Method and system for surgical zone and implant planning

Abstract

Systems and methods for mapping a zone for monitoring the position of a surgical instrument from a model vertebra to a 3D image of a patient's vertebra during a procedure. A model vertebra is received in a first coordinate system, the model vertebra including a plurality of model features positioned in the first coordinate system and a pose of a model region in the first coordinate system. 3D images of the first and second vertebrae of the patient in a second coordinate system are also received. A model vertebra including the model region is mapped to the first vertebra such that a region for the first vertebra is generated. An input indicative of a revised pose for the region of the first vertebra is received, and a region for the second vertebra is generated based on the revised pose for the region of the first vertebra.

Description

[0001] Cross-references to related applications

[0002] This application claims the benefit and priority of U.S. Provisional Patent Application No. 63 / 367,550, filed July 1, 2022, the entire contents of which are incorporated herein by reference. Background Technology

[0003] In modern surgery, one of the most important instruments available to medical professionals is powered surgical instruments, such as cordless drills, saws, wire-driven instruments, high-speed drills, and ultrasonic handheld devices. Typically, these instruments include a motor and / or processor within the handheld device or housing. Surgical instruments may include attachment features configured to receive cutting attachments designed to be applied to the surgical site to perform specific medical procedures. For example, a surgical drill may utilize cutting attachments such as a hole drill, dental drill, or reamer to create holes in tissue or to selectively remove tissue such as bone. The ability to use powered surgical instruments on patients reduces physical strain on medical professionals performing medical procedures. Furthermore, most surgical procedures can be performed faster and more accurately using powered surgical instruments than with their previous manual equivalents.

[0004] Surgical navigation systems help medical professionals navigate surgical instruments during surgical procedures. One or more 2D or 3D images of a patient's spine can be acquired before or during spinal surgery and accessed by the surgical navigation system. Warning zone planning for spinal surgery involves establishing areas relative to the 2D or 3D images to define areas surrounding critical anatomical structures of the spine (such as vertebrae or spinal cord) to be avoided during spinal surgery. Warning zones can be used to control the operation of surgical instruments to avoid accidental impacts to critical anatomical structures. Existing surgical navigation systems automatically generate warning zones and subsequently allow medical professionals to provide input to manually edit one or more automatically generated warning zones. However, in cases where surgery involves multiple vertebrae (which is often the case), medical professionals typically have to edit the warning zone for each vertebra in which the surgery will be performed. Therefore, warning zone planning with existing surgical navigation systems can be quite cumbersome.

[0005] Similarly, while existing surgical navigation systems may suggest an initial implant posture, medical professionals typically must adjust that implant posture from the initial posture for each vertebra on which surgery will be performed, and also manually edit the warning zone and implant in a similar manner among similar patients based on the medical professionals' own medical preferences and beliefs. Therefore, there is a need to optimize warning zone and implant planning for medical professionals.

[0006] The background description provided herein is for the purpose of generally presenting the context of this disclosure. Within the scope described in this background section, the work of the inventors currently identified, as well as various aspects of this specification that may not have been otherwise described as prior art at the time of filing, are neither expressly nor impliedly acknowledged as prior art compared to this disclosure. Summary of the Invention

[0007] A system of one or more computers can be configured to perform specific operations or actions by installing software, firmware, hardware, or combinations thereof on the system, which, in operation, cause the system to perform actions. One or more computer programs can be configured to perform specific operations or actions by including instructions that, when executed by a data processing device, cause that device to perform actions.

[0008] One general aspect includes a method for mapping regions of an anatomical model to a three-dimensional image of a patient's anatomical structure, said regions being used to monitor the position of surgical instruments relative to the patient's anatomical structure corresponding to the anatomical model during surgical procedures. The method includes receiving a three-dimensional anatomical model in a first coordinate system, the three-dimensional model including a plurality of model features positioned in the first coordinate system and the pose of model regions in the first coordinate system. The method also includes receiving a three-dimensional image of the patient's anatomical structure corresponding to the anatomical model. The method further includes mapping the three-dimensional anatomical model, including the model regions, to the patient's anatomical structure based on the plurality of model features positioned in the first coordinate system, such that regions of the patient's anatomical structure are generated in a second coordinate system. The method also includes receiving input from a medical professional indicating a corrected pose of the regions for the patient's anatomical structure in the second coordinate system. The method further includes generating regions for another anatomical structure of the patient based on the corrected pose of the regions for the patient's anatomical structure, which may also correspond to the anatomical model and / or be shown in the three-dimensional image, and / or adjusting the pose of the model regions based on the corrected pose of the regions for the patient's anatomical structure, for example, for mapping the adjusted region model to other three-dimensional images of the patient's anatomical structure corresponding to the anatomical model and / or three-dimensional images of other patients' anatomical structures corresponding to the anatomical model. In some implementations, the anatomical model may be a vertebral model, and the patient's anatomical structure may be the patient's vertebrae. Other examples of this aspect include corresponding computer systems, devices, and computer programs recorded on one or more computer storage devices, each computer program being configured to perform actions of the method.

[0009] One general aspect includes a method for mapping regions to three-dimensional medical images to control surgical instruments. The method includes retrieving a three-dimensional vertebral model in a first coordinate system, the three-dimensional vertebral model including (i) multiple model features located in the first coordinate system and (ii) the pose of a model region for the surgical instrument relative to key structures in the first coordinate system. The method also includes retrieving a three-dimensional image in a second coordinate system, the three-dimensional image representing a first vertebra and a second vertebra. The method further includes mapping the three-dimensional vertebral model including the model region to the first vertebra based on the multiple model features located in the first coordinate system, such that a region for the first vertebra is generated. The method also includes receiving input from a medical professional indicating a corrected pose of the region for the first vertebra in the second coordinate system. The method further includes generating a region for the second vertebra based on the corrected pose of the region for the first vertebra. Other examples of this aspect include corresponding computer systems, devices, and computer programs recorded on one or more computer storage devices, each computer program being configured to perform actions of the method.

[0010] One general aspect includes a method for mapping a region for surgical instruments to a three-dimensional medical image. The method includes retrieving a three-dimensional vertebral model in a first coordinate system, the three-dimensional vertebral model including multiple model features positioned in the first coordinate system and the pose of the model region for surgical instruments in the first coordinate system. The method also includes retrieving a three-dimensional image having a first vertebra and a second vertebra in a second coordinate system. The method further includes mapping the three-dimensional vertebral model including the model region to the first vertebra to generate a region for the first vertebra and a region for the second vertebra. The method also includes receiving input from a medical professional indicating a corrected pose of the model region of the three-dimensional vertebral model in the first coordinate system. The method further includes propagating the corrected pose of the model region to at least one of the regions for the first vertebra and the regions for the second vertebra. Other examples of this aspect include corresponding computer systems, devices, and computer programs recorded on one or more computer storage devices, each computer program being configured to perform actions of the method.

[0011] One general aspect includes a method for mapping a region for a surgical instrument to a three-dimensional image. The method includes retrieving a three-dimensional vertebral model in a first coordinate system, the three-dimensional vertebral model including (i) a plurality of model features positioned in the first coordinate system and (ii) the pose of the model region for the surgical instrument in the first coordinate system. The method also includes retrieving a three-dimensional image of a first patient having at least one vertebra in a second coordinate system. The method further includes mapping the three-dimensional vertebral model including the model region to the at least one vertebra to generate a region for the at least one vertebra. The method also includes receiving input regarding a corrected pose of the region for the at least one vertebra. The method further includes correcting the pose of the model region based on the corrected pose of the region for the at least one vertebra. The method also includes retrieving a three-dimensional image of a second patient having at least one vertebra in a third coordinate system. The method further includes mapping the three-dimensional vertebral model including the corrected pose of the model region to the at least one vertebra of the second patient to generate a region for the at least one vertebra of the second patient. Other examples of this aspect include corresponding computer systems, devices, and computer programs recorded on one or more computer storage devices, each computer program being configured to perform actions of the method.

[0012] One general aspect includes a method for adjusting regions for a three-dimensional image based on the historical preferences of a medical professional. The method further includes retrieving a three-dimensional image having at least one vertebra in a first coordinate system. The method also includes receiving a three-dimensional vertebral model in a second coordinate system, the three-dimensional vertebral model including the pose of a model region for surgical instruments in the second coordinate system and multiple model features positioned in the second coordinate system. The method further includes mapping the three-dimensional vertebral model including the model region to the at least one vertebra based on the multiple model features positioned in the second coordinate system, such that a region for the at least one vertebra is generated. The method also includes receiving input from a medical professional regarding the corrected pose of the region for the at least one vertebra. The method further includes determining one or more transformations based on the pose of the model region of the three-dimensional vertebral model in the first coordinate system and the corrected pose of the region for the at least one vertebra in the first coordinate system. The method further includes storing one or more transformations based on the pose of the model region of the three-dimensional vertebral model in the first coordinate system and the corrected pose of the region for the at least one vertebra in the first coordinate system in a database including transformation data for multiple patients. The method further includes determining correction data based on the transformation data for multiple patients. The method also includes retrieving a three-dimensional image having at least one vertebra of a second patient in a third coordinate system. The method also includes mapping a three-dimensional vertebral model, including the model region, to at least one vertebra of a second patient based on multiple model features positioned in a third coordinate system and on calibration data, thereby generating a region for at least one vertebra of the second patient. Other examples of this aspect include corresponding computer systems, devices, and computer programs recorded on one or more computer storage devices, each computer program being configured to perform actions of the method.

[0013] One general aspect includes a method for adjusting a region for a three-dimensional image based on the historical preferences of a medical professional. The method includes receiving a three-dimensional image of at least one vertebra in a first coordinate system. The method also includes receiving a three-dimensional vertebral model in a second coordinate system, the three-dimensional vertebral model including the pose of a model region relative to a surgical instrument in the second coordinate system and multiple model features positioned in the second coordinate system. The method further includes mapping the three-dimensional vertebral model including the model region to the at least one vertebra based on the multiple model features positioned in the second coordinate system, such that a region for the at least one vertebra is generated. The method also includes receiving input from a medical professional regarding the corrected pose of the region for the at least one vertebra. The method further includes determining one or more transformations based on the pose of the model region of the three-dimensional vertebral model in the first coordinate system and the corrected pose of the region for the at least one vertebra in the first coordinate system. The method further includes storing one or more transformations based on the pose of the model region of the three-dimensional vertebral model in the first coordinate system and the corrected pose of the region for the at least one vertebra in the first coordinate system in a database including transformation data for multiple patients. The method further includes determining correction data based on the transformation data for multiple patients. The method further includes selectively adjusting the pose of the model region of the three-dimensional vertebral model based on the correction data. Other examples of this aspect include corresponding computer systems, devices, and computer programs recorded on one or more computer storage devices, each computer program being configured to perform the actions of the method.

[0014] One general aspect includes a method for adjusting regions for a three-dimensional image based on the historical preferences of a medical professional. The method includes retrieving a three-dimensional image having at least one vertebra in a first coordinate system. The method also includes retrieving a three-dimensional vertebral model in a second coordinate system, the three-dimensional vertebral model including the pose of a model region for surgical instruments in the second coordinate system. The method further includes mapping an initial pose of the regions for at least one vertebra in the three-dimensional image based on the pose of the model regions of the three-dimensional vertebral model. The method also includes receiving input from a medical professional regarding a corrected pose of the regions for at least one vertebra. The method further includes comparing the corrected pose of the regions for at least one vertebra with the initial pose of the regions for at least one vertebra. The method also includes storing the comparison of the corrected pose of the regions for at least one vertebra with the initial pose of the regions for at least one vertebra in a region correction database. The method further includes learning the region preferences of the medical professional based on the region correction database. The method further includes adjusting the pose of the regions for at least one vertebra for a second patient based on the learned region preferences. Other examples of this aspect include corresponding computer systems, devices, and computer programs recorded on one or more computer storage devices, each computer program being configured to perform actions of the method.

[0015] One general aspect includes a method for adjusting a planned implant based on the historical preferences of a medical professional. The method includes retrieving a three-dimensional image of a first patient in a first coordinate system, the three-dimensional image including at least one vertebra. The method also includes retrieving a three-dimensional vertebral model in a second coordinate system, the three-dimensional vertebral model including the pose of a model implant in the second coordinate system. The method further includes mapping the three-dimensional vertebral model, including the pose of the model implant, to the at least one vertebra to generate an initial pose of the planned implant for the at least one vertebra in a three-dimensional image. The method also includes receiving input from a medical professional indicating corrections to the planned implant, the corrections including a revised pose of the planned implant. The method further includes determining one or more transformations based on the initial pose and the revised pose of the planned implant. The method also includes storing one or more transformations based on the initial pose and the revised pose of the planned implant for the at least one vertebra in a database including implant transformation data for multiple patients. The method further includes determining correction data based on the implant transformation data for multiple patients. The method further includes selectively adjusting the pose of the model implant for the three-dimensional vertebral model based on the correction data. Other examples of this aspect include corresponding computer systems, devices, and computer programs recorded on one or more computer storage devices, each computer program being configured to perform the actions of the method.

