Ultrasonic bone knife position determination method and system

Abstract

The present application provides a method, system, computer-readable storage medium and computer program product for determining the position of an ultrasonic bone cutter, the method comprising: obtaining an acoustic impedance signal of an ultrasonic bone cutter; and determining the current position of the ultrasonic bone cutter in the bone tissue to be cut based on the acoustic impedance signal. The method, system, computer-readable storage medium and computer program product for determining the position of an ultrasonic bone cutter provided in the present application determine the current position of an ultrasonic bone cutter in the bone tissue to be cut by means of an acoustic impedance signal, thereby facilitating the operator to obtain the position of the ultrasonic bone cutter in real time, and effectively preventing the moving path of the ultrasonic bone cutter from deviating from the target path, thereby reducing damage to soft tissue during surgery.

Description

Technical Field

[0001] The present application relates to the field of medical device technology, and in particular to a method and system for determining the position of an ultrasonic bone knife, a computer-readable storage medium, and a computer program product. Background Art

[0002] Ultrasonic bone knives have been widely used for cutting and crushing bone tissue. Although ultrasonic bone knives have the characteristics of protecting soft tissue, when ultrasonic bone knives apply a certain pressure on soft tissue, it will still cause damage to the soft tissue, especially in spinal surgery or neurosurgery. After cutting through the inner cortical bone, if the downward cutting is not stopped, it will still cause damage to the spinal cord or brain and other nerve tissues in the bone cavity. Therefore, how to reduce the damage to soft tissue caused by surgery is of great significance. Summary of the invention

[0003] The present application aims to solve at least one of the technical problems existing in the prior art. To this end, one purpose of the present application is to propose an ultrasonic osteotome position determination method, system, computer readable storage medium and computer program product to reduce the damage to soft tissue during surgery.

[0004] An embodiment of the first aspect of the present application provides a method for determining the position of an ultrasonic bone knife, comprising: acquiring an acoustic impedance signal of the ultrasonic bone knife; and determining the current position of the ultrasonic bone knife in the bone tissue to be cut based on the acoustic impedance signal.

[0005] In some embodiments, the current position of the ultrasonic bone knife in the bone tissue to be cut is determined based on the acoustic impedance signal, including: in response to determining that the acoustic impedance signal is at a first rising edge within a preset time and the average slope of the first rising edge is within a first slope range, determining that the current position is the interface between other tissues and cortical bone.

[0006] In some embodiments, determining the current position as the interface between other tissues and cortical bone includes: in response to determining that the acoustic impedance amplitude at the starting point of the first rising edge is within a first preset range, determining the current position as the interface between air and cortical bone.

[0007] In some embodiments, determining the current position as the interface between other tissues and cortical bone includes: in response to determining that the acoustic impedance amplitude at the starting point of the first rising edge is within a second preset range, determining the current position as the interface between soft tissue and cortical bone.

[0008] In some embodiments, determining the current position as the interface between other tissues and cortical bone includes: in response to determining that the acoustic impedance amplitude at the starting point of the first rising edge is within a third preset range, determining the current position as the interface between cancellous bone and cortical bone.

[0009] In some embodiments, the current position of the ultrasonic bone knife in the bone tissue to be cut is determined based on the acoustic impedance signal, including: in response to determining that the acoustic impedance signal is at a first falling edge within a preset time and the average slope of the first falling edge is within a second slope range, determining that the current position is the interface between cortical bone and other tissues.

[0010] In some embodiments, determining the current position as the interface between cortical bone and other tissues includes: in response to determining that the acoustic impedance amplitude at the end point of the first falling edge is within a third preset range, determining the current position as the interface between cortical bone and cancellous bone.

[0011] In some embodiments, determining the current position as the interface between cortical bone and other tissues includes: in response to determining that the acoustic impedance amplitude at the end point of the first falling edge is within a second preset range, determining the current position as the interface between cortical bone and soft tissue.

[0012] In some embodiments, determining that the current position is the interface between cortical bone and other tissues includes: in response to determining that the acoustic impedance signal is always within a fourth preset range within a preset time, determining that the current position is in the cortical bone.

[0013] In some embodiments, determining that the current position is the interface between cortical bone and other tissues includes: in response to determining that the acoustic impedance signal is always within a third preset range within a preset time, determining that the current position is in cancellous bone.

[0014] In some embodiments, the bone tissue to be cut includes an outer cortical bone, cancellous bone and an inner cortical bone arranged in sequence from the outside to the inside; the method also includes: issuing a first prompt message in response to determining that the current position is the interface between the inner cortical bone and the soft tissue.

[0015] In some embodiments, determining the current position as the interface between inner cortical bone and soft tissue includes: in response to determining that the current position is located at the interface between cortical bone and other tissues for the second time, determining that the current position is the interface between inner cortical bone and soft tissue.

[0016] In some embodiments, the bone tissue to be cut includes cortical bone and cancellous bone arranged in sequence from the outside to the inside; the method further includes: in response to determining that the displacement of the ultrasonic osteotome is within the preset size and the current position is the interface between the cancellous bone and the cortical bone, issuing a second prompt message

[0017] In some embodiments, the bone tissue to be cut includes cortical bone; the method further includes: in response to determining that the current position is the interface between the cortical bone and the soft tissue, issuing a third prompt message.

[0018] According to an embodiment of the second aspect of the present application, there is provided an ultrasonic surgical system, comprising: an ultrasonic bone knife for cutting bone tissue to be cut; and a processor for executing the above method.

[0019] In some embodiments, the ultrasonic surgical system also includes: a surgical robot connected to the ultrasonic bone knife; a display device for displaying the acoustic impedance signal of the ultrasonic bone knife; and the processor is also used to operate the ultrasonic bone knife by controlling the surgical robot.

[0020] According to an embodiment of the third aspect of the present application, a non-transitory computer-readable storage medium storing computer instructions is provided, wherein the computer instructions are used to enable the computer to execute any of the methods described above.

[0021] According to an embodiment of the fourth aspect of the present application, a computer program product is provided, comprising a computer program, wherein the computer program implements any of the methods described above when executed by a processor.

