 2016 | A1 |
20170000562 | Frank et al. | Jan 2017 | A1 |
20170020609 | Wentorf et al. | Jan 2017 | A1 |
20170079727 | Crawford et al. | Mar 2017 | A1 |
20170112552 | Sinnott et al. | Apr 2017 | A1 |
20170135770 | Scholl et al. | May 2017 | A1 |
20170143284 | Sehnert et al. | May 2017 | A1 |
20170143426 | Isaacs et al. | May 2017 | A1 |
20170156816 | Ibrahim | Jun 2017 | A1 |
20170189126 | Weir | Jul 2017 | A1 |
20170202629 | Maillet et al. | Jul 2017 | A1 |
20170212723 | Atarot et al. | Jul 2017 | A1 |
20170215825 | Johnson et al. | Aug 2017 | A1 |
20170215826 | Johnson et al. | Aug 2017 | A1 |
20170215827 | Johnson et al. | Aug 2017 | A1 |
20170231710 | Scholl et al. | Aug 2017 | A1 |
20170245946 | Tabandeh et al. | Aug 2017 | A1 |
20170245951 | Crawford et al. | Aug 2017 | A1 |
20170258426 | Risher-Kelly et al. | Sep 2017 | A1 |
20170258532 | Shalayev et al. | Sep 2017 | A1 |
20170258535 | Crawford et al. | Sep 2017 | A1 |
20170265952 | Donhowe et al. | Sep 2017 | A1 |
20170273748 | Hourtash et al. | Sep 2017 | A1 |
20170296277 | Hourtash et al. | Oct 2017 | A1 |
20170360493 | Zucher et al. | Dec 2017 | A1 |
20180042464 | Arai et al. | Feb 2018 | A1 |
20180064496 | Hladio et al. | Mar 2018 | A1 |
20180064497 | Hussain et al. | Mar 2018 | A1 |
20180092699 | Finley | Apr 2018 | A1 |
20180200016 | Chappuis | Jul 2018 | A1 |
20180325608 | Kang et al. | Nov 2018 | A1 |
20180325610 | Cameron et al. | Nov 2018 | A1 |
Number | Date | Country |
---|---|---|
2015234609 | Oct 2016 | AU |
1714742 | Jan 2006 | CN |
102036615 | Apr 2011 | CN |
102438551 | May 2012 | CN |
103945764 | Jul 2014 | CN |
104334110 | Feb 2015 | CN |
105101903 | Nov 2015 | CN |
105939687 | Sep 2016 | CN |
106691600 | May 2017 | CN |
106999168 | Aug 2017 | CN |
106999245 | Aug 2017 | CN |
107088091 | Aug 2017 | CN |
107405170 | Nov 2017 | CN |
107545585 | Jan 2018 | CN |
108601569 | Sep 2018 | CN |
108652743 | Oct 2018 | CN |
209153975 | Jul 2019 | CN |
107847275 | Oct 2020 | CN |
102012215001 | Dec 2021 | DE |
1103223 | May 2001 | EP |
1224918 | Jul 2002 | EP |
1346687 | Sep 2003 | EP |
1523950 | Apr 2005 | EP |
2468207 | Jun 2012 | EP |
2471617 | Jul 2012 | EP |
3181085 | Jun 2017 | EP |
3391848 | Oct 2018 | EP |
3517069 | Jul 2019 | EP |
3-118053 | May 1991 | JP |
2004518475 | Jun 2004 | JP |
2007537835 | Dec 2007 | JP |
2008507361 | Mar 2008 | JP |
2008188417 | Aug 2008 | JP |
2009537229 | Oct 2009 | JP |
2011-120782 | Jun 2011 | JP |
2012075507 | Apr 2012 | JP |
2013075195 | Apr 2013 | JP |
2014036700 | Feb 2014 | JP |
2014-48228 | Mar 2014 | JP |
2014097220 | May 2014 | JP |
2015119968 | Jul 2015 | JP |
2015528713 | Oct 2015 | JP |
2015-534480 | Dec 2015 | JP |
2015534845 | Dec 2015 | JP |
2016-33474 | Mar 2016 | JP |
2016043211 | Apr 2016 | JP |
2016539681 | Dec 2016 | JP |
2017087313 | May 2017 | JP |