[0016] One general aspect includes a method for adjusting the pose of a planned implant based on the historical preferences of a medical professional. The method includes retrieving a three-dimensional image of a first patient in a first coordinate system, the three-dimensional image including at least one vertebra. The method also includes retrieving a three-dimensional vertebral model in a second coordinate system, the three-dimensional vertebral model including the pose of a model implant in the second coordinate system. The method further includes mapping the three-dimensional vertebral model including the pose of the model implant onto the at least one vertebra to generate an initial pose of the planned implant. The method also includes receiving input from a medical professional indicating a correction to the modified pose of the planned implant. The method further includes determining one or more transformations based on the initial pose and the modified pose of the planned implant. The method also includes storing one or more transformations based on the initial pose and the modified pose of the planned implant in a database including implant transformation data for multiple patients. The method further includes determining correction data based on the implant transformation data for multiple patients. The method further includes storing the correction data in an implant correction database. The method also includes retrieving a three-dimensional image of a second patient in a third coordinate system, the three-dimensional image including at least one vertebra. The method further includes mapping a three-dimensional vertebral model, including the pose of the model implant, to at least one vertebra of a three-dimensional image of a second patient to generate a planned implant pose for at least one vertebra of the three-dimensional image of the second patient. The method also includes selectively adjusting the pose of the planned implant based on correction data. Other examples of this aspect include corresponding computer systems, devices, and computer programs recorded on one or more computer storage devices, each computer program configured to perform actions of the method.

[0017] One general aspect includes a method for adjusting a region based on historical preferences of a medical professional. The method includes retrieving a three-dimensional image of a first patient in a first coordinate system, the three-dimensional image including at least one vertebra. The method also includes retrieving a three-dimensional vertebral model in a second coordinate system, the three-dimensional vertebral model including multiple model regions in multiple poses in the second coordinate system. The method further includes retrieving one or more preferences associated with a previous surgery performed by the medical professional. The method also includes mapping the three-dimensional vertebral model including at least one pose of multiple model regions to the at least one vertebra based on the one or more preferences associated with the previous surgery, such that at least one region for the at least one vertebra is generated. Other examples of this aspect include corresponding computer systems, devices, and computer programs recorded on one or more computer storage devices, each computer program configured to perform actions of the method.

[0018] Other areas of application of this disclosure will become apparent from the detailed description, claims, and drawings. The detailed description and specific examples are intended for illustrative purposes only and are not intended to limit the scope of this disclosure. Attached Figure Description

[0019] This disclosure will be more fully understood from the detailed description and accompanying drawings.

[0020] Figure 1 An exemplary layout of an operating room according to the teachings of this disclosure is shown, the operating room including at least one surgical instrument assembly and a surgical navigation system for performing medical procedures on a patient.

[0021] Figure 2 A surgical system according to the teachings of this disclosure is shown, the surgical system including a plurality of surgical instrument assemblies and a surgical navigation system for tracking surgical instruments associated with each of the various surgical instrument assemblies.

[0022] Figure 3 A handheld surgical instrument according to the teachings of this disclosure is shown, the handheld surgical instrument including a battery and multiple end effectors.

[0023] Figure 4 An exemplary graphical user interface of a navigation system according to the teachings of this disclosure is shown, which displays lumbar spine regions selected by a medical professional to be segmented using the navigation system.

[0024] Figure 5 An exemplary graphical user interface of a navigation system according to the teachings of this disclosure is shown, which displays a vertebral model in multiple views, one view including multiple model warning zones and multiple model virtual boundaries, another view including a first model implant and a second model implant, and a third view including a plan view of the vertebral model without implants, warning zones or boundaries.

[0025] Figure 6 An exemplary graphical user interface of a navigation system according to the teachings of this disclosure is shown, which displays the vertebrae of a segmented lumbar region to be operated on by a surgical system.

[0026] Figure 7 An exemplary graphical user interface for a navigation system according to the teachings of this disclosure is shown, the graphical user interface including user-selectable objects related to the planning and / or implementation of surgical procedures.

[0027] Figure 8 An exemplary graphical user interface of a navigation system according to the teachings of this disclosure is shown, which displays, in multiple views, the suggested positions of a first and second implant for a segmented lumbar vertebral region to which the surgical system is to be used.

[0028] Figure 9An exemplary graphical user interface of a navigation system according to the teachings of this disclosure is shown, which displays, in multiple views, the corrected posture of a first implant of a segmented vertebra in the lumbar region to be operated upon by the surgical system.

[0029] Figure 10 An exemplary graphical user interface of a navigation system according to the teachings of this disclosure is shown, which displays, in multiple views, a suggested posture of the first warning zone of the vertebrae in a segmented lumbar region to which the surgical system to be used operates.

[0030] Figure 11 An exemplary graphical user interface of a navigation system according to the teachings of this disclosure is shown, which displays, in multiple views, the corrected posture of the first warning zone of the vertebrae in a segmented lumbar region to be operated upon by the surgical system to be utilized.

[0031] Figure 12 An exemplary method for generating a warning zone for a vertebra, performed by a navigation system in accordance with the teachings of this disclosure, is shown.

[0032] Figure 13 Another exemplary method for generating a warning zone for a vertebra, performed by a navigation system in accordance with the teachings of this disclosure, is shown.

[0033] Figure 14A and Figure 14B Another exemplary method for generating a warning zone for a vertebra, performed by a navigation system in accordance with the teachings of this disclosure, is shown.

[0034] Figure 15A and Figure 15B An exemplary method for adjusting a warning zone for a model vertebra, performed by a navigation system in accordance with the teachings of this disclosure, is shown.

[0035] Figure 16 An exemplary method for adjusting a warning zone for a vertebra, performed by a navigation system in accordance with the teachings of this disclosure, is shown.

[0036] Figure 17A and Figure 17B An exemplary method, performed by a navigation system in accordance with the teachings of this disclosure, is shown to adjust the posture of an implant for a model vertebra.

[0037] Figure 18A and Figure 18B An exemplary method for adjusting the posture of an implant for a vertebra, performed by a navigation system in accordance with the teachings of this disclosure, is shown.

[0038] Figure 19 Another exemplary method for adjusting a warning zone for a vertebra, performed by a navigation system in accordance with the teachings of this disclosure, is shown.

[0039] In the accompanying drawings, reference numerals may be used repeatedly to identify similar and / or identical elements. Detailed Implementation

[0040] refer to Figure 1 An exemplary configuration of an operating room or operating room for performing medical procedures on a patient 20 using surgical system 10 is shown. Surgical navigation system 100 may include a navigation computer 140, a user input device 130, a display unit 120, and a tracking unit 110. Navigation computer 140 may include a central processing unit (CPU) and / or other processors, memory (not shown), and storage devices (not shown). Navigation computer 140 may be a personal computer, laptop computer, tablet computer, or any other suitable computing device. Navigation computer 140 may include surgical navigation software that includes one or more modules and / or operating instructions related to the operation of surgical navigation system 100 and to implementing the various routines, functions, or methods disclosed herein.

[0041] Display unit 120 is configured to display various graphical user interfaces (GUIs) 150 and patient images (e.g., preoperative or intraoperative patient images). Preoperative images can be uploaded to surgical navigation system 100 before surgery. Medical professionals can interact with various GUIs 150 via user input device 130 or via touch input. Specifically, regarding... Figure 4-11 These various GUIs 150 will be discussed in more detail. The display unit 120 of the surgical navigation system 100 can be configured to display various prompts or data input boxes. For example, the display unit 120 can be configured to display text boxes or prompts that allow medical professionals to manually enter or select the type of surgical procedure to be performed.

[0042] Display unit 120 may also be configured to display surgical planning for a medical procedure superimposed on a patient image. Surgical planning may include a surgical path for performing the medical procedure or a planned trajectory or orientation for a medical device during the medical procedure. Surgical planning may also include the posture of an implant or medical device to be inserted during the medical procedure, superimposed on patient data or images. It is conceivable that surgical navigation system 100 may be configured to display and / or project a holographic image of a surgical path for performing a medical procedure or a planned trajectory or orientation for a medical device during the medical procedure. This may include projecting the surgical path onto the patient 20 or other surfaces in the operating room. It may also include projecting the surgical path onto a head unit (e.g., lenses, shields, or glasses) worn by a medical professional. An exemplary configuration of surgical navigation system 100 including a display unit worn by a medical professional to display a target trajectory and / or target location is disclosed in International Publication No. WO / 2018 / 203304A1, the entire contents of which are incorporated herein by reference.

[0043] GUI 150 can be configured to allow medical professionals to input or enter patient data or modify surgical plans. In addition to patient images, patient data may include additional information related to the type of medical procedure being performed, the patient's anatomical features, the patient's specific medical condition, and / or operational settings used for surgical navigation. For example, during spinal fusion surgery, medical professionals can input information related to a specific vertebra or the vertebra on which the procedure is being performed via user input device 130 and / or GUI 150. Medical professionals can also input various anatomical dimensions associated with the vertebra and / or the size and shape of medical devices or implants to be inserted during the procedure. User input device 130 and / or GUI 150 can also be configured to allow medical professionals to select, edit, or manipulate patient data. For example, medical professionals can identify and / or select anatomical features from the patient data. This may include selecting a surgical site, such as selecting a vertebra and / or a specific area on the vertebra where the procedure will be performed.

[0044] The surgical navigation system 100 can be configured to utilize segmentation to facilitate the generation of a warning zone of interest around key anatomical features. These key anatomical features may include cortical walls, nerves, blood vessels, or similar key anatomical structures. The warning zone may be defined by one or more virtual boundaries. Medical professionals may also provide input to the user input device 130 or GUI 150 to identify additional key anatomical features and / or warning zones besides those suggested by the navigation computer 140, or to edit the warning zones and / or virtual boundaries generated by the navigation computer 140. Medical professionals may also provide input to the user input device 130 or GUI 150 to select and / or input target locations, target trajectories, target depths, or similar features of the surgical path to help guide the medical professional in performing the medical procedure.

[0045] The user input device 130 or GUI 150 may provide input to select surgical instruments to be used, select devices and / or implants to be inserted, select the planned posture for placing the device or implant in the patient, and allow medical professionals to select parameters of the implant to be inserted (such as the length and / or diameter of the screw to be inserted), as will be discussed in more detail below.

[0046] Surgical system 10 may also include imaging system 500 and surgical navigation system 100. Imaging system 500 (e.g., CT or MRI imaging device) can perform intraoperative imaging. Imaging system 500 may include scanner 510 and display unit 520. Scanner 510 can be used to capture images of surgical site 30 on patient 20 and display them on display unit 520. For example, scanner 510 may include a C-arm configured to be rotated around patient 20 to generate multiple images of surgical site 30. Imaging system 500 may also include processor (not shown) including software (as known to those skilled in the art) capable of capturing multiple images captured by scanner 510 and generating 2D images and / or 3D models of surgical site 30. Display unit 520 may be configured to display the obtained 2D images and / or 3D models.

[0047] The imaging system 500 can also communicate with the navigation computer 140 of the surgical navigation system 100. The imaging system 500 can be configured to communicate with the navigation computer 140 via a wired and / or wireless connection. For example, the imaging system 500 can be configured to provide preoperative and / or intraoperative image data (e.g., acquired 2D images and / or 3D models of the surgical site 30) to the navigation computer 140 to provide the acquired 2D images and / or 3D models to the display unit 120.

[0048] The surgical system 10 also includes at least one of the surgical instrument assemblies 200 that communicate directly or indirectly with the navigation computer 140 via wired or wireless communication. Although Figure 1 Only the first surgical instrument assembly 200 is shown, but it should be understood that this is merely an exemplary configuration of the surgical system 10, and it is conceivable that any number of surgical instrument assemblies 200, 300, 400 (as in combination) can be positioned within the operating room. Figure 2 (Further detailed description). The first surgical instrument assembly 200 includes a first surgical instrument 220, which includes an end effector 240 and a tracking device 230. The tracking device 230 includes a plurality of markers 235 capable of being identified and / or tracked by the surgical navigation system 100. Reliably tracking the surgical instrument during surgical procedures to follow the planned surgical path and / or avoid critical anatomical structures is crucial. Furthermore, providing feedback and / or notifying the medical professional performing the procedure when the surgical instrument becomes misaligned with the surgical path and / or indicates a risk of impacting critical anatomical structures is of similar importance. See also... Figure 3 The surgical instrument 220 may be coupled to a drill chuck 240A, a tap 240B for forming threads on the inner surface of a hole or cavity, or an actuator 240C for driving or inserting a screw into a hole or cavity into bone.

[0049] Tracking unit 110 may include one or more sensors 115 for tracking device 230 of surgical instrument assembly 200. Sensors may include cameras (e.g., CCD cameras, CMOS cameras, and / or optical imaging cameras), magnetic sensors, radio frequency sensors, or any other sensors suitable for detecting and / or sensing the position of tracking device 230 of surgical instrument assembly 200. A description of suitable tracking units and various locators that may be used can be found in U.S. Patent Publication No. 2017 / 0333137, which is incorporated herein by reference in its entirety.