[0022] The ultrasonic bone knife position determination method, system, computer-readable storage medium and computer program product provided in the embodiments of the present application determine the current position of the ultrasonic bone knife in the bone tissue to be cut through the acoustic impedance signal, thereby facilitating the operator to obtain the position of the ultrasonic bone knife in real time, and can effectively prevent the movement path of the ultrasonic bone knife from deviating from the target path, thereby reducing damage to soft tissue during surgery. BRIEF DESCRIPTION OF THE DRAWINGS

[0023] In the accompanying drawings, unless otherwise specified, the same reference numerals throughout the multiple drawings represent the same or similar parts or elements. These drawings are not necessarily drawn to scale. It should be understood that these drawings only depict some embodiments disclosed in the present application and should not be regarded as limiting the scope of the present application.

[0024] Figure 1A A flow chart showing a method for determining the position of an ultrasonic osteotome according to some embodiments of the present application is shown;

[0025] Figure 1B A working principle diagram of an ultrasonic surgical system according to some embodiments of the present application is shown;

[0026] Figure 2 It is a specific implementation of step S102 in FIG. 1 ;

[0027] Figure 3A A working principle diagram of an ultrasonic surgical system according to some embodiments of the present application is shown;

[0028] Figure 3B for Figure 3A The acoustic impedance change diagram of the ultrasonic bone knife;

[0029] Figure 3C For application Figure 3A A flow chart of a method for determining the position of an ultrasonic bone knife in an ultrasonic surgical system;

[0030] Figure 4A A working principle diagram of an ultrasonic surgical system according to some embodiments of the present application is shown;

[0031] Figure 4B for Figure 4A The acoustic impedance change diagram of the ultrasonic bone knife;

[0032] Figure 4C For application Figure 4A A flow chart of a method for determining the position of an ultrasonic bone knife in an ultrasonic surgical system;

[0033] Figure 5A A working principle diagram of an ultrasonic surgical system according to some embodiments of the present application is shown;

[0034] Figure 5B for Figure 5A The acoustic impedance change diagram of the ultrasonic bone knife;

[0035] Figure 5C For application Figure 5A A flow chart of a method for determining the position of an ultrasonic bone knife in an ultrasonic surgical system;

[0036] Figure 6 A structural diagram of an ultrasonic surgical system according to some embodiments of the present application is shown;

[0037] Figure 7 for Figure 6 A partial enlarged view of the ultrasonic bone knife.

[0038] Description of reference numerals:

[0039] 10: ultrasonic osteotome; 11: transducer;

[0040] 20: bone tissue to be cut; 21: cortical bone;

[0041] 21a: outer cortical bone; 21b: inner cortical bone;

[0042] 22: cancellous bone; 30: processor;

[0043] 40: display device; 50: operator;

[0044] 51: surgical robot; 60: ultrasonic driving power supply. DETAILED DESCRIPTION

[0045] In the following, only some exemplary embodiments are briefly described. As those skilled in the art will appreciate, the described embodiments may be modified in various ways without departing from the spirit or scope of the present application. Therefore, the drawings and descriptions are considered to be exemplary and non-restrictive in nature.

[0046] In related technologies, ultrasound surgery usually uses image positioning to detect the cutting position. However, due to the patient's breathing movement and bone position deformation during the cutting process, the image positioning method will cause positioning errors and easily damage soft tissue. In particular, in spinal surgery or neurosurgery, soft tissue is usually nerve tissue such as the spinal cord or brain in the bone cavity, which will have serious effects on the patient if damaged.

[0047] In order to solve at least one of the above problems, the present application provides an ultrasonic bone knife position determination method and system, which determines the current position of the ultrasonic bone knife in the bone tissue to be cut through the acoustic impedance signal, so that the operator can easily obtain the position of the ultrasonic bone knife in real time. Compared with image positioning, it has higher accuracy and can effectively prevent the moving path of the ultrasonic bone knife from deviating from the target path, thereby reducing damage to soft tissue during surgery.

[0048] The embodiments of the present application are described in detail below with reference to the accompanying drawings. Figure 1A A flow chart showing a method for determining the position of an ultrasonic osteotome according to some embodiments of the present application is shown; Figure 1B The working principle diagram of the ultrasonic surgical system according to some embodiments of the present application is shown; please refer to Figure 1A and Figure 1B This embodiment provides a method 100 for determining the position of an ultrasonic bone cutter, which can be used in open surgery or minimally invasive surgery using an ultrasonic bone cutter, especially in surgery related to bone tissue. The method 100 includes steps S101 to S102.

[0049] In step S101, the acoustic impedance signal of the ultrasonic osteotome 10 is obtained.

[0050] In step S102, the current position of the ultrasonic osteotome 10 in the bone tissue 20 to be cut is determined based on the acoustic impedance signal.

[0051] like Figure 1B As shown, the ultrasonic bone knife 10 can be a common structure in the related art that can use ultrasonic energy to cut bone tissue, which can include a knife body and a transducer 11. The knife body has a knife head that contacts the patient, and the knife head can serve as a cutting actuator. The knife head can have a variety of shapes, including various cutting, grinding, drilling knife heads, etc. The transducer 11 can be connected to the ultrasonic drive power supply 60 and the knife head to convert electrical energy into ultrasonic vibrations, and at the same time provide a feedback circuit connection for collecting acoustic impedance information. The ultrasonic drive power supply 60 is a power supply device that can generate an ultrasonic drive signal.

[0052] The acoustic impedance signal can be used to reflect the damping characteristics of a particle at a certain position in the medium caused by mechanical disturbance, which can be expressed as an acoustic impedance curve or a data table. It can be understood that for the ultrasonic osteotome 10, the acoustic impedance of the blade head in contact with different media such as air, soft tissue, bone tissue, etc. is different. Among them, bone tissue can be structurally divided into cortical bone and cancellous bone, and the acoustic impedance of the blade head in contact with cortical bone and cancellous bone is also different. The acoustic impedance signal can be acquired in real time through a certain sampling frequency.

[0053] The bone tissue 20 to be cut is the bone tissue that needs to be cut using the ultrasonic bone knife 10. There can be multiple types of bone tissue 20 to be cut, for example, it can be cortical bone, or it can be a combination structure of cortical bone and cancellous bone, which can vary depending on the type of surgery or the location of the surgery.