2017-528255 | Sep 2017 | JP |
2017530842 | Oct 2017 | JP |
2017221660 | Dec 2017 | JP |
2018011938 | Jan 2018 | JP |
2018516107 | Jun 2018 | JP |
2018-114283 | Jul 2018 | JP |
2018523516 | Aug 2018 | JP |
2018-202156 | Dec 2018 | JP |
2021-25802 | Feb 2021 | JP |
2021025802 | Feb 2021 | JP |
2005039417 | May 2005 | WO |
2009126953 | Oct 2009 | WO |
2011128766 | Oct 2011 | WO |
2012050634 | Apr 2012 | WO |
2013114823 | Aug 2013 | WO |
2013118047 | Aug 2013 | WO |
2013192598 | Dec 2013 | WO |
2014010760 | Jan 2014 | WO |
2014062890 | Apr 2014 | WO |
2014139023 | Sep 2014 | WO |
2015023665 | Feb 2015 | WO |
2015052718 | Apr 2015 | WO |
2015061638 | Apr 2015 | WO |
2015142762 | Sep 2015 | WO |
2016087539 | Jun 2016 | WO |
2016114834 | Jul 2016 | WO |
2016152255 | Sep 2016 | WO |
2016154557 | Sep 2016 | WO |
2017127202 | Jul 2017 | WO |
2017147596 | Aug 2017 | WO |
2017186799 | Nov 2017 | WO |
2017204832 | Nov 2017 | WO |
2017221257 | Dec 2017 | WO |
2018075784 | Apr 2018 | WO |
2018165767 | Sep 2018 | WO |
2018183461 | Oct 2018 | WO |
2019193775 | Oct 2019 | WO |
Entry |
---|
US 8,231,638 B2, 07/2012, Swarup et al. (withdrawn) |
Markelj et al.: “A review of 3D/2D registration methods for image-guided interventions”, Medical Image Analysis, Oxford University Press, Oxford, GB, vol. 16, No. 3,pp. 642-661, Apr. 1, 2012. |
Gong Ren Hui et al.: “Interactive initialization of 2D/3D rigid registration”, Medical Physics, AIP, Melville, NY, US, vol. 40, No. 12, 14 pages, Dec. 2013. |
Dumenil A et al.: “A versatile intensity-based 3D/2D rigid registration compatible with mobile C-arm for endovascular treatment of abdominal aortic aneurysm”, International Journal of Computer Assisted Radiology and Surgery, Springer, DE, vol. 11, No. 9, pp. 1713-1729, May 26, 2016. |
Marintschev et al.: “Navigation of vertebro-pelvic fixations based on CT-fluoro macthing”, European Spine Journal, Springer, Berlin, DE, vol. 19, No. 11, pp. 1921-1927, Jun. 16, 2010. |
Andreas Alk et al: “Smart Device Assisted Method for Rod Length and Rod Radius Measurement in Percutaneous Pedicle Screw Surgery”, Przeglad Elektrotechniczny, vol. 3, Mar. 5, 2016 (Mar. 5, 2016), pp. 30-33, XP055668769, PO ISSN: 0033-2097, DOI: 10.15199/48.2016.03.07. |
Number | Date | Country | |
---|---|---|---|
20200323609 A1 | Oct 2020 | US |
Number | Date | Country | |
---|---|---|---|
61800527 | Mar 2013 | US | |
61662702 | Jun 2012 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 15289537 | Oct 2016 | US |
Child | 16913354 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 15157444 | May 2016 | US |
Child | 15289537 | US | |
Parent | 15095883 | Apr 2016 | US |
Child | 15157444 | US | |
Parent | 14062707 | Oct 2013 | US |
Child | 15095883 | US | |
Parent | 13924505 | Jun 2013 | US |
Child | 14062707 | US |