[0050] See Figure 2This diagram illustrates various other surgical instrument assemblies 300, 400 that communicate with the surgical navigation system 100, in addition to surgical instrument assembly 200. Each of the various exemplary surgical instrument assemblies 200, 300, 400 will be described in more detail below. Surgical instrument assemblies 200, 300, 400 may be configured for wired and / or wireless communication with the surgical navigation system 100. Furthermore, each of surgical instrument assemblies 200, 300, 400 may have multiple similar components capable of performing similar functions and / or operations. Similar components among the various surgical instrument assemblies 200, 300, 400 will include the same two-digit number with a leading digit 2, 3, or 4 to reflect the associated surgical instrument assembly 200, 300, 400. For example, each of surgical instrument assemblies 200, 300, 400 may include surgical instrument 220.

[0051] The first surgical instrument assembly 200 communicates with the surgical navigation system 100. As previously described, the first surgical instrument assembly 200 may be configured to include a first surgical instrument 220 (e.g., a surgical drill or actuator) with a handhold 225. The handhold 225 may include a housing 210 configured to receive components of the first surgical instrument 220. The handhold 225 may be shaped to define a handle or grip portion for a medical professional to hold during a medical procedure. Suitable handholds are described in U.S. Patent No. 5,747,953, the entirety of which is incorporated herein by reference.

[0052] The first surgical instrument 220 may further include a first instrument processor 215 and a motor 245. Each of the first instrument processor 215 and the motor 245 may be housed within a handpiece 225 of the first surgical instrument 220. The first instrument processor 215 and the motor 245 may communicate with each other, and the first instrument processor 215 may be configured to control the operation of the motor 245, and consequently control the operation of the first surgical instrument 220. For example, the first surgical instrument 220 may include an end effector 240, such as a drill bit for drilling or a driver for inserting a screw. The end effector 240 may be coupled to the handpiece 225 of the first surgical instrument 220 such that the motor 245 is operatively coupled to the end effector 240. For example, the motor 245 may be configured to rotate the drill bit 240 to drill and / or remove biological tissue. The first instrument processor 215 may communicate with the motor 245 and is configured to control the operation of the motor 245, and consequently control the operation of the drill bit 240. The first instrument processor 215 can also communicate with the navigation computer 140 and is configured to exchange data related to the position and / or orientation of the first surgical instrument 220, as well as data related to the operation of the first surgical instrument 220. For example, the first instrument processor 215 and the navigation computer 140 can be configured to transmit data related to the operation of the first surgical instrument 220 to each other based on the position and / or orientation of the first surgical instrument 220 detected by the surgical navigation system 100.

[0053] The first surgical instrument assembly 200 may also include a power source 260. The power source 260 may be removably coupled to the handpiece 225 of the surgical drill 220. For example, the power source 260 may include a removable battery pack. It is also contemplated that the power source 260 may be formed as part of or housed within the handpiece 225 of the first surgical instrument 220. The power source 260 may be electrically connected to the first instrument processor 215 and / or the motor 245 and is configured to selectively power the motor 245 to rotate the end effector 240. The power source 260 may also be a surgical console that powers the first surgical instrument 220 via a cable.

[0054] In the case where the power source 260 is in the form of a removable battery pack, the power source 260 may also include a processor 265. The processor 265 may communicate with the first instrument processor 215 via power signals and / or data signals. The processor 265 and the first instrument processor 215 may be configured to communicate with each other to control the operation of the motor 245, and consequently, the operation of the first surgical instrument 220. For example, the processor 265 in the power source 260 may be configured to identify when the power source 260 has dropped below a threshold charge level, such that the power source 260 may be unable to continue operating the motor 245 at a minimum threshold for drilling or cutting biological tissue. The processor 265 may be configured to cut off all power to the first instrument processor 215 and / or the motor 245 to prevent operation of the end effector 240 until the power source 260 has a sufficient charge level to operate the motor 245 at a rate above the minimum threshold for drilling or cutting biological tissue. The processor 265 in the power source 260 may also communicate wirelessly with the navigation computer 140. The power source 260 may include a transceiver configured to send and receive signals between the power source 260 and the surgical navigation system 100 and / or the instrument processor 215.

[0055] Processor 265 and navigation computer 140 may be configured to transmit data related to the operation of the first surgical instrument 220 to each other based on the position and / or orientation of the first surgical instrument 220 detected by surgical navigation system 100. For example, surgical navigation system 100 may be configured to transmit data to processor 265 including instructions for processor 265 to interrupt the supply of power to first instrument processor 215 and / or motor 245 based on the position and / or orientation of the first surgical instrument 220 detected by surgical navigation system 100. Surgical navigation system 100 may also be configured to transmit data to processor 265 including instructions for processor 265 to continue and / or resume the supply of power to first instrument processor 215 and / or motor 245 based on the position and / or orientation of the first surgical instrument 220 detected by surgical navigation system 100.

[0056] The first surgical instrument assembly 200 may also include a switch 250 (e.g., a trigger, button, or joystick) operably coupled to the first instrument processor 215. The switch 250 may be configured to be operated by a medical professional to control the energization of the variable speed motor 245. For example, the switch 250 may be operable between a first position (power-off state) and a second position (power-on state). The first surgical instrument assembly 200 may also include a switch sensor configured to detect the position of the switch 250 and generate a signal indicating the position of the switch 250 based on user manipulation of the switch 250 and / or transmit that signal to the first instrument processor 215 to control the operation of the first surgical instrument 220. For example, the switch 250 may include a first position, a second position, and multiple intermediate positions between the first and second positions.

[0057] The first position can be configured as a closed position, such that when the first instrument processor 215 receives a signal from the switch sensor that the switch 250 has been detected in the first position, the first instrument processor 215 prevents energy from flowing from the power source 260 to the motor 245, thereby preventing operation of the first surgical instrument 220. Alternatively, when the first instrument processor 215 receives a signal from the switch sensor that the switch 250 has been detected in the second position, the first instrument processor 215 can be configured to allow maximum energy flow from the power source 260 to the motor 245, thereby allowing the first surgical instrument 220 to operate at maximum drilling or cutting speed.

[0058] When the first instrument processor 215 receives a signal from the switch sensor that the switch 250 has indicated one of the intermediate positions, the first instrument processor 215 can be configured to allow energy to flow from the power source 260 to the motor 245 at a level corresponding to the position of the switch 250 between the first and second positions, thereby allowing the first surgical instrument 220 to operate at an intermediate drilling or cutting speed. For example, if the first instrument processor 215 receives a signal from the switch sensor that the switch 250 has been positioned midway (50%) between the first and second positions, the first instrument processor 215 can be configured to allow energy to flow from the power source 260 to the motor 245 at a level that allows the first surgical instrument 220 to operate at 50% of the maximum drilling or driving speed. Alternatively, the first instrument processor 215 can be configured to allow the maximum energy flow from the power source 260 to the motor 245 whenever the switch 250 indicates a position other than the first position, thereby allowing the first surgical instrument 220 to operate at the maximum drilling or cutting speed when the switch 250 is in either the second or intermediate position. An exemplary switch sensor can be found in U.S. Patent No. 9,295,476, the entire contents of which are incorporated herein by reference.

[0059] The first surgical instrument assembly 200 may also include a first alarm device 255. In an exemplary configuration, the first alarm device 255 may include any of a variety of devices, such as a vibration device positioned to contact a medical professional and configured to vibrate to notify the medical professional of a specific condition or to provide a warning; an auditory device (e.g., a loudspeaker) configured to provide an auditory alarm to notify the medical professional of a specific condition or to provide a warning; or a visually perceptible device or indicator used to provide a visual indication to notify the medical professional of a specific condition or to provide a warning. An exemplary first alarm device can be found in International Publication No. WO2021 / 062373A2, the entire contents of which are incorporated herein by reference.

[0060] The first alarm device 255 can be configured to communicate with the processor of the first instrument processor 215 or the power source 260. The first instrument processor 215 or other processor can be configured to send a signal to activate the first alarm device 255, thereby providing a warning or notification based on pre-programmed conditions or settings. For example, as described above, a medical professional can input defined conditions and / or settings into the surgical navigation system 100, such as selecting cortical walls, nerves, blood vessels, or similar anatomical structures that the medical professional wishes to avoid and establishing warning zones around those anatomical structures. Based on data provided by the navigation computer 140, the first instrument processor 215 can be configured to send a signal to activate the first alarm device 255 when the end effector 240 of the first surgical instrument 220 enters one of the warning zones defined by the medical professional. Based on data provided by the navigation computer 140, the first instrument processor 215 or other processor can also be configured to send a signal to activate the first alarm device 255 when the end effector 240 of the first surgical instrument 220 deviates from its trajectory and / or when the end effector 240 reaches a target position.

[0061] Although the first alarm device 255 is shown as a switch 250 coupled to or near the first surgical instrument assembly 200, it is contemplated that the first alarm device 255 may be coupled to and / or positioned in alternative locations. For example, when the first alarm device 255 includes a tactile device, it may be configured to be removably attached to a vibrating member of a medical professional. The first alarm device 255 may be configured as a wearable device (e.g., a bracelet to be worn on the wrist or arm of a medical professional) so that the medical professional will be able to feel the vibration of the first alarm device 255 in the event of a defined situation. Alternatively, when the first alarm device 255 includes an auditory device, it may be configured to be removably attached to a speaker of a medical professional. The first alarm device 255 may be configured as a Bluetooth speaker or earphone to be worn on the head of a medical professional or positioned inside the ear of a medical professional so that the medical professional will be able to hear the first alarm device 255 generating noise in the event of a defined situation.

[0062] While not strictly necessary, positioning the first alarm device 255 away from the first surgical instrument 220 offers several advantages. For example, one advantage of positioning the first alarm device 255 away from the first surgical instrument 220 is that it allows for a smaller size of the first surgical instrument 220. This allows the first surgical instrument 220 to be fitted into a smaller space. A smaller first surgical instrument 220 also provides the medical professional with a less obstructed view of the surgical site. Another advantage of positioning the first alarm device 255 (especially in the case of a tactile device) away from the first surgical instrument 220 is that the first alarm device 255 will not vibrate or affect the movement of the first surgical instrument 220, while still providing an alarm or notification to the medical professional. During high-tech surgeries, a vibrating alarm on the first surgical instrument 220 could cause the medical professional to move the first surgical instrument 220 to an undesirable position due to being startled by the first alarm device 255 and / or the vibration forcing unintended movement of the first surgical instrument 220.

[0063] The first surgical instrument assembly 200 may further include a tracking device 230. The tracking device 230 may be coupled to a handheld component 225 of the first surgical instrument 220. The tracking device 230 may include a plurality of markers 235 recognizable by the tracking unit 110 of the surgical navigation system 100. The markers 235 may include passive tracking elements (e.g., reflectors) for transmitting optical signals (e.g., reflecting light emitted from the tracking unit 110) to the sensor 115. In other configurations, the markers 235 may be configured as active markers. It is also contemplated that the markers 235 may include a combination of active and passive arrangement structures.

[0064] Markers 235 may be arranged in defined or known locations and orientations relative to other markers 235 to allow the surgical navigation system 100 to determine the location and orientation (posture) of the surgical instrument 220. For example, markers 235 may be registered with a first surgical instrument 220 to allow the surgical navigation system 100 to determine the location and / or orientation of the end effector 240 or cutting portion of the first surgical instrument 220 within a defined space (e.g., the surgical field). In one exemplary configuration, the surgical navigation system 100 may be configured to determine the location and / or orientation of the end effector 240 or the cutting portion of the second surgical instrument 220, or the location and / or orientation relative to a target trajectory and / or target location of a planned surgical path. In another exemplary configuration, the surgical navigation system 100 may also be configured to determine the location and / or orientation of the end effector 240 or the cutting portion of the second surgical instrument 220 relative to key anatomical structures within the patient's body and relative to virtual boundaries and / or warning zones.

[0065] Alternatively, the surgical system 10 may include a second surgical instrument assembly 300 to be used with the surgical navigation system 100. For example, the second surgical instrument assembly 300 may include a second surgical instrument 320 (e.g., a high-speed surgical drill or ultrasonic surgical handheld device) including a handheld part 325. The handheld part 325 may be coupled to a console 310 configured to control the operation of various components of the second surgical instrument 320. The handheld part 325 may be shaped to define a handle or grip portion for a medical professional to hold during a medical procedure. Exemplary second surgical instruments coupled to a console are found in U.S. Patent No. 10,016,209 and U.S. Patent Publication No. 2019 / 0117322, both of which are incorporated herein by reference in their entirety.