[0054] The current position may be the current position information of the blade of the ultrasonic osteotome 10 in the bone tissue to be cut. The operator 50 may be a doctor or a surgical robot operating the ultrasonic osteotome 10, without limitation.

[0055] During surgery, the acoustic impedance signal of the ultrasonic bone knife 10 can be obtained in real time, and the current position of the blade of the ultrasonic bone knife 10 can be determined according to the different acoustic impedance signals fed back by different bone tissues and their interfaces, and then it can be judged whether the cutting position meets the surgical requirements, so that cutting and detection can be performed simultaneously. Compared with the image positioning of related technologies, the accuracy is higher, and it can effectively prevent the movement path of the ultrasonic bone knife from deviating from the target path, thereby reducing damage to nerve tissues such as the spinal cord or brain during surgery, improving surgical safety, and improving surgical efficiency.

[0056] Figure 2 For the specific implementation of step S102 in FIG. 1 , please refer to Figure 2 , determining the current position of the ultrasonic bone knife 10 in the bone tissue 20 to be cut based on the acoustic impedance signal may include: step S201, in response to determining that the acoustic impedance signal is at a first rising edge within a preset time and the average slope of the first rising edge is within a first slope range, determining that the current position is the interface between other tissues and cortical bone.

[0057] To facilitate the description of step S201, Figure 3A A working principle diagram of an ultrasonic surgical system according to some embodiments of the present application is shown; Figure 3B for Figure 3A The acoustic impedance change diagram of ultrasonic bone knife in the middle; please refer to Figure 3A and Figure 3BIn some embodiments, the bone tissue 20 to be cut includes an outer cortical bone 21a, a cancellous bone 22, and an inner cortical bone 21b arranged in sequence from the side close to the ultrasonic bone cutter 10 to the side away from the ultrasonic bone cutter 10. The inner cortical bone 21b and the outer cortical bone 21a are both cortical bones 21, and the inner and outer sides respectively represent their positional relationship with the cancellous bone 22, the outer side can be the position cut earlier in the operation, and the inner side can be the position cut relatively later in the operation.

[0058] Figure 3B The acoustic impedance signal of the ultrasonic osteotome 10 cutting through the outer cortical bone 21a, the cancellous bone 22 and the inner cortical bone 21b in sequence is represented by an acoustic impedance curve. The horizontal axis is time and the vertical axis is the amplitude of the acoustic impedance. Figure 3B In FIG. 1 , the solid line is the acoustic impedance change curve during the experiment, and the dotted line is the ideal acoustic impedance change curve. It can be understood that due to the existence of interference, the acoustic impedance change curve during the experiment has certain jitter and deviation compared with the ideal acoustic impedance change curve.

[0059] In step S201, the first rising edge is the process in which the amplitude of the acoustic impedance signal increases with time. Figure 3B Taking the dotted line in as an example, 41a and 41b both represent the first rising edge.

[0060] The preset time can be set to multiple sampling cycles according to actual conditions. By judging whether the amplitude of the acoustic impedance signal gradually increases over time within the preset time, it can be judged whether the acoustic impedance signal is in the first rising edge. And by setting the preset time reasonably, it can also avoid the interference of signal jitter on the judgment of the first rising edge.

[0061] The slope of the first rising edge can be the angle between the first falling edge and the horizontal coordinate, and the average slope of the first rising edge is the average value of the slope of the first rising edge within a preset time period. The first slope range is a numerical interval, which can be specifically set according to the actual cutting speed. For example, when the cutting speed of the ultrasonic bone knife 10 is greater than or equal to 0.5 mm / s, seconds are used as the unit of the horizontal coordinate of the acoustic impedance signal, and ohms are used as the unit of the vertical coordinate of the acoustic impedance signal, the first slope range is 45 degrees to 90 degrees, for example, 45 degrees, 50 degrees, 55 degrees, 60 degrees, 65 degrees, 70 degrees, 75 degrees, 80 degrees, 85 degrees or 90 degrees. In a preferred embodiment, the first slope range is 60 degrees to 90 degrees, that is, the first slope range can be greater than or equal to 60 degrees and less than or equal to 90 degrees, so that the current position of the cutter head can be judged more accurately.

[0062] The other tissues may be other tissues except cortical bone, such as cancellous bone, soft tissue or air, etc. The interface between the other tissues and the cortical bone 21 represents that the other tissues are located outside the cortical bone 21 , and the cutting direction of the blade is from the other tissues to the cortical bone 21 .

[0063] refer to Figure 3B If the acoustic impedance signal is located at the first rising edge 41a and 41b and its average slope is within the first slope range, it can be more accurately determined that the current position is the interface between other tissues and the cortical bone 21, thereby facilitating the operator 50 to understand the current position of the ultrasonic bone knife 10.

[0064] In some embodiments, determining in step S201 that the current position is the interface between other tissues and cortical bone may include: in response to determining that the acoustic impedance amplitude at the starting point of the first rising edge is within a first preset range, determining that the current position is the interface between air and cortical bone.

[0065] It can be understood that, since the acoustic impedance of the ultrasonic bone knife 10 in different tissues is different, the acoustic impedance amplitude at the starting point of the entire first rising edge 41a can be used to determine the interface between the tissue and the cortical bone 21 at which the ultrasonic bone knife 10 is located.

[0066] The first preset range is the acoustic impedance amplitude range of the ultrasonic bone knife 10 in the air. By judging whether the acoustic impedance amplitude at the starting point of the first rising edge 41a is within the first preset range, it is possible to accurately judge whether the current position is the interface between the air and the cortical bone 21.

[0067] In addition, determining the current position as the interface between other tissues and cortical bone in step S201 may further include:

[0068] In response to determining that the acoustic impedance amplitude at the starting point of the first rising edge is within a second preset range, the current position is determined to be an interface between soft tissue and cortical bone.

[0069] The second preset range is the acoustic impedance amplitude range of the ultrasonic bone knife 10 in the soft tissue. Similarly, by judging whether the acoustic impedance amplitude at the starting point of the first rising edge 41a is within the second preset range, it is possible to accurately judge whether the current position is the interface between the soft tissue and the cortical bone 21.

[0070] Of course, determining that the current position is the interface between other tissues and cortical bone in step S201 may also include: in response to determining that the acoustic impedance amplitude at the starting point of the first rising edge is within a third preset range, determining that the current position is the interface between cancellous bone and cortical bone.

[0071] The third preset range is the acoustic impedance amplitude range of the ultrasonic bone knife 10 in the cancellous bone. Similarly, by judging whether the acoustic impedance amplitude at the starting point of the first rising edge 41b is within the third preset range, it is possible to accurately judge whether the current position is the interface between the cancellous bone 22 and the cortical bone 21.

[0072] In addition, the lowest value of the third preset range is greater than the highest value of the first preset range, and the lowest value of the third preset range is greater than the highest value of the second preset range.

[0073] It can be understood that for the cutting of three layers of bone tissue, when the cutting speed of the ultrasonic bone knife 10 is greater than or equal to 0.5 mm / s, the average slope of the first rising edge 41a of the interface between the air or soft tissue and the outer cortical bone 21a is 45 degrees to 90 degrees, and the average slope of the first rising edge 41b of the interface between the cancellous bone 22 and the inner cortical bone 21b is 45 degrees to 90 degrees.

[0074] like Figure 2 As shown, in some embodiments, step S102, determining the current position of the ultrasonic bone knife 10 in the bone tissue 20 to be cut based on the acoustic impedance signal, may also include: step S202, in response to determining that the acoustic impedance signal is at a first falling edge within a preset time and the average slope of the first falling edge is within a second slope range, determining that the current position is the interface between cortical bone and other tissues.

[0075] Continue to refer to Figure 3B In step S202, the first falling edge is the process in which the amplitude of the acoustic impedance signal decreases with time. Figure 3B Taking the dotted line in FIG. 4 as an example, 42a and 42b both represent the first falling edge.

[0076] The preset time can be set to multiple sampling cycles according to actual conditions. By judging whether the amplitude of the acoustic impedance signal gradually decreases over time within the preset time, it can be judged whether the acoustic impedance signal is in the first falling edge. And by setting the preset time reasonably, it can also avoid the interference of signal jitter on the judgment of the first falling edge.

[0077] The slope of the first falling edge can be the angle between the first falling edge and the horizontal coordinate, and the average slope of the first falling edge is the average value of the slope of the first falling edge within a preset time period. The second slope range is a numerical interval, which can be specifically set according to the actual cutting speed. For example, when the cutting speed of the ultrasonic bone knife 10 is greater than or equal to 0.5 mm / s, seconds are used as the unit of the horizontal coordinate of the acoustic impedance signal, and ohms are used as the unit of the vertical coordinate of the acoustic impedance signal, the second slope range is 45 degrees to 90 degrees, for example, 45 degrees, 50 degrees, 55 degrees, 60 degrees, 65 degrees, 70 degrees, 75 degrees, 80 degrees, 85 degrees or 90 degrees. In a preferred embodiment, the second slope range is 60 degrees to 90 degrees. That is, the second slope range can be greater than or equal to 60 degrees and less than or equal to 90 degrees, so that the current position of the cutter head can be judged more accurately.

[0078] The other tissues may be other tissues except cortical bone, such as cancellous bone, soft tissue or air, etc. The interface between the cortical bone 21 and other tissues represents that the cortical bone 21 is located outside the other tissues, and the cutting direction of the blade is from the cortical bone 21 to the other tissues.

[0079] refer to Figure 3B If the acoustic impedance signal is located at the first falling edge 42a and 42b and its average slope is within the second slope range, the current position can be more accurately determined to be the interface between the cortical bone 21 and other tissues, thereby facilitating the operator 50 to understand the current position of the ultrasonic bone knife 10.

[0080] In some embodiments, the step of determining the current position as the interface between cortical bone and other tissues in step S202 may include: in response to determining that the acoustic impedance amplitude at the end point of the first falling edge is within a third preset range, determining that the current position is the interface between cortical bone 21 and cancellous bone 22.

[0081] It can be understood that, since the acoustic impedance of the ultrasonic bone knife 10 in different tissues is different, the acoustic impedance amplitude at the end point of the entire first falling edge 42a can be used to determine whether the ultrasonic bone knife 10 is located at the interface between the cortical bone 21 and which tissue.

[0082] The third preset range is the acoustic impedance amplitude range of the ultrasonic bone knife 10 in the cancellous bone 22. By judging whether the acoustic impedance amplitude at the end point of the first falling edge 42a is within the third preset range, it is possible to accurately judge whether the current position is the interface between the cortical bone 21 and the cancellous bone 22.

[0083] In some embodiments, the step of determining the current position as the interface between cortical bone and other tissues in step S202 may also include: in response to determining that the acoustic impedance amplitude at the end point of the first falling edge is within a second preset range, determining that the current position is the interface between cortical bone and soft tissue.

[0084] The second preset range is the acoustic impedance amplitude range of the ultrasonic bone knife 10 in the soft tissue. Similarly, by judging whether the acoustic impedance amplitude at the end point of the first falling edge 42b is within the second preset range, it is possible to accurately judge whether the current position is the interface between the cortical bone 21 and the soft tissue.

[0085] Of course, the step of determining the current position as the interface between cortical bone and other tissues in step S202 may also include: in response to determining that the acoustic impedance amplitude at the end point of the first falling edge is within a first preset range, determining the current position as the interface between cortical bone and air.

[0086] Continue to refer to Figure 2 Step S102 determines the current position of the ultrasonic bone knife 10 in the bone tissue 20 to be cut based on the acoustic impedance signal, which may include: Step S203, in response to determining that the acoustic impedance signal is always in the fourth preset range within the preset time, determines that the current position is in the cortical bone.

[0087] The fourth preset range may be the acoustic impedance amplitude range of the ultrasonic osteotome 10 in the cortical bone 21, which may have a minimum value. When the acoustic impedance amplitude is greater than the minimum value, it can be considered that the blade head is located in the cortical bone 21. Similarly, by determining whether the acoustic impedance signal is within the fourth preset range, it can be accurately determined whether the current position is the cortical bone 21.