[0066] The second surgical instrument 320 may further include a second instrument processor 315 and a motor 345. The second instrument processor 315 may be disposed within a console 310 of the second surgical instrument assembly 300. The motor 345 may be disposed within a handpiece 325 of the second surgical instrument 320. The second instrument processor 315 and the motor 345 can communicate with each other, and the second instrument processor 315 may be configured to control the operation of the motor 345, and consequently control the operation of the second surgical instrument 320. For example, the second surgical instrument 320 may be coupled to the console 310 via a cable connecting the second instrument processor 315 to the motor 345 to allow communication between the second instrument processor 315 and the motor 345, thereby controlling the operation of the motor 345. The second instrument processor 315 may also include an end effector 340, such as a high-speed cutting drill or an ultrasonic tip. The end effector 340 may be coupled to the handpiece 325 of the second surgical instrument 320 such that the motor 345 can be operatively coupled to the end effector 340. For example, motor 345 may be configured to actuate high-speed cutting drill 340 to grind and / or remove biological tissue from the surgical site or to vibrate an ultrasonic tip. A second instrument processor 315 may communicate with motor 345 and is configured to control the operation of motor 345, and consequently, the operation of high-speed cutting drill 340.

[0067] The second surgical instrument assembly 300 may further include a tracking device 330. The tracking device 330 may be coupled to the handpiece 325 of the second surgical instrument 320. The tracking device 330 is similar to the tracking device described above for the first surgical instrument assembly 200. For example, the tracking device 330 may include a plurality of markers 335 recognizable by the tracking unit 110 of the surgical navigation system 100, and each marker 335 may be arranged in a position and orientation defined or known relative to the other markers 335 to allow the surgical navigation system 100 to determine the position and orientation (posture) of the second surgical instrument 320. The second instrument processor 315 may also communicate with the navigation computer 140 and is configured to exchange data related to the position and / or orientation of the second surgical instrument 320 and data related to the operation of the second surgical instrument 320. For example, the second instrument processor 315 and the navigation computer 140 may be configured to transmit data related to the operation of the second surgical instrument 320 to each other based on the position and / or orientation of the second surgical instrument 320 detected by the surgical navigation system 100. It is also conceivable that additional surgical instruments may be coupled to the console 310 and / or communicate with a second instrument processor 315 disposed within the console 310.

[0068] The second surgical instrument assembly 300 may further include a power source (not shown). The power source may be coupled to a console 310 of the second surgical instrument assembly 300 and configured to supply power to a motor 345 of the second surgical instrument 320 to actuate the end effector 340. It is also contemplated that the console 310 may include a cable configured to be inserted into a socket connected to an electrical grid for supplying power to the second surgical instrument assembly 300. The power source may be electrically connected to the second instrument processor 315 and / or the motor 345 and is configured to selectively supply power to the motor 345 to actuate the end effector 340.

[0069] The second surgical instrument assembly 300 may also include a switch 350 (e.g., a foot switch, trigger, or button) operably coupled to the second instrument processor 315. The switch 350 may be configured to generate and / or transmit signals to the second instrument processor 315 based on user input to control the operation of the second surgical instrument 320. Although not shown in the figures, it is contemplated that multiple surgical instruments 320 may be coupled to the console 310 and controlled by foot switches. The switch 350 (e.g., a foot switch) may be configured to control each of the multiple surgical instruments 320. For example, a single foot switch may include multiple buttons, each of which may be assigned to one of the multiple surgical instruments 320. An exemplary surgical system including switches coupled to a console for controlling multiple surgical instruments is disclosed in U.S. Patent No. 10,820,912, the entirety of which is incorporated herein by reference.

[0070] The second surgical instrument assembly 300 may also include a second alarm device 355 similar to the first alarm device 255. The second alarm device 355 may include one of the auditory, tactile, and / or visually perceptible devices discussed with respect to the first alarm device 255. The second alarm device 355 may be configured to communicate with the second instrument processor 315 or directly with the navigation processor. The second instrument processor 315 or the navigation processor may be configured to send a signal to activate the second alarm device 355, thereby providing a warning or notification based on pre-programmed conditions or settings. As shown, the second alarm device 355 is coupled to a switch 350 of the second surgical instrument assembly 300, and it is contemplated that the second alarm device 355 may be coupled to and / or positioned in an alternative location.

[0071] Surgical system 10 may include a third surgical instrument assembly 400 that communicates with surgical navigation system 100. For example, the third surgical instrument assembly 400 may include a third surgical instrument 420 (e.g., an ultrasound instrument) that includes a handpiece 425. The handpiece 425 may be coupled to a console 410 configured to control the operation of various components of the third surgical instrument 420. The handpiece 425 may be shaped to include a handle or grip portion for a medical professional to hold during a medical procedure.

[0072] The third surgical instrument 420 may further include a third instrument processor 415 and a motor 445. The third instrument processor 415 may be disposed within a console 410 of the third surgical instrument assembly 400. The motor 445 may be disposed within a handpiece 425 of the third surgical instrument 420. The third instrument processor 415 and the motor 445 may communicate with each other. The motor 445 may include a piezoelectric element configured to expand and contract when an electric current is applied to the piezoelectric element. The piezoelectric element may include a plurality of disc-shaped piezoelectric elements arranged end-to-end in a stack. The third instrument processor 415 may be configured to control the operation of the motor 445, and consequently control the operation of the third surgical instrument 420. For example, the third surgical instrument 420 may include an end effector 440, such as an ultrasonic end effector assembly.

[0073] The end effector 440 may include an ultrasonic end-effector assembly comprising a horn, the ultrasonic end portion of which vibrates at ultrasonic speeds when the piezoelectric element expands and contracts. The ultrasonic end-effector assembly may also include an outer sheath at least partially disposed above the horn, excluding the ultrasonic end-effector portion. The end effector 440 may be coupled to a handpiece 425 of a third surgical instrument 420 such that a motor 445 may be operatively coupled to the end effector 440. For example, the motor 445 may be configured to actuate the ultrasonic end-effector assembly to abrade and / or remove biological tissue from the surgical site. A third instrument processor 415 may communicate with the motor 445 and is configured to control the flow of current to the piezoelectric element, thereby controlling the operation of the motor 445 and, consequently, the operation of the ultrasonic end-effector assembly.

[0074] The third surgical instrument assembly 400 may further include a tracking device 430. The tracking device 430 may be coupled to the handpiece 425 of the third surgical instrument 420. The tracking device 430 may be similar to those defined above for other instrument assemblies. For example, the tracking device 430 may include a plurality of markers 435 recognizable by the tracking unit 110 of the surgical navigation system 100, and each marker 435 may be arranged in a position and orientation defined or known relative to the other markers 435 to allow the surgical navigation system 100 to determine the position and orientation (posture) of the third surgical instrument 420. The third instrument processor 415 may also communicate with the navigation computer 140 and be configured to exchange data related to the position and / or orientation of the third surgical instrument 420 and data related to the operation of the third surgical instrument 420. For example, the third instrument processor 415 and the navigation computer 140 may be configured to transmit data related to the operation of the third surgical instrument 420 to each other based on the position and / or orientation of the third surgical instrument 420 detected by the surgical navigation system 100.

[0075] The third surgical instrument assembly 400 may also include a power source (not shown). The power source may be coupled to the console 410 of the third surgical instrument assembly 400 and configured to supply power to the motor 445 of the third surgical instrument 420 to actuate the end effector 440. For example, the power source may include a removable battery pack. It is also contemplated that the console 410 may include a cable configured to be plugged into a socket connected to the power grid for supplying power to the third surgical instrument assembly 400. The power source may be electrically connected to the third instrument processor 415 and / or the motor 445 and is configured to selectively supply power to the motor 445 to actuate the end effector 440.

[0076] The third surgical instrument assembly 400 may also include a switch 450 (e.g., a foot switch, pedal, or button) operably coupled to the third instrument processor 415. The switch 450 may be configured to generate signals based on user input and / or transmit signals to the third instrument processor 415 to control the operation of the third surgical instrument 420.

[0077] The third surgical instrument assembly 400 may also include a third alarm device 455, similar to the first alarm device 255 and the second alarm device 355. The third alarm device 455 may include one of the auditory, tactile, and / or visually perceptible devices discussed with respect to the first alarm device 255. The third alarm device 455 may be configured to communicate with a third instrument processor 415. The third instrument processor 415 may be configured to send a signal to activate the third alarm device 455, thereby providing a warning or notification based on pre-programmed conditions or settings.

[0078] The surgical instrument assemblies 200, 300, and 400 described above are intended as exemplary instruments and / or configurations within the surgical system 10, but are not intended to be limiting. Other types and forms of surgical instrument assemblies are contemplated. While multiple exemplary surgical instrument assemblies 200, 300, and 400 are described as part of the surgical system 10 and communicating with the surgical navigation system 100, it is contemplated that the surgical system 10 may include only a single surgical instrument assembly 200, 300, or 400. Furthermore, although... Figure 2 The surgical system 10 shown includes three surgical instrument assemblies 200, 300, and 400 and a single surgical navigation system 100; however, it is contemplated that the surgical system 10 can be configured for any combination including the surgical instrument assemblies 200, 300, and 400 and / or the surgical navigation system 100. For example, the surgical system 10 may include a single surgical instrument assembly 200, 300, and 400 and multiple surgical navigation systems 100.

[0079] refer to Figure 4 An exemplary configuration of the GUI 150A of the surgical navigation system 100 is shown. The GUI 150A can be configured as a touchscreen on the display unit 120 of the surgical navigation system 100. Figure 4 As shown, GUI 150A can be referred to as a segmentation interface. GUI 150A may include a selection area button 141 for selecting the area to be segmented and a segmentation button 142 for medical professionals to select the segmentation of the selected area.

[0080] The surgical navigation system 100 can be configured to utilize segmentation to facilitate warning zone planning for generating alerts or controlling surgical instrument parameters based on the tracking posture of surgical instruments, as described in more detail below. When operating with the lumbar spine as the target, a medical professional can provide input to the user input device 130 by selecting the selection area button 141 of the graphical user interface (GUI) 150A to define the area of ​​interest in the patient image (e.g., the lumbar spine region 153), and thus the segmentation of the patient image can be limited to the lumbar spine region 153. Once the medical professional has selected the area of ​​interest (e.g., the lumbar spine region 153), the medical professional can select the segmentation button 142 to segment the lumbar spine region 153.

[0081] Segmentation can be performed automatically, semi-automatically, or manually. Once the surgical navigation system 100 can be configured to perform this automatic segmentation, it is an atlas-to-image mapping process used to map a three-dimensional vertebral model onto each vertebra in the lumbar region 153. The three-dimensional vertebral model can then be overlaid onto each vertebra in the lumbar region 153, and the vertebral model can then be automatically, manually, or semi-automatically deformed until the three-dimensional vertebral model fits each vertebra in the lumbar region 153.

[0082] In an example of an automated segmentation process, the surgical navigation system 100 may be configured to perform segmentation of the lumbar region 153 using a model fitting algorithm. For example, the model may represent variations within a set of images of the structure represented in the first image and may be fitted to the first image based on its properties. Fitting may include applying a fitting technique selected from the group consisting of rigid registration, non-rigid registration, active shape modeling, and active appearance modeling. The fitting technique may be similar to the technique described in International Publication No. WO / 2011 / 098752A2, which is incorporated herein by reference. In practice, fitting may include applying any applicable fitting technique. While an example of performing automated segmentation based on a model fitting algorithm is provided, the system may be configured to perform automated or semi-automatic segmentation using another suitable algorithm.

[0083] During semi-automatic segmentation, medical professionals may need to provide some input during the segmentation process to identify anatomical landmarks. Surgical navigation system 100 can be configured to implement one of the semi-automatic segmentation methods for segmenting the lumbar region 153, based on one of the methods described in U.S. Patent No. 8,698,795 (titled "Interactive Image Segmentation"), the contents of which are incorporated herein by reference.

[0084] The surgical navigation system 100 can also be configured to perform segmentation of the lumbar region 153 using a combination of manual, semi-automatic, and automatic segmentation algorithms. For example, the surgical navigation system 100 may use a first algorithm (e.g., utilizing the model fitting algorithm described above) to perform initial segmentation, and then use a second segmentation algorithm (e.g., utilizing a graphic cutting algorithm) to refine the initial segmentation of one or more vertebrae in the lumbar region 153. A method for segmenting medical images based on a first segmentation algorithm and a second segmentation algorithm is described in U.S. Patent Publication No. 2021 / 0192743A1, the entire contents of which are incorporated herein by reference.

[0085] During or after segmentation of the lumbar region 153, the surgical navigation system 100 can map one or more virtual implants, multiple warning zones, and / or multiple virtual boundaries to each vertebra of the lumbar region 153 based on a three-dimensional vertebral model. (Reference) Figure 5 The graphical user interface 150B displays multiple views of the vertebral model 145, including: an implant view showing a top view of the vertebral model 145, where model implants 275A-M and 275B-M are shown in optimal posture; a model warning zone view of the vertebral model 145, showing multiple model warning zones and virtual boundaries in the top view, these multiple model warning zones (zones 1-6) being defined by multiple model virtual boundaries (boundaries 1-13); and a planar model view of the vertebral model 145, where the model is shown without model implants or model warning zones. The vertebral model 145 can be defined in a second coordinate system (i.e., the vertebral body coordinate system). The optimal posture of the model implants 275A-M and 275B-M is defined in the second coordinate system with respect to various landmarks or anatomical features of the vertebral model 145.