[0088] The preset time can be set to multiple sampling cycles according to actual conditions. By judging whether the amplitude of the acoustic impedance signal is always within the fourth preset range within the preset time, it can be judged whether the acoustic impedance signal is in the cortical bone impedance level segment. Figure 3B As shown, the acoustic impedance signal is always within the fourth preset range within the preset time, that is, it is located in the cortical bone impedance horizontal segment 43b. The cortical bone impedance horizontal segment 43b indicates that the cutting head passes through the interface between other tissues and the cortical bone 21 and is located in the cortical bone 21. The length of the cortical bone impedance horizontal segment 43b on the horizontal axis may vary depending on the thickness of the cortical bone 21.

[0089] In addition, for cortical bones of different individuals or different positions of the same individual, the fourth preset range may be different, for example, Figure 3B In the embodiment, the fourth preset ranges of the cortical bone impedance level 43b representing the outer cortical bone and the cortical bone impedance level 43d representing the inner cortical bone may be different.

[0090] In some embodiments, continue to refer to Figure 2 Step S102 determines the current position of the ultrasonic bone knife 10 in the bone tissue 20 to be cut based on the acoustic impedance signal, which may include: Step S204, in response to determining that the acoustic impedance signal is always in the third preset range within the preset time, determining that the current position is in the cancellous bone.

[0091] Since the hardness of cortical bone is greater than that of cancellous bone, the maximum value of the third preset range is less than the minimum value of the fourth preset range. The amplitude of the acoustic impedance in the cancellous bone should be 60% or less of the amplitude of the acoustic impedance in the cortical bone, that is, the average value of the third preset range is approximately 60% or less of the average value of the fourth preset range. The third preset range can be the acoustic impedance amplitude range of the ultrasonic osteotome 10 in the cancellous bone 22, such as Figure 3B As shown, when the acoustic impedance amplitude is within this range, it can be considered that the acoustic impedance signal is located in the cancellous bone impedance level segment 43c, and the blade head is located in the cancellous bone 22. The cancellous bone impedance level segment 43c indicates that the blade head passes through other tissues such as the interface between the cortical bone 21 and the cancellous bone 22, and is located in the cancellous bone 22. The length of the cancellous bone impedance level segment 43c on the horizontal axis may vary depending on the thickness of the cancellous bone 22.

[0092] In this step S204, the method of determining that the current position is cancellous bone is similar to the method of determining that the current position is cortical bone in step S203. For details, please refer to the description of the above step S203 and will not be repeated here.

[0093] The above embodiments describe a method for determining the current position. The application of the present application will be described below in conjunction with a specific type of bone tissue 20 to be cut.

[0094] Figure 3C For application Figure 3A Flow chart of the method for determining the position of an ultrasonic bone knife in an ultrasonic surgical system. Figure 3A , Figure 3B and Figure 3C The method provided in this embodiment can be used in the cutting operation of three-layer bone tissue. For example, it can be a spinal fenestration operation, etc. Figure 3A As shown, the bone tissue 20 to be cut includes an outer cortical bone 21a, a cancellous bone 22 and an inner cortical bone 21b which are arranged in sequence from the outside to the inside.

[0095] The ultrasonic osteotome position determination method 300 may include steps S301 and S302.

[0096] Step S301, obtaining the acoustic impedance signal of the ultrasonic osteotome 10.

[0097] Step S302: determining the current position of the ultrasonic osteotome 10 in the bone tissue 20 to be cut based on the acoustic impedance signal.

[0098] Step S303: in response to determining that the current position is the interface between the inner cortical bone 21b and the soft tissue, a first prompt message is issued.

[0099] Among them, step S301 and step S302 are the same as step S101 and step S102 in the above embodiment, and the details can be referred to the description of the above embodiment.

[0100] Understandably, Figure 3B The acoustic impedance curve of the complete penetration of three layers of bone tissue is shown. The impedance level segment 43a indicates that the blade of the ultrasonic bone knife 10 is always located in the air or soft tissue. The first rising edge 41a indicates that the blade is located at the interface between the air or soft tissue and the outer cortical bone 21a. The cortical bone impedance level segment 43b indicates that the blade is located in the outer cortical bone 21a. The first falling edge 42a indicates that the blade is located at the interface between the outer cortical bone 21a and the cancellous bone 22. The cancellous bone impedance level segment 43c indicates that the blade is located in the cancellous bone 22. The first rising edge 41b indicates that the blade is located at the interface between the cancellous bone 22 and the inner cortical bone 21b. The cortical bone impedance level segment 43d indicates that the blade is located in the inner cortical bone 21b. The first falling edge 42b indicates that the blade is located at the interface between the inner cortical bone 21b and the soft tissue. The impedance level segment 43e indicates that the blade has penetrated three layers of bone tissue structure.

[0101] During the actual operation, the inner side of the inner cortical bone 21b is usually soft tissue such as the spinal cord or the brain. Once the ultrasonic bone knife 10 penetrates the inner cortical bone 21b, it will easily damage the nerve tissue.

[0102] Therefore, when the current position is determined to be the interface between the inner cortical bone 21b and the soft tissue, if the operator 50 is a doctor, a first prompt message can be sent to the operator 50 in a timely manner. The first prompt message can be a signal such as sound, light or vibration, so as to facilitate the doctor to stop or lift the ultrasonic bone knife 10. In addition, if the operator 50 is a surgical robot, the first prompt message sent can be directly used to control the ultrasonic bone knife 10 to stop cutting.

[0103] In summary, the above method 300 can detect the current position of the cutting head and provide a prompt for dangerous positions, thereby further improving the safety of the operation and reducing accidental damage to nerve tissues such as the spinal cord or brain.

[0104] In some embodiments, the step of determining the current position as the interface between the inner cortical bone and the soft tissue in step S303 may include: in response to determining that the current position is located at the interface between the cortical bone 21 and other tissues for the second time, determining that the current position is the interface between the inner cortical bone 21b and the soft tissue.

[0105] It can be understood that for three layers of bone tissue, the cutting order is outer cortical bone 21a, cancellous bone 22 and inner cortical bone 21b. The outer cortical bone 21a and the inner cortical bone 21b are both cortical bone 21, and the determination method of the interface between the cortical bone and other tissues can refer to the determination method of the interface between the cortical bone and other tissues in the above embodiment.

[0106] In this embodiment, the number of times the current position is at the interface between the cortical bone 21 and other tissues can be recorded to determine whether the current position is the interface between the outer cortical bone 21a or the inner cortical bone 21b and the soft tissue. When the current position of the cutter head is at the interface between the cortical bone 21 and other tissues for the first time, the interface is the interface between the outer cortical bone 21a and the cancellous bone 22. When the current position of the cutter head is at the interface between the cortical bone 21 and other tissues for the second time, the interface is the interface between the inner cortical bone 21b and the soft tissue, so that it can be accurately determined whether the cutter head is in contact with the outer cortical bone 21a or the inner cortical bone 21b.

[0107] Figure 4A A working principle diagram of an ultrasonic surgical system according to some embodiments of the present application is shown; Figure 4B for Figure 4A The acoustic impedance change diagram of the ultrasonic bone knife; Figure 4C For application Figure 4A Flow chart of a method for determining the position of an ultrasonic bone knife in an ultrasonic surgical system.

[0108] Please refer to Figure 4A , Figure 4B and Figure 4C This embodiment also provides an ultrasonic bone knife position determination method 400, which can be used in a two-layer bone tissue structure cutting operation, such as a pedicle screw drilling operation. Figure 4A As shown, the bone tissue 20 to be cut may include a cortical bone 21 and a cancellous bone 22 arranged in sequence from the outside to the inside, and the cortical bone 21 is located outside the cancellous bone 22. The method may include steps S401 to S403.

[0109] Step S401, acquiring the acoustic impedance signal of the ultrasonic osteotome 10.

[0110] Step S402: determining the current position of the ultrasonic osteotome 10 in the bone tissue 20 to be cut based on the acoustic impedance signal.

[0111] Step S403 , in response to determining that the displacement of the ultrasonic osteotome 10 is within the preset size and the current position is the interface between the cancellous bone 22 and the cortical bone 21 , a second prompt message is issued.

[0112] Among them, step S401 and step S402 are the same as step S101 and step S102 in the above embodiment, and the details can be referred to the description of the above embodiment.

[0113] Understandably, Figure 4BThe acoustic impedance curve of the two-layer bone tissue is shown. The impedance level segment 43f indicates that the blade of the ultrasonic osteotome 10 is always located in the air or soft tissue. The first rising edge 41c indicates that the blade is located at the interface between the air or soft tissue and the cortical bone 21. The cortical bone impedance level segment 43g indicates that the blade is located in the cortical bone 21. The first falling edge 42c indicates that the blade is located at the interface between the cortical bone 21 and the cancellous bone 22. The cancellous bone impedance level segment 43h indicates that the blade is located in the cancellous bone 22.

[0114] In the case of pedicle screw drilling, in the actual operation, the drilling should penetrate the cortical bone 21 and stop in the cancellous bone 22. It is understood that the knife head does not exist at the interface between the cancellous bone and the cortical bone during the operation.

[0115] In step S403, the preset size may be the required drilling length, i.e., the displacement of the ultrasonic bone cutter 10 should reach the preset size. Furthermore, when the displacement of the ultrasonic bone cutter 10 does not reach the preset size, and the current position is the interface between the cancellous bone 22 and the cortical bone, it indicates that the cutting direction of the cutter head, i.e., the drilling direction, is wrong, and the ultrasonic bone cutter 10 has contacted other cortical bones, and the drilling direction needs to be adjusted. The method for determining that the current position is the interface between the cancellous bone 22 and the cortical bone can refer to the above embodiment.

[0116] In addition, when the displacement of the ultrasonic bone knife 10 is within the preset size and the current position is the interface between the cancellous bone 22 and the cortical bone 21, if the operator 50 is a doctor, a second prompt message can be sent to the operator 50 in time. The second prompt message can be a signal such as sound, light or vibration to remind the doctor to adjust the cutting direction of the blade. In addition, if the operator 50 is a surgical robot, the second prompt message sent can be directly used to control the ultrasonic bone knife 10 to adjust the direction of the blade.

[0117] In summary, the above method 400 can detect the current position of the tool head and promptly remind the operator 50 when the drilling direction is wrong, so that the drilling position is accurate and the safety of the operation is further improved.

[0118] Figure 5A A working principle diagram of an ultrasonic surgical system according to some embodiments of the present application is shown; Figure 5B for Figure 5A The acoustic impedance change diagram of the ultrasonic bone knife; Figure 5C For application Figure 5A Flow chart of a method for determining the position of an ultrasonic bone knife in an ultrasonic surgical system.

[0119] Please refer to Figure 5A , Figure 5B and Figure 5C This embodiment also provides an ultrasonic bone knife position determination method 500, which can be used in a single-layer cortical bone cutting operation, such as a leg bone. Figure 5A As shown, the bone tissue 20 to be cut may include cortical bone 21. The method may include steps S501 to S503.

[0120] Step S501, obtaining the acoustic impedance signal of the ultrasonic osteotome 10.

[0121] Step S502: determining the current position of the ultrasonic osteotome 10 in the bone tissue 20 to be cut based on the acoustic impedance signal.

[0122] Step S503: in response to determining that the current position is the interface between the cortical bone and the soft tissue, issuing a third prompt message.

[0123] Among them, step S501 and step S502 are the same as step S101 and step S102 in the above embodiment, and the details can be referred to the description of the above embodiment.

[0124] Understandably, Figure 5B The acoustic impedance curve of a single layer of cortical bone fully cut is shown. The impedance level segment 43i indicates that the blade of the ultrasonic osteotome 10 is always located in the air or soft tissue. The first rising edge 41d indicates that the blade is located at the interface between the air or soft tissue and the cortical bone 21. The cortical bone impedance level segment 43j indicates that the blade is located in the cortical bone 21. The first falling edge 42d indicates that the blade is located at the interface between the cortical bone 21 and the soft tissue.

[0125] In step S503, when the interface between the cortical bone 21 and the soft tissue appears, it is considered that the ultrasonic bone knife 10 has cut through the bone tissue. At this time, if the operator 50 is a doctor, a third prompt message can be sent to the operator 50 in time. The third prompt message can be a signal such as sound, light or vibration to facilitate the doctor to stop or lift the ultrasonic bone knife 10. In addition, if the operator 50 is a surgical robot, the third prompt message sent can be directly used to control the ultrasonic bone knife 10 to stop cutting.

[0126] The method for determining that the current position is the interface between the cortical bone and the soft tissue may refer to the description of the above embodiment.