[0086] refer to Figure 5 In the model warning zone view, the pose of each of the multiple model warning zones and / or virtual boundaries is shown relative to the vertebral model 145 and defined in a second coordinate system. The multiple model warning zones include a first model warning zone (zone 1), a second model warning zone (zone 2), a third model warning zone (zone 3), a fourth model warning zone (zone 4), a fifth model warning zone (zone 5), and a sixth model warning zone (zone 6). Model warning zone 1 can be defined relative to the spinal cord. For example, model warning zone 1 can be defined as the volume between a first virtual boundary (boundary 1) and a second virtual boundary (boundary 2). Boundary 1 can be defined relative to the external perimeter of the spinal cord. Boundary 2 can be placed at a default distance from boundary 1, at least in part, based on the surgical procedure being performed. For example, boundary 2 can be offset by two millimeters relative to boundary 1.

[0087] Model warning zone 2 can be defined at a second distance from a key anatomical structure, such that the second distance is greater than the first distance. Model warning zone 2 can be defined as a volume between boundary 2 and a third virtual boundary (boundary 3). Boundary 3 can be placed at a default distance from boundary 2, at least in part, based on the surgical procedure being performed. Model warning zone 3 can be defined at and / or include the boundary of the key anatomical structure. For example, boundary 3 can define the outer perimeter of model warning zone 3. The eighth boundary (boundary 8) and the ninth boundary (boundary 9) define the outer perimeter of the vertebra. Model warning zone 4 can be defined relative to the outer perimeter of the vertebra. Model warning zone 4 can be defined by the fourteenth virtual boundary (boundary 14) and the ninth virtual boundary (boundary 9). Boundary 14 can be offset relative to boundary 9, which can be defined at the outer perimeter of the vertebra.

[0088] The model warning zone 5 can be defined such that it is contoured around a critical anatomical structure (the central foramen within the vertebra) to alert a medical professional when the end effector 240 of the first surgical instrument 220 approaches the critical anatomical structure, thereby preventing the medical professional from accessing the critical anatomical structure. The model warning zone 5 can be defined by a tenth virtual boundary (boundary 10) and an eleventh virtual boundary (boundary 11). Boundary 10 can touch or be adjacent to boundary 3, while boundary 11 is placed at a default distance from boundary 10.

[0089] Model warning zone 6 is outlined around the outer perimeter of the pedicle to alert a medical professional if the end effector 240 of the first surgical instrument 220 may be approaching the outer perimeter of the vertebra, thereby preventing the medical professional from damaging the outer perimeter of the pedicle. Model warning zone 6 may be defined by a twelfth virtual boundary (boundary 12) and boundary 8. Boundary 12 may be offset relative to the outer boundary of the pedicle region of the vertebra, while boundary 8 may be defined at the outer perimeter of the pedicle region of the vertebra.

[0090] It is also conceivable that the surgical navigation system 100 can be configured to define virtual boundaries (boundaries 1-13) and / or model warning zones (zones 1-6) based on information selected or input by a medical professional. For example, the surgical navigation system 100 can be configured to define model warning zones (zones 1-6) based on one or more of the following items input by a medical professional: the type of surgery to be performed, the location of the surgery on the patient, the type of implant 275 to be used, the type of surgical instruments 220, 320, 420 to be used, and / or the type of end effectors 240, 340, 440. The medical professional can then have the opportunity to modify or change the virtual boundaries (boundaries 1-13) and / or model warning zones (zones 1-6) of the three-dimensional vertebral model using the user input device 130 and / or the GUI 150.

[0091] In addition to multiple model warning zones (zones 1-6) and virtual boundaries (boundaries 1-13), the vertebral model 145 may include multiple features or regions defined about a second coordinate system. These features or regions may include the superior articular surface, spinous process, mammary duct protrusion, reverse protrusion, pedicle, vertebral foramen, superior articular process, dental arch, superior vertebral notch, vertebral body, etc.

[0092] The vertebral model 145 may include multiple planar virtual boundaries that can be used to depict multiple target depths (e.g., three target depths) of a single instrument to be used in a single surgical procedure. For example, a fifth virtual boundary (model boundary 5) represents the target depth of drilling, a sixth virtual boundary (model boundary 6) represents the target depth of tapping, and a seventh virtual boundary (model boundary 7) represents the target depth of screw insertion by the actuator, as shown below. Figure 5 As shown and will be referenced below Figure 7 To explain in more detail.

[0093] During or after segmentation, model implants 275A-M, 275B-M, model warning zones (zones 1-6), and model virtual boundaries (boundaries 1-12) of vertebral model 145 can be mapped to the vertebrae of lumbar region 153, enabling the generation of patient-specific surgical plans based on the vertebral models. For example, for the L3 vertebra of lumbar region 153, after lumbar region 153 is segmented and mapped for implants, warning zones, and virtual boundaries, each vertebra will have a planned pose for one or more implants 275A, 275B, multiple warning zones (zones 1-6), and multiple virtual boundaries (1-12). Healthcare professionals can adjust one or more of the poses of the multiple warning zones (zones 1-6), virtual boundaries (boundaries 1-12), and planned implants 275A, 275B, as described in more detail below.

[0094] Virtual boundaries (boundaries 1-12) and warning zones (zones 1-6) can be one-dimensional (ID), two-dimensional (2D), or three-dimensional (3D), and can include points, lines, axes, trajectories, planes (infinite planes or plane segments defined by anatomical structures or other virtual boundaries), volumes, or other shapes (including complex geometries). Virtual boundaries (boundaries 1-12) and warning zones (zones 1-6) can be represented by pixels, point clouds, voxels, triangular meshes, other 2D or 3D models, or combinations thereof, as disclosed in U.S. Patent Publication No. 2018 / 0333207 and U.S. Patent No. 8,898,043, all of which are incorporated herein by reference.

[0095] As will be discussed in further detail below, virtual boundaries and / or warning zones can be used in a variety of ways. For example, navigation computer 140 can control certain operations / functions of surgical instrument 220 based on its relationship with one or more virtual boundaries and / or warning zones (e.g., space, speed, etc.). Other uses for virtual boundaries are also envisioned. As described in more detail regarding the alarm interface, navigation computer 140 can activate / deactivate multiple warning zones (zones 1-6) one at a time.

[0096] The surgical navigation system 100 may be programmed and / or configured to manipulate the speed of motors 245, 345, 445 of surgical instruments 220, 320, 420 and / or activate alarm devices 255, 355, 455 when the surgical navigation system 100 determines that surgical instruments 220, 320, 420 indicate or are adjacent to one or more virtual boundaries or have entered one of the defined warning zones. For example, when the surgical navigation system 100 detects that a first end effector 240A is coupled to a handpiece 225, the surgical navigation system 100 may be configured to transmit signals to the instrument processors 215, 315, 415 of the surgical instruments 220 to deactivate motors 245, 345, 445 when the first end effector 240A is adjacent to and / or located distal to a boundary 5.

[0097] refer to Figure 6 GUI 150C shows a lumbar region 153 segmented according to one of the described methods for segmentation. GUI 150C includes sagittal views, axial views, and model or perspective views of the lumbar region 153, with the L3 vertebra located at the focal point of GUI 150C. GUI 150C may include one or more buttons, such as an accept segmentation button 165, a manual segmentation editing button 167, an automatic segmentation editing button 177, and a settings button 179. When selected by a medical professional, the settings button can bring up a notification settings interface, such as About Figure 7As discussed in more detail, GUI 150C may include one or more labels 174 that identify the vertebrae displayed on GUI 150C. Figure 6 As shown, three labels 174A, 174B, and 174C are displayed on GUI 150C, where the first label 174A identifies the L3 vertebra, the second label 174B identifies the L2 vertebra adjacent to the L3 vertebra, and the third label 174C identifies the L1 vertebra adjacent to the L2 vertebra. GUI 150C can be configured to allow a user to manipulate GUI 150C to navigate among multiple vertebrae such as the L3, L2, and L1 vertebrae. Navigation computer 140 can be configured to display the L3 vertebra at the center of GUI 150C when the label corresponding to L3 is selected. Alternatively, a medical professional can select the second label 174B, and navigation computer 140 can be configured to identify the L2 vertebra near the second label 174B as the primary anatomical structure and to center the L2 vertebra and the second label 174B in GUI 150C. Although in Figure 6 Only three labels are shown, but GUI 150C can be configured to include any number of labels 174.

[0098] The navigation computer 140 can be configured such that when a medical professional selects the propagation button 197, the navigation computer propagates the warning zone edit to all vertebrae associated with the height label 174, which is set to a first lighting state. Therefore, the medical professional can deselect the height label 174 before selecting the propagation button 197 to exclude vertebrae from the propagation of the warning zone edit performed on a specific vertebra. Figure 11 In the current configuration, all height labels 174 have been selected, so the navigation computer 140 will propagate the warning zone edit for the L3 vertebra to the L1 and L2 vertebrae. However, if, for example, a medical professional deselects the height label 174C associated with the L1 vertebra, the navigation computer will propagate the warning zone edit only to the L2 vertebra.

[0099] Referring to GUI 150C, a lumbar region 153 is shown after segmentation of the L3 vertebra displayed by GUI 150C, including the positions of various virtual boundaries (1, 8, 9) defining the segments of the L3 vertebra. If a healthcare professional is not satisfied with the segmentation, they can choose to manually edit the segmentation button 167 and then reposition one or more of the virtual boundaries to the desired location, or they can choose to automatically edit the segmentation button 177 and then select a region of the L3 vertebra for further segmentation using a second segmentation algorithm, as disclosed in U.S. Patent Publication No. 2021 / 0192743A1, which is previously incorporated herein by reference in its entirety.

[0100] Medical professionals can navigate through a selected lumbar region 153 by interacting with sliders 169A and 169B to shift the focus of the GUI 150C within the selected lumbar region 153. Once the medical professional has viewed a segmented vertebra (e.g., segmented L3), the medical professional can select to accept the segmentation button 165 to signal to the navigation computer 140 that the medical professional is satisfied with the segmentation of the L3 vertebra and can then accurately view the other remaining segmented vertebrae within the lumbar region 153.

[0101] refer to Figure 7 An exemplary configuration of the GUI 150F of the surgical navigation system 100, referred to as the notification interface 151, is shown. The GUI 150F may include multiple buttons 156, 162, 164, and 169, which are configured to receive input from medical professionals to control, modify, or adjust various settings for alerts provided during the implementation of a medical procedure, as will be discussed in more detail below.

[0102] The notification interface 151 may include tool selection buttons 152A and 152B. Tool selection buttons 152A and 152B may allow a medical professional to select surgical instrument components 200, 300, and 400 from a completed list of surgical instruments, or may allow the medical professional to input specific surgical instrument components 200, 300, and 400 to be used during surgical procedures. For example, tool selection buttons 152A and 152B may allow the medical professional to select a second surgical instrument 320, including a high-speed cutting drill. This identifies the specific instrument 320 to the navigation computer 140, allowing the navigation computer 140 to fill in various virtual boundaries and / or warning zones that will be used for the identified instrument. Tool selection buttons 152A and 152B may also be configured to allow a medical professional to select surgical instrument components 200, 300, and 400, as well as one or more end effectors 240, 340, and 440 that may be coupled to the surgical instruments 220, 320, and 420. For example, a medical professional may select a first surgical instrument 220 and further select one or more of end effectors 240A, 240B, 240C, which may be used during surgery to allow the navigation system to fill in various virtual boundaries and / or warning zones for each of the various end effectors 240A, 240B, 240C.

[0103] The notification interface 151 may also include one or more alarm buttons 156A, 156B, 156C, 156D for manipulating the various alarms described above. A first alarm button 156A may be configured to allow a medical professional to activate or deactivate an alarm related to the rotational speed of the end effectors 240, 340, 440. For example, as described above, the navigation computer 140 and / or the device processors 215, 315, 415 may be configured to manipulate the rotational speed (RPM) of the end effectors 240, 340, 440 based on their position relative to at least one of the virtual boundaries and / or at least one of the warning zones. A second alarm button 156B may be configured to allow a medical professional to activate or deactivate a tactile alarm. For example, a medical professional may manipulate the second alarm button 156B to activate one of the aforementioned tactile alarms. This may include a navigation computer 140 configured to send signals to surgical instrument assemblies 200, 300, 400 to activate alarm devices 255, 355, 455, which are configured to provide tactile alerts to healthcare professionals based on the position of end effectors 240, 340, 440 relative to at least one of virtual boundaries and / or at least one of warning zones.