[0127] In summary, the above method 500 can detect the current position of the blade head and provide prompts in time after the ultrasonic bone knife 10 cuts through the bone tissue, thereby further improving the safety of the operation and reducing damage to soft tissue.

[0128] like Figure 1B The present application also provides an ultrasonic surgical system, including: an ultrasonic bone knife 10 and a processor 30, wherein the ultrasonic bone knife 10 is used to cut the bone tissue 20 to be cut; and the processor 30 is used to execute the ultrasonic bone knife position determination method described in the above embodiment.

[0129] Among them, the ultrasonic bone knife 10 can be controlled by a doctor or a surgical robot, and the processor 30 is a common structure capable of realizing data processing, which can collect the acoustic impedance signal of the blade through the transducer 11 and process the acoustic impedance signal to determine the current position of the blade. The ultrasonic bone knife position determination method is the same as the above embodiment, and the above embodiments can be referred to for details.

[0130] The ultrasonic surgical system provided in this embodiment determines the current position of the ultrasonic bone knife 10 in the bone tissue to be cut through the acoustic impedance signal, so that the operator 50 can obtain the position of the ultrasonic bone knife 10 in real time. Compared with image positioning, it has higher accuracy and can effectively prevent the moving path of the ultrasonic bone knife from deviating from the target path, thereby reducing damage to soft tissue during surgery and improving surgical efficiency.

[0131] Figure 6 A structural diagram of an ultrasonic surgical system according to some embodiments of the present application is shown; Figure 7 for Figure 6 A partial enlarged view of the ultrasonic bone knife. Please refer to Figure 6 and Figure 7 In some embodiments, the ultrasonic surgical system further includes: a surgical robot 51 and a display device 40, wherein the surgical robot 51 is connected to the ultrasonic bone knife 10; the display device 40 is used to display the acoustic impedance signal of the ultrasonic bone knife 10; and the processor 30 is also used to operate the ultrasonic bone knife 10 by controlling the surgical robot 51.

[0132] The surgical robot 51 may be a common robot capable of realizing motion control. The display device 40 may be a display structure such as a display, which may be used to display acoustic impedance information and data feedback in real time, and may also be used to display prompt information and the like.

[0133] The surgical robot 51 can be connected to the ultrasonic bone knife 10, and the processor 30 can be communicatively connected to the surgical robot 51 to send control instructions to the surgical robot 51, thereby driving the ultrasonic bone knife 10 to move along the target path.

[0134] Of course, the ultrasonic surgical system may also be provided with an imaging device, which can be used to capture images of the ultrasonic bone knife 10 and the bone tissue 20 to be cut. The display device 40 can display the image to assist the operator 50 in intuitively understanding the position of the knife head.

[0135] According to an embodiment of the present application, a non-transitory computer-readable storage medium storing computer instructions and a computer program product are also provided.

[0136] The computer instructions are used to make the computer execute any of the above methods. The computer program product includes a computer program, wherein the computer program implements any of the above methods when executed by a processor.

[0137] The computer may be any machine configured to perform processing and / or calculations, and may be, but is not limited to, a workstation, a server, a desktop computer, a laptop computer, a tablet computer, a personal digital assistant, a smart phone, a vehicle-mounted computer, a wearable device, or any combination thereof. According to some embodiments, the above-mentioned ultrasonic bone knife position determination method may also be implemented in whole or in part by a computer or similar device or system.

[0138] The computer may include (possibly via one or more interfaces) an element connected to a bus or communicating with the bus. For example, the computer may include a bus, one or more processors, one or more input devices, and one or more output devices. The one or more processors may be any type of processor, and may include but is not limited to one or more general purpose processors and / or one or more special purpose processors (e.g., special processing chips). The input device may be any type of device that can input information to the computer, and may include but is not limited to a sensor (e.g., a sensor for acquiring an image as described above), a mouse, a keyboard, a touch screen, a microphone, and / or a remote controller. The output device may be any type of device that can present information, and may include but is not limited to a display, a speaker (e.g., an output device that can be used to implement the output sound data described above), a video / audio output terminal, a vibrator, and / or a printer. The computer may also include or be connected to a non-transient storage device, which may be any storage device that is non-transient and can implement data storage, and may include but is not limited to a disk drive, an optical storage device, a solid-state memory, a floppy disk, a flexible disk, a hard disk, a tape, or any other magnetic medium, an optical disk or any other optical medium, a ROM (read-only memory), a RAM (random access memory), a cache memory, and / or any other memory chip or box, and / or any other medium from which the computer can read data, instructions, and / or codes. The non-transient storage device may be detachable from the interface. The non-transient storage device may have data / programs (including instructions) / codes for implementing the above methods and steps. The computer may also include a communication device. The communication device may be any type of device or system that enables communication with an external device and / or with a network, and may include but is not limited to a modem, a network card, an infrared communication device, a wireless communication device, and / or a chipset, such as a Bluetooth device, a 1302.11 device, a WiFi device, a WiMax device, a cellular communication device, and / or the like.

[0139] The computer may also include a working memory (which may be used to implement the aforementioned system), which may be any type of working memory that can store programs (including instructions) and / or data useful for the work of the processor, and may include but is not limited to random access memory and / or read-only memory devices.

[0140] The software elements (programs) may be located in a working memory, including but not limited to an operating system, one or more application programs, drivers, and / or other data and code. Instructions for performing the above methods and steps may be included in one or more application programs. The executable code or source code of the instructions of the software elements (programs) may be stored in a non-transitory computer-readable storage medium (such as the above storage device) and may be stored in the working memory (possibly compiled and / or installed) when executed. The executable code or source code of the instructions of the software elements (programs) may also be downloaded from a remote location.

[0141] The program code for implementing the method of the present application can be written in any combination of one or more programming languages. These program codes can be provided to a processor or controller of a general-purpose computer, a special-purpose computer, or other programmable data processing device, so that the program code, when executed by the processor or controller, implements the functions / operations specified in the flow chart and / or block diagram. The program code can be executed entirely on the machine, partially on the machine, partially on the machine and partially on a remote machine as a stand-alone software package, or entirely on a remote machine or server.