[0104] The third alarm button 156C may be configured to allow a medical professional to activate or deactivate a visual alarm. For example, a medical professional may manipulate the third alarm button 156C to activate one of the visual alarms. This may include the navigation computer 140 being configured to send signals to the surgical instrument assemblies 200, 300, 400 to activate alarm devices 255, 355, 455, which are configured to provide a visual alarm to the medical professional based on the position of the end effectors 240, 340, 440 relative to at least one of the virtual boundaries and / or at least one of the warning zones. The fourth alarm button 156D may be configured to allow a medical professional to activate or deactivate one of the aforementioned auditory alarms. For example, a medical professional can manipulate the fourth alarm button 156D to activate an auditory alarm, causing the navigation computer 140 to send a signal to the surgical instrument assemblies 200, 300, 400 to activate alarm devices 255, 355, 455, which are configured to provide an auditory alarm to the medical professional based on the position of the end effectors 240, 340, 440 relative to at least one of the virtual boundaries and / or at least one of the warning zones.

[0105] The notification interface 151 of the GUI 150D may also include one or more alarm graphics 158A, 158B. Alarm graphics 158A, 158B may be specific to a particular surgical instrument and / or end effector and may be configured to provide a schematic and / or visual representation of the location of various virtual boundaries and / or warning zones, described in more detail below. The first alarm graphic 158A may include a visual representation of the surgical area and any implant or device to be inserted during the medical procedure to help medical professionals identify the location of the procedure and set various alarms. For example, as Figure 7 As shown, the first alert graphic includes a visual representation of the vertebral body, wherein the area where surgery will take place is outlined with dashed lines. The first alert graphic 158A may also include a visual representation of the pedicle screw to be inserted during surgery.

[0106] The second alarm graphic 158B can be configured to provide a visual representation of the implant or device to be inserted during surgery, along with markings indicating various virtual boundaries (boundaries 5, 6, 7) relative to the implant or device, to help medical professionals adjust or modify the location of alarms that should be triggered by each of the various virtual boundaries and / or alert zones. For example, as... Figure 7 As shown, the second alarm graphic 158B includes a visual representation of the pedicle screw to be inserted and markings along the pedicle screw, which indicate the position of various virtual boundaries (boundaries 5, 6, 7) relative to the pedicle screw that will trigger various alarms during the operation.

[0107] The notification interface 151 of the GUI 150D may also include warning zone or virtual boundary setting interfaces 160A, 160B. Warning zone or boundary setting interfaces 160A, 160B may include one or more prompts or buttons 162A, 162B, 162C, 162D, 162E for setting and / or manipulating when a virtual boundary will trigger one or more of the aforementioned alarms. The first warning zone or boundary setting interface 160A may include a first set of buttons 162A, which may be configured to identify implants and / or devices to be inserted during surgery. This allows the surgical navigation system 100 to determine which and how many virtual boundaries and / or warning zones to provide. For example, if a medical professional manipulates the laminectomy button of the first set of buttons 162A to indicate that a laminectomy will be performed, the surgical navigation system 100 knows that this involves the removal of portions of one or more vertebrae, and the surgical navigation system 100 will identify and provide various warning zones around key structures of the patient's vertebrae to assist the medical professional in performing the surgery. If a medical professional manipulates the pedicle button of the first set of buttons 162A to indicate that a pedicle screw surgery will be performed, the surgical navigation system 100 will identify and provide various virtual boundaries required to assist the medical professional in drilling, tapping and placing the pedicle screw.

[0108] The second button 162B of the warning zone or virtual boundary setting interface 160A may correspond to a depth button. The depth button can be configured to allow medical professionals to select the depth of the warning zone for surgical procedures (e.g., laminectomy). For example, Figure 7 The first alert zone or virtual boundary setting interface 160A shown indicates that a medical professional is setting an alarm for laminectomy based on manipulation of the first button 162A. Based on this selection made by the medical professional, the second button 162B provides a manipulateable button configured to allow the medical professional to select the depth of the alert zone to be used by the surgical navigation system 100 to trigger one or more of various alarms.

[0109] The second alert zone or virtual boundary setting interface 160B of the notification interface 151 may include additional buttons 162C, 162D, 162E, which are associated with the configuration of various virtual boundaries and / or alert zones of the implant (e.g., screws) and trigger implant-related alarms during the medical procedure. For example, the second alert zone or virtual boundary setting interface 160B may be configured to provide buttons 162C, 162D, 162E for manipulating alarm settings for surgery involving the insertion of pedicle screws.

[0110] The third button 162C of the second alert zone or virtual boundary setting interface 160B can be configured to set the distance or depth of a reference position to locate the virtual boundary (e.g., boundary 5) along the target trajectory. For example, as... Figure 7 As shown, the third button 162C includes a trigger to allow a medical professional to set the insertion depth of the first end effector (i.e., the drill) before triggering the alarm. In this example, the medical professional has set the third button 162C to 30mm to indicate that the surgical navigation system 100 should trigger an alarm for the first end effector when it reaches a depth of 30mm.

[0111] The second warning zone or virtual boundary setting interface 160B may include additional buttons 162D, 162E for manipulating and / or adjusting when an alarm should be triggered for the second end effector (i.e., the tap) and / or the third end effector (i.e., the driver) to insert a screw. As described above, the surgical navigation system 100 may be configured such that the fourth button 162D and the fifth button 162E for manipulating alarms for the second and third end effectors can manipulate the position of the virtual boundary used to trigger the alarm for the first end effector based on the virtual boundary used to trigger the alarm for the first end effector. For example, as indicated by the fourth button 162D, the virtual boundary used to trigger the alarm for the second end effector (i.e., the tap) should be shifted by zero millimeters (0 mm) relative to the virtual boundary used to trigger the alarm for the first end effector. However, the fourth button 162D can be manipulated to shift the virtual boundary, thereby triggering the alarm for the second end effector as needed. Similarly, the fifth button 162E can be manipulated to modify or adjust the virtual boundary used to trigger the alarm for the third end effector.

[0112] The notification interface 151 of the graphical user interface (GUI) 150D may also include alarm test buttons 164A and 164B. Alarm test buttons 164A and 164B can be configured to test and / or confirm that a selected alarm is functioning correctly. For example, during operation, after a medical professional has selected or entered various information related to the medical procedure into the notification interface 151, the medical professional can select alarm test buttons 164A and 164B to confirm that the selected alarm is functioning. For example, if the medical professional selects the first alarm button 156A, which relates to a motor speed alarm, as active, the medical professional can activate surgical instruments 220, 320, and 420 and press alarm test buttons 164A and 164B. Pressing alarm test buttons 164A and 164B instructs the navigation system to send a test signal to instrument processors 215, 315, and 415, thereby activating the alarm associated with the first alarm button 156A, such as reducing the motor speed and consequently reducing the rotational speed of end effectors 240, 340, and 440. Once the user selects alarm test buttons 164A and 164B, each of the various alarms that has been activated based on the manipulation of alarm buttons 156A, 156B, 156C, and 156D should be triggered. Any active alarms that were not triggered when alarm test buttons 164A and 164B were selected should be further evaluated by a medical professional to confirm that they were actually functioning correctly before the medical procedure began.

[0113] refer to Figure 8 Once the medical professional is satisfied with the segmentation of the lumbar region 153 and has entered various preferences into the notification interface 151, the medical professional can proceed with the implant planning steps. Figure 7 An exemplary GUI 150E for facilitating implant planning is illustrated. GUI 150E can be configured to display a visual representation of surgical planning, including the planned pose of implants 275A, 275B in an image coordinate system (i.e., a first coordinate system). A medical professional can input the planned pose of implants 275A, 275B, or in some cases, such as when the medical professional has selected the suggested implant button 190, the surgical navigation system 100 can suggest the planned pose of implants 275A, 275B obtained from the vertebral model 145. GUI 150E may also include: a preference adjustment button 191, selectable by the medical professional to apply historical preferences for corrections made to previous similar surgeries; and a propagation button 197, selectable by the medical professional to propagate corrections made to a specific vertebra (e.g., the L3 vertebra) to another vertebra, as will be discussed in more detail below.

[0114] As shown, implants 275A and 275B can define target axes (axis T1 and axis T2). The surgical navigation system 100 can provide virtual boundaries (boundaries 5, 6, and 7) along the target axes (axis T1 and axis T2), these target axes representing the target depth for each of the multiple end effectors 240A, 240B, and 240C used in the surgical procedure. Figure 8 As shown, for each of implants 275A and 275B, the fifth boundaries (boundaries 5A and 5B) are shown along the target axes (axis T1 and axis T2). The navigation computer 140 can be configured to define the fifth boundaries (boundaries 5A and 5B) based on the target depth set for the end effector 240A and the vertebral model 145 (e.g., for drilling holes for placing screws 275A and 275B).

[0115] The surgical navigation system 100 can be further configured to define a sixth virtual boundary (boundaries 6A, 6B) based on the target depth of the second end effector 240C (e.g., a tap for cutting threads in a hole). It is conceivable that the surgical navigation system 100 can define the sixth virtual boundary (boundaries 6A, 6B) relative to the fifth virtual boundary (boundaries 5A, 5B) based at least in part on the selected implants 275A, 275B, their orientation, and the vertebral model 145. For example, the surgical navigation system 100 can define the fifth virtual boundary (boundaries 5A, 5B) in a first coordinate system along target axes (axis T1, axis T2). Then, based on the selected implants 275A, 275B, the surgical navigation system 100 can be configured to define the sixth virtual boundary (boundaries 6A, 6B) at a location based on the selected implants 275A, 275B at a distance from the fifth virtual boundary (boundaries 5A, 5B). The navigation computer 140 can also be configured to define a seventh virtual boundary (boundary 7A, 7B) based on the target depth for the third end effector 240C (e.g., a driver for placing screws 275A, 275B in holes).

[0116] It is conceivable that the surgical navigation system 100 can define a seventh virtual boundary (boundary 7A, 7B) relative to a fifth virtual boundary (boundary 5A, 5B) based at least in part on the selected implants 275A, 275B, their orientation, and the vertebral model 145. For example, the surgical navigation system 100 can define the fifth virtual boundary (boundary 5A, 5B) in the patient's first coordinate system along the target axes (axis T1, axis T2). Then, based on the selected implants 275A, 275B, the navigation system can be configured to define the seventh virtual boundary (boundary 7A, 7B) at a location based on the selected implants 275A, 275B at a distance from the fifth virtual boundary (boundary 5A, 5B). For example, the navigation computer 140 can be configured to determine, based on the depth of the fifth virtual boundary (boundaries 5A, 5B) and the known lengths of the selected implants 275A, 275B and the vertebral model 145, that the seventh virtual boundary (boundaries 7A, 7B) should be spaced thirty millimeters (30 mm) apart from the fifth virtual boundary (boundaries 5A, 5B) along the target axis (axis T1, axis T2).

[0117] Although Figure 8Only the fifth virtual boundary (boundaries 5A, 5B), the sixth virtual boundary (boundaries 6A, 6B), and the seventh virtual boundary (boundaries 7A, 7B) are shown, but additional virtual boundaries are conceivable. The navigation computer 140 can be configured to define and assign these virtual boundaries to each of the end effectors 240A, 240B, 240C. The location of these virtual boundaries and / or the timing at which they are configured to trigger one of the aforementioned alarms can be manipulated and / or adjusted as needed by the medical professional.

[0118] Figure 8 The GUI 150D may also include a planning interface 166A, which includes multiple buttons that can be manipulated by a medical professional to modify or adapt the placement of implants 275A, 275B. For example, the planning interface 166A may include one or more diameter buttons 168A that can be manipulated by a medical professional to modify the diameter of the planning screw. The planning interface 166A may also include one or more length buttons 168B that can be manipulated by a medical professional to modify the length of the planning screws 275A, 275B. The planning interface 166A may also allow a medical professional to reposition the planning screws 275A, 275B by changing their posture (i.e., position and / or orientation) relative to the L3 vertebra. The GUI 150D may also display various virtual buttons 186, 188 and the planning interface 166A near axis T1 to facilitate adjustment of the posture of implants 275A, 275B.

[0119] For further reference Figure 9 , Figure 8 The planning interface 166A of the GUI 150D may also include an alarm button 170. The GUI 150D can be configured such that selection of the alarm button 170 by a medical professional can open a boundary settings interface 160C, allowing the medical professional to access settings similar to those on... Figure 7The described virtual boundary setting interface 160B activates, modifies, and / or disables one or more of the various alarms described above. The virtual boundary setting interface 160C may include additional buttons and / or prompts that can be manipulated by a healthcare professional to modify or adjust the virtual boundaries and / or warning zones configured to trigger one or more alarms. Alarm indicators 172 may be positioned near one or more specific virtual boundaries (e.g., virtual boundaries (5, 6, 7)) and are configured to indicate to a healthcare professional whether an alarm assigned to one of the specific virtual boundaries (5, 6, 7) is activated, deactivated, or paused. For example, an alarm indicator 172 showing a bell with a line passing through it (e.g., 172A, shown near boundary 6B) indicates that the nearest virtual boundary is deactivated. An alarm indicator 172 without a line passing through the bell (e.g., alarm indicator 172A) indicates that an alarm for the nearest virtual boundary is activated. Although not specifically shown, an alarm indicator 172 with a dotted line passing through the bell can indicate that the alarm indicator is paused. Alarm indicator 172 can also be selected and / or manipulated by medical professionals to activate or deactivate alarms assigned to specific virtual boundaries (5, 6, 7).

[0120] GUI 150E depicts a virtual boundary setup interface 160C for implants 275A and 275B, which can be viewed by a medical professional when an alarm button 170 is selected. For example, from Figure 8 A user who selects the alarm button 170 of the planning interface 166A in the GUI 150E can open the virtual boundary setup interface 160C for viewing on the navigation display 120. The virtual boundary setup interface 160C may include an alarm button 156D configured to allow medical professionals to activate or deactivate various alarms. The virtual boundary setup interface 160C may also include three virtual boundary manipulation buttons 162C, 162D, and 162E, each for one of a plurality of end effectors 240A, 240B, and 240C.

[0121] As described above, a medical professional can select one of buttons 162C, 162D, and 162E to trigger an alarm for each of the various end effectors 240A, 240B, and 240C. In other words, when a medical professional provides input to one of buttons 162C, 162D, and 162E, the corresponding virtual boundary (5, 6, 7) will be moved based on that input. Based on the values ​​input by the medical professional using buttons 162C, 162D, and 162E, the positions of the various virtual boundaries will be updated within the surgical plan used to navigate the system to trigger alarms based on the positions of the various end effectors 240A, 240B, and 240C relative to one or more virtual boundaries during the procedure.

[0122] Once the navigation computer 140 has suggested the orientation of implants 275A and 275B, medical professionals may need to correct or refine the orientation because the navigation computer 140 makes suggestions based solely on the vertebral model 145. Therefore, medical professionals can interact with one or more buttons 186 and 188 positioned near target axis T1 or target axis T2 to reposition implants 275A and 275B. Figure 9 As shown, medical professionals have adjusted the orientation of implant 275A so that it is moved away from the external pedicle wall and toward the vertebral foramen and toward the external virtual boundary of the L3 vertebra.

[0123] Once the medical professional is satisfied with the desired positioning of implants 275A and 275B, they may wish to apply the corrections made to the L3 vertebrae implants 275A and 275B to other vertebrae in the lumbar region 153. The medical professional can select the propagation button 197 to cause the navigation computer 140 to propagate the corrections to the remaining vertebrae in the lumbar region 153. In other words, the navigation computer 140 can update the recommended positions of the L1 and L2 vertebrae implants based on the corrected position of the L3 vertebrae implants 275A and 275B.

[0124] When a medical professional selects propagation button 197, navigation computer 140 can disable the navigation functions discussed above regarding label 174. Navigation computer 140 can be configured to prompt the medical professional to select one or more labels 174 associated with one or more desired vertebrae from lumbar region 153 when propagation button 197 is selected, in order to propagate the corrected posture of implants 275A, 275B. In this way, navigation computer 140 is able to exclude specific vertebrae from the propagation of implant correction in lumbar region 153.

[0125] Healthcare professionals can opt out of propagating correction to the remaining vertebrae by selecting the Approved L3 Vertebra button 194 on the implant planning for the remaining vertebrae in the lumbar region 153. When a healthcare professional selects the Approved L3 Vertebra button, the default position of the planned implant will correspond to the mapped posture of the implant based on the vertebral model 145.

[0126] The navigation computer 140 may include an implant calibration database storing implant calibration data and related patient data. The implant calibration data may include spatial information (e.g., one or more transformations) describing how to calibrate the implant relative to an initial recommended posture of implants 275A, 275B, or spatial information describing how to calibrate the implant relative to model implants 275A, 275B. The implant calibration data may also include implant parameters such as screw diameter, screw length, warning zone, and virtual boundary preferences (e.g., the distance between virtual boundaries 5, 6, and 7).

[0127] The navigation computer 140 can access an implant calibration database to update the orientation of implants 275A-M and 275B-M of the vertebral model 145, or to suggest implant orientations for future patients while taking into account previous calibrations to the implant orientation and the preferences of medical professionals. For example, the navigation computer 140 can be configured to determine one or more transformations between an initial orientation of implant 275A relative to a first coordinate system and a corrected orientation of implant 275A relative to the first coordinate system. The navigation computer 140 can be configured to store transformation data in an implant calibration database that includes transformation data from other patients on whom medical professionals have previously performed surgery. Based on the transformation data stored in the implant calibration database, the navigation computer 140 can periodically (e.g., when a threshold of new patient cases is entered into the implant calibration database) retrieve transformation data for a patient from the implant calibration database. The navigation computer 140 can determine the average transformation of all transformation data stored in the implant calibration database based on the retrieved transformation data. The navigation computer 140 can update the model orientation of implants 275A-M and 275B-M to reflect average transformation data or other statistical analysis parameters. For example, when the number of patients reaches a threshold (e.g., one hundred patients) and the average transformation data indicates that the medical professional prefers a larger gap between the implant and the vertebral foramen, the navigation computer 140 can update the orientation of model implants 275A-M and 275A-B to reflect the medical professional's preference. In some cases, the navigation computer can edit the recommended implants (e.g., 275A, 275B) based on an implant calibration database. In another example, if the data stored in the implant calibration database indicates a clear trend toward a preference for smaller diameter screws, the navigation computer 140 can update model implants 275A-M and 275B-M to reflect the medical professional's preference. The medical professional can select the preference adjustment button 191 to update the L3 vertebra based on preferences determined by the medical professional and as described above in the implant calibration database.

[0128] The navigation computer 140 may include a machine learning module configured to implement machine learning algorithms to train a machine learning model based on an implant calibration database, thereby providing a recommended posture for implants 275A and 275B. For example, the machine learning module may train the machine learning model based on calibrations, preferences, or settings selected by a medical professional during a previous surgical procedure and the patient's outcome. The machine learning module may train the machine learning model according to one of the algorithms described in U.S. Patent Publication No. 2021 / 0378752A1, the entire contents of which are incorporated herein by reference. The navigation computer 140 may be configured to process image data of each vertebra in the lumbar region 153 and other relevant patient data through the machine learning model to provide a recommended posture for implants 275A and 275B.

[0129] refer to Figure 10 An exemplary GUI 150F is shown, in which multiple views of the L3 vertebra with selected virtual boundaries (1, 2, 8, and 9) and warning zone 1 are displayed. For ease of illustration, the virtual boundaries (3-6, 7, and 10-12) and warning zones (zones 2-6) have been omitted. However, it should be understood that the teachings of this disclosure applied to zone 1 also apply to any of the other zones (e.g., zones (2-6)) and virtual boundaries (boundaries 3-6, 7, and 10-12). The multiple views shown on the L3 vertebra GUI 150 include sagittal views, axial views, and plan views, which are described in more detail below.

[0130] GUI 150E may include a planning interface 166B, which includes one or more buttons, such as alarm buttons 156D configured to activate and / or deactivate one or more of various alarms. The planning interface 166B may also include a planning button 168C configured to allow medical professionals to manipulate various virtual boundaries (1, 2, 8, 9) to adjust various alert zones (e.g., alert zone 1) and various alarms, and is configured to trigger one or more of the various alarms. For example, the planning button 168C of the planning interface 166B may be configured to receive user input to adjust the distance between one or more of the virtual boundaries (1, 2) defining at least a portion of alert zone 1, thereby increasing or decreasing the depth of one or more of the various alert zones (e.g., zone 1).

[0131] The planning button 168C includes a pair of virtual touch buttons for a medical professional to increase or decrease the depth of one or more of the various alert zones (e.g., zone 1). Virtual boundaries (1, 2, 8, 9) can be provided as selectable objects that the medical professional can manipulate as needed. For example, the medical professional can provide input to the GUI 150F (via a touchscreen or user input device) to manually manipulate the virtual boundaries (1, 2) to move one or more of them, thereby adjusting the size (e.g., depth) of the various alert zones (e.g., zone 1). For example, the medical professional can move virtual boundary 2 away from virtual boundary 1 to expand zone 1, or move virtual boundary 2 inward toward virtual boundary 1 to contact zone 1. In another example, the medical professional can adjust a portion of virtual boundary 1 or virtual boundary 2 to exclude or include an anatomical feature.

[0132] The GUI 150F may also include an alarm indicator 172, which is positioned within the display of the L3 vertebra relative to the respective virtual boundaries (1, 2, 8, 9) and / or zone 1. Similar to the description... Figure 8 and Figure 9 The alarm indicator 172 can be located near a specific virtual boundary (e.g., virtual boundaries (1, 2, 8, 9)) and / or individual alert zones (e.g., zone 1), and is configured to indicate to a healthcare professional whether an alarm assigned to a proximity alarm button within a specific virtual boundary (1, 2, 8, 9) and / or zone 1 is activated, deactivated, or paused. For example, an alarm indicator showing a bell with a line passing through it (e.g., 172A, shown as being near a virtual boundary (boundary 8, 9)) indicates that the nearest virtual boundary is deactivated. An alarm indicator without a line passing through the bell (e.g., alarm indicator 172B) indicates that an alarm for the nearest virtual boundary is activated. Although not specifically shown, an alarm indicator 172 with a dotted line passing through the bell can indicate that the alarm indicator is paused. The alarm indicator 172 can also be selectable and / or manipulated by a healthcare professional to activate or deactivate alarms assigned to a specific virtual boundary (e.g., virtual boundaries (boundary 1, 2, 8, 9)) and / or zone 1.

[0133] refer to Figure 11 The user inputs into the planning button 168C to adjust the depth from such... Figure 10 After the adjustment from 2mm to 3mm, GUI 150F (the position of the virtual boundaries (boundaries 1 and 2)) is shown to indicate the corrected attitude. The virtual boundaries (boundaries 7 and 8) are then adjusted from... Figures 10 to 11 This remains unchanged. Additionally, medical professionals have selected alarm button 156D, which is configured to activate various alarms (e.g., alarm 172B).

[0134] Once the healthcare professional is satisfied with the appearance of Zone 1 and / or the virtual boundaries (boundaries 1, 2, 8, 9), they can click the "Apply Vigilance Zone Virtual" button on the GUI 150F, as shown below. Figure 11 As shown. By clicking the virtual button for the application alert zone, the surgical navigation system 100 can propagate the various virtual alert zones applied to the L3 vertebra to the remaining vertebrae in the lumbar region 153.

[0135] Similar to the discussion regarding propagation for implant correction, when a medical professional selects the propagation button 197 on the GUI 150F, the navigation computer 140 can disable the navigation functionality discussed above regarding label 174. The navigation computer 140 can be configured to prompt the medical professional to select one or more labels 174 associated with one or more desired vertebrae from the lumbar region 153 for propagation when the medical professional selects the propagation button 197. In this way, the navigation computer 140 is able to exclude specific vertebrae from the propagation of implant correction within the lumbar region 153.

[0136] Healthcare professionals can opt out of propagating the warning zone correction to the remaining vertebrae by selecting the Approved L3 Vertebra button 194 on the warning zone planning for the remaining vertebrae in lumbar region 153. When a healthcare professional selects the Approved L3 Vertebra button, the default pose of the warning zone will be based on the mapped pose of the vertebral model 145 corresponding to the warning zone.

[0137] The navigation computer 140 may include a warning zone correction database that stores warning zone and virtual boundary correction data (hereinafter collectively referred to as warning zone correction data) and related patient data. The warning zone correction data may include spatial information (e.g., one or more transformations) describing how to correct the warning zone and / or virtual boundary relative to an initial suggested pose, or describing how to correct the spatial information of the warning zone and / or virtual boundary relative to a model warning zone and / or model virtual boundary. The warning zone correction data may also include alarm preferences and depth preferences for each warning zone.

[0138] The navigation computer 140 can access a warning zone correction database to update the pose of the model warning zone and / or the virtual boundaries of the vertebral model, or to suggest warning zones and / or virtual boundaries for future patients while taking into account previous corrections made by a medical professional. For example, the navigation computer 140 can be configured to determine one or more transformations between the initially mapped virtual boundaries of the warning zone and / or the L3 vertebra and the corrected pose of the mapped virtual boundaries of the warning zone and / or the L3 vertebra relative to a first coordinate system. In another example, the navigation computer 140 can store, for example, depth settings (e.g., from...) when a medical professional sets the depth... Figure 10 The 2mm shown is changed to another depth setting (e.g., as shown). Figure 11When the depth is 3 mm (as shown), depth adjustments are made for each warning zone. The navigation computer 140 can be configured to store the change data in a warning zone correction database, which includes warning zone change data from other patients on whom medical professionals have previously performed surgery.

[0139] Based on the alert zone correction data stored in the alert zone correction database, the navigation computer 140 can periodically (e.g., when new patient cases input into the alert zone correction database reach a threshold) retrieve the patient's alert zone correction data from the database. The navigation computer 140 can determine the average alert zone transformation data for all alert zone transformation data stored in the alert zone correction database based on the retrieved alert zone correction data. For example, the navigation computer 140 will determine the average alert zone transformation data for alert zones (zones 1-6). The navigation computer 140 can update the vertebral model 145 to reflect the average zone transformation. For example, when the number of patients reaches a threshold (e.g., one hundred patients) and the average transformation data indicates that the medical professional prefers a greater depth in zone 1 (i.e., a greater distance between virtual boundary 1 and virtual boundary 2), the navigation computer 140 can update the pose of the model alert zone 1 of the vertebral model to reflect the medical professional's preference for greater depth.