[0142] It should be understood that the various forms of processes shown above can be used to reorder, add or delete steps. For example, the steps recorded in this application can be performed in parallel, sequentially or in different orders, as long as the desired results of the technical solution disclosed in this application can be achieved, and this document is not limited here.

[0143] It should be understood that in this specification, the terms "center", "longitudinal", "lateral", "length", "width", "thickness", "up", "down", "front", "back", "left", "right", "vertical", "horizontal", "top", "bottom", "inside", "outside", "clockwise", "counterclockwise", "axial", "radial", "circumferential" and the like indicate orientations or positional relationships or dimensions that are based on the orientations or positional relationships or dimensions shown in the accompanying drawings, and these terms are used only for the convenience of description and do not indicate or imply that the referred device or element must have a specific orientation, be constructed and operated in a specific orientation, and therefore should not be understood as limiting the scope of protection of the present application.

[0144] In addition, the terms "first", "second", "third", etc. are used for descriptive purposes only and should not be understood as indicating or implying relative importance or implicitly indicating the number of the indicated technical features. Thus, a feature defined as "first", "second", "third" may explicitly or implicitly include one or more of the feature. In the description of this application, the meaning of "plurality" is two or more, unless otherwise clearly and specifically defined.

[0145] In this application, unless otherwise clearly specified and limited, the terms "installed", "connected", "connected", "fixed" and the like should be understood in a broad sense, for example, it can be a fixed connection, a detachable connection, or an integral connection; it can be a mechanical connection, an electrical connection, or a communication; it can be a direct connection, or an indirect connection through an intermediate medium, it can be the internal connection of two elements or the interaction relationship between two elements. For ordinary technicians in this field, the specific meanings of the above terms in this application can be understood according to specific circumstances.

[0146] In the present application, unless otherwise clearly specified and limited, a first feature being "above" or "below" a second feature may include that the first and second features are in direct contact, or may include that the first and second features are not in direct contact but are in contact through another feature between them. Moreover, a first feature being "above", "above" and "above" a second feature includes that the first feature is directly above and obliquely above the second feature, or simply indicates that the first feature is higher in level than the second feature. A first feature being "below", "below" and "below" a second feature includes that the first feature is directly below and obliquely below the second feature, or simply indicates that the first feature is lower in level than the second feature.

[0147] This specification provides many different embodiments or examples that can be used to implement the present application. It should be understood that these different embodiments or examples are purely exemplary and are not intended to limit the scope of protection of the present application in any way. Those skilled in the art can conceive of various changes or replacements based on the disclosure of the specification of the present application, which should all be included in the scope of protection of the present application. Therefore, the scope of protection of the present application should be based on the scope of protection defined by the attached claims.

Claims

1. An ultrasonic surgical system, characterized in that: include: Ultrasonic bone knife, used for cutting bone tissue to be cut; The processor is used to perform the following steps: obtaining an acoustic impedance signal of the ultrasonic bone cutter; determining a current position of the ultrasonic bone cutter in the bone tissue to be cut based on the acoustic impedance signal; Wherein, determining the current position of the ultrasonic osteotome in the bone tissue to be cut based on the acoustic impedance signal comprises any one of the following steps: In response to determining that the acoustic impedance signal is at a first rising edge within a preset time and an average slope of the first rising edge is within a first slope range, determining that the current position is an interface between other tissues and cortical bone; In response to determining that the acoustic impedance signal is at a first falling edge within a preset time and an average slope of the first falling edge is within a second slope range, determining that the current position is an interface between cortical bone and other tissues; In response to determining that the acoustic impedance signal is always within a fourth preset range within a preset time, determining that the current position is in the cortical bone; In response to determining that the acoustic impedance signal is always within a third preset range within a preset time, determining that the current position is in cancellous bone; The processor is further configured to perform one of the following steps: In the case where the bone tissue to be cut includes an outer cortical bone, cancellous bone, and inner cortical bone arranged in sequence from the outside to the inside, the processor is further configured to perform the following steps: in response to determining that the current position is the interface between the inner cortical bone and the soft tissue, issuing a first prompt message; In the case where the bone tissue to be cut includes cortical bone and cancellous bone arranged in sequence from the outside to the inside, the processor is further used to perform the following steps: in response to determining that the displacement of the ultrasonic osteotome is within a preset size and the current position is the interface between the cancellous bone and the cortical bone, issuing a second prompt message; In the case where the bone tissue to be cut includes cortical bone, the processor is further configured to perform the following steps: in response to determining that the current position is the interface between the cortical bone and the soft tissue, issuing a third prompt message; Wherein, determining that the current position is the interface between the inner cortical bone and the soft tissue includes: In response to determining that the current position is located at the interface between the cortical bone and other tissues for the second time, the current position is determined to be the interface between the inner cortical bone and the soft tissue.

2. The system according to claim 1, characterized in that The determining that the current position is an interface between other tissues and cortical bone includes: In response to determining that the acoustic impedance amplitude at the starting point of the first rising edge is within a first preset range, the current position is determined to be an interface between air and cortical bone.

3. The system according to claim 1, characterized in that The determining that the current position is an interface between other tissues and cortical bone includes: In response to determining that the acoustic impedance amplitude at the starting point of the first rising edge is within a second preset range, the current position is determined to be an interface between soft tissue and cortical bone.

4. The system according to claim 1, characterized in that The determining that the current position is an interface between other tissues and cortical bone includes: In response to determining that the acoustic impedance amplitude at the starting point of the first rising edge is within a third preset range, it is determined that the current position is an interface between cancellous bone and cortical bone.

5. The system according to claim 1, characterized in that Determining that the current position is an interface between cortical bone and other tissues includes: In response to determining that the acoustic impedance amplitude at the end point of the first falling edge is within a third preset range, it is determined that the current position is an interface between cortical bone and cancellous bone.

6. The system according to claim 1, characterized in that Determining that the current position is an interface between cortical bone and other tissues includes: In response to determining that the acoustic impedance amplitude at the end point of the first falling edge is within a second preset range, it is determined that the current position is an interface between cortical bone and soft tissue.

7. The system according to any one of claims 1 to 6, characterized in that: Also includes: A surgical robot connected to the ultrasonic osteotome; A display device, used for displaying the acoustic impedance signal of the ultrasonic osteotome; The processor is also used to operate the ultrasonic bone knife by controlling the surgical robot.

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