[0140] In some cases, the navigation computer 140 can edit the suggested warning zones and / or virtual boundaries based on a warning zone correction database. For example, after the navigation computer has already mapped the model warning zone to the L3 vertebra, such as... Figure 10 As shown, medical professionals can select the preference adjustment button 191 to update the L3 vertebra based on preferences derived from the medical professional, which are determined based on the warning zone correction database.

[0141] The machine learning module can be configured to train a machine learning model based on a warning zone correction database to provide suggested warning zones. For example, the machine learning module can train the machine learning model based on warning zone and / or virtual boundary corrections, alarm settings and depth preferences during previous surgeries, and patient outcomes. The navigation computer 140 can be configured to process image data of each vertebra in the lumbar region 153 and other relevant patient data through the machine learning model to provide suggested warning zones based on historical preferences.

[0142] refer to Figure 12-19The diagrams depict flowcharts illustrating methods according to the teachings of this disclosure. As will be understood from the following description, these methods are merely exemplary and non-limiting flowcharts describing specific methods for implementing the teachings of this disclosure. These methods can be implemented by the surgical navigation system 100 described above. These methods are in no way intended to be used as complete or general methods for implementing the various teachings described above.

[0143] refer to Figure 12 Method 1200 will be described below. At 1204, method 1200 retrieves a three-dimensional vertebral model in a first coordinate system, the three-dimensional vertebral model including (i) multiple model features located in the first coordinate system, and (ii) the orientation of a model region for surgical instruments relative to a key structure in the first coordinate system. At 1208, method 1200 retrieves a three-dimensional medical image in a second coordinate system, the three-dimensional image representing a first vertebra and a second vertebra. At 1212, method 1200 maps the vertebral model including the model region to the first vertebra based on the multiple model features located in the first coordinate system, such that a region for the first vertebra is generated. For example, but not limited to, the vertebral model including the model region can be mapped to a vertebra using the methods described in U.S. Patent Publication No. 2009 / 0089034A1 and U.S. Provisional Patent Application No. 63 / 505,466, filed June 1, 2023 and published as PCT Publication No. __, the contents of each of which are hereby incorporated herein by reference in their entirety. At 1216, method 1200 receives input from a medical professional indicating the corrected pose of the region for the first vertebra in the second coordinate system. At 1220, method 1200 generates a region for the second vertebra based on the corrected pose of the first vertebra.

[0144] In some implementations, the three-dimensional vertebral model may include the poses of multiple model regions, each with a different pose in the coordinate system of the vertebral model. Assuming multiple three-dimensional images of patient vertebrae, each model region may be mapped to one of the patient vertebrae based on multiple model features located in the coordinate system of the model, such that a region for each of the model regions is generated in the coordinate system of the vertebrae, wherein each region has a different pose. Then, in response to receiving input indicating a corrected pose of any of the regions for a vertebra in the coordinate system of that vertebra, a region for a different patient vertebra can be generated based on the corrected pose of that region for a previous vertebra.

[0145] refer to Figure 13Method 1300 will be described below. At 1304, method 1300 retrieves a three-dimensional vertebral model in a first coordinate system. The three-dimensional vertebral model includes multiple model features positioned in the first coordinate system and the pose of a model region for surgical instruments in the first coordinate system. At 1308, method 1300 retrieves a three-dimensional medical image with a first vertebra and a second vertebra in a second coordinate system. At 1312, method 1300 maps the vertebral model including the model region to the first vertebra to generate a region for the first vertebra and a region for the second vertebra. At 1316, method 1300 receives input from a medical professional indicating a corrected pose of the model region of the three-dimensional vertebral model in the first coordinate system. At 1320, method 1300 propagates the corrected pose of the model region to at least one of the regions for the first vertebra and the regions for the second vertebra.

[0146] Referring to Figure 14, method 1400 will be described. At 1404, method 1400 retrieves a three-dimensional medical image of at least one vertebra in a first coordinate system. At 1408, method 900 receives a three-dimensional vertebral model in a second coordinate system. The three-dimensional vertebral model includes a model region for surgical instruments with a pose in the second coordinate system. At 1412, method 900 maps the vertebral model including the model region to a first vertebra based on multiple model features positioned in the second coordinate system, thereby generating a region for the first vertebra. At 1416, method 900 receives input from a medical professional regarding the corrected pose of the region for the at least one vertebra. At 1420, method 900 determines one or more transformations based on the pose of the model region of the three-dimensional vertebral model in the first coordinate system and the corrected pose of the region for the at least one vertebra in the first coordinate system. At 1424, method 1400 stores one or more transformations based on the pose of the model region of the three-dimensional vertebral model in the first coordinate system and the corrected pose of the region for the at least one vertebra in the first coordinate system in a database including transformation data for multiple patients. At 1428, method 1400 determines correction data based on transformation data for multiple patients. At 1432, method 1400 retrieves a three-dimensional medical image of at least one vertebra of a second patient in a third coordinate system. At 1436, method 1400 maps a three-dimensional vertebral model, including a model region, to the second vertebra based on multiple model features located in the third coordinate system and based on the correction data, thereby generating a region for the second vertebra.

[0147] Referring to Figure 15, method 1500 will be described. At 1504, method 1500 receives a three-dimensional medical image having at least one vertebra in a first coordinate system. At 1508, method 1500 receives a three-dimensional vertebral model in a second coordinate system, the three-dimensional vertebral model including the pose of a model region relative to a surgical instrument in the second coordinate system. At 1512, method 1500 maps the vertebral model including the model region to a first vertebra based on multiple model features positioned in the second coordinate system, such that a region for the first vertebra is generated. At 1516, method 1500 receives input from a medical professional regarding the corrected pose of the region for the at least one vertebra. At 1520, method 1500 determines one or more transformations based on the pose of the model region of the three-dimensional vertebral model in the first coordinate system and the corrected pose of the region for the at least one vertebra in the first coordinate system. At 1524, method 1500 stores one or more transformations based on the pose of the model region of the three-dimensional vertebral model in the first coordinate system and the corrected pose of the region for the at least one vertebra in the first coordinate system in a database including transformation data for multiple patients. At 1528, method 1500 determines correction data based on transformation data for multiple patients. At 1532, method 1500 selectively adjusts the pose of a model region of a three-dimensional vertebral model based on the correction data, which can then be used to generate and / or adjust regions for patient vertebrae. For example, in response to receiving another three-dimensional image of at least one vertebra (e.g., from another patient) in a third coordinate system, a three-dimensional vertebral model including the adjusted pose of the model region can be mapped to at least one vertebra in the third coordinate system, such that regions for at least one vertebra are generated for the other three-dimensional image.

[0148] In some cases, selectively adjusting the pose of the model area of ​​a 3D vertebral model can be based on the number of multiple patients for whom calibration data has been obtained. More specifically, this number can be compared to a predefined threshold, and in response to the number of multiple patients exceeding the threshold, the pose of the model area of ​​the 3D vertebral model can be adjusted based on the calibration data.

[0149] In some cases, a three-dimensional vertebral model may include the pose of each of a plurality of model regions used to monitor the position of surgical instruments during surgery. Typically, given a three-dimensional image of at least one vertebra of a patient, the poses of the plurality of model regions of the three-dimensional vertebral model can be defined such that the pose of each model region mapped to at least one vertebra generates regions with different coordinates in the coordinate system of the patient's at least one vertebra. Furthermore, the pose of each model region of the three-dimensional vertebral model can be individually and selectively adjusted in response to receiving an input indicating a corrected pose for a region corresponding to the model region for the patient's at least one vertebra. In other words, in response to an input indicating a corrected pose for a region generated for at least one patient vertebra corresponding to any of the model regions, one or more transformations can be determined based on the pose of that model region in the coordinate system of the three-dimensional vertebral model and the corrected pose of that region in the coordinate system of the patient's three-dimensional image, and these one or more transformations can be stored in the database as described above. Correction data can then be determined based on the transformation data corresponding to that particular model region for multiple patients, and this correction data can be used to selectively adjust the pose of that model region of the three-dimensional vertebral model.

[0150] refer to Figure 16 Method 1600 will be described below. At 1604, method 1600 retrieves a three-dimensional medical image having at least one vertebra in a first coordinate system. At 1608, method 1600 retrieves a three-dimensional vertebral model in a second coordinate system, the three-dimensional vertebral model including the pose of a model area for surgical instruments in the second coordinate system. At 1610, method 1600 maps an initial pose of the area for at least one vertebra in the three-dimensional medical image based on the pose of the model area of ​​the three-dimensional vertebral model. At 1612, method 1600 receives input from a medical professional regarding the corrected pose of the area for at least one vertebra. At 1616, method 1600 analyzes the corrected pose of the area for at least one vertebra relative to the initial pose of the area for at least one vertebra. At 1620, method 1600 stores the analysis of the corrected pose of the area for at least one vertebra relative to the initial pose of the at least one vertebra in a area correction database. At 1624, method 1600 learns the area preferences of the medical professional based on the area correction database.

[0151] Referring to Figure 17, method 1700 will be described. At 1704, method 1700 retrieves a three-dimensional medical image of a first patient in a first coordinate system, the three-dimensional medical image including at least one vertebra. At 1708, method 1700 retrieves a three-dimensional vertebral model in a second coordinate system, the three-dimensional vertebral model including the pose of a model implant in the second coordinate system. At 1712, method 1700 maps the three-dimensional vertebral model including the pose of the model implant to at least one vertebra to generate an initial pose of the planned implant for at least one vertebra in the three-dimensional medical image. At 1716, method 1700 receives input from a medical professional indicating corrections for the implant, the corrections including a corrected pose of the implant. At 1720, method 1700 determines one or more transformations based on the initial pose and the corrected pose of the planned implant. At 1724, method 1700 stores one or more transformations based on the initial pose and the corrected pose of the planned implant for at least one vertebra in a database including implant transformation data for multiple patients. At 1728, Method 1700 determines correction data based on implant transformation data from multiple patients. At 1732, Method 1700 selectively adjusts the orientation of the model implant used in the three-dimensional vertebral model based on the correction data.

[0152] Referring to Figure 18, method 1800 will be described. At 1804, method 1800 retrieves a three-dimensional medical image of a first patient in a first coordinate system, the three-dimensional medical image including at least one vertebra. At 1808, method 1800 retrieves a three-dimensional vertebral model in a second coordinate system, the three-dimensional vertebral model including the pose of a model implant in the second coordinate system. At 1812, method 1800 maps the three-dimensional vertebral model including the pose of the model implant onto at least one vertebra to generate a planned implant pose. At 1816, method 1800 receives input from a medical professional indicating corrections for the planned implant. At 1820, method 1800 determines one or more transformations based on an initial pose and a corrected pose of the planned implant. At 1824, method 1800 stores one or more transformations based on the initial pose and corrected pose of the planned implant in a database including implant transformation data for multiple patients. At 1828, method 1800 determines correction data based on the implant transformation data for multiple patients. At 1832, method 1800 stores the calibration data in an implant calibration database. At 1836, method 1800 retrieves a three-dimensional medical image of a second patient in a third coordinate system, the three-dimensional medical image including at least one vertebra. At 1840, method 1800 maps a three-dimensional vertebra model, including the pose of a model implant, to at least one vertebra of the three-dimensional medical image of the second patient to generate a planned implant pose for at least one vertebra of the three-dimensional medical image of the second patient. At 1844, method 1800 selectively adjusts the pose of the planned implant based on the calibration data.

[0153] refer to Figure 19 Method 1900 will be described below. At 1904, method 1900 retrieves a three-dimensional medical image of a first patient in a first coordinate system, the three-dimensional medical image including at least one vertebra. At 1908, method 1900 retrieves a three-dimensional vertebral model in a second coordinate system, the three-dimensional vertebral model including multiple model regions in multiple poses in the second coordinate system. At 1912, method 1900 retrieves one or more preferences associated with a previous surgery performed by a medical professional. For example, but not limited to, the one or more preferences associated with the previous surgery performed by the medical professional may include selecting one or more model regions from multiple model regions during the previous surgery, and / or selecting edges previously selected by the medical professional to define a region used in the previous surgery. At 1916, method 1900 maps a three-dimensional vertebral model including at least one pose of at least one model region to at least one vertebra based on one or more preferences associated with the previous surgery, such that at least one region for at least one vertebra is generated.

[0154] Terms and Conditions

[0155] Clause 1—A method for mapping a region for controlling a surgical instrument to a three-dimensional medical image, the method comprising: retrieving a three-dimensional bone model in a first coordinate system, the three-dimensional bone model including (i) a plurality of model features located in the first coordinate system and (ii) the pose of a model region for the surgical instrument relative to a key structure in the first coordinate system; retrieving a three-dimensional medical image in a second coordinate system, the three-dimensional image representing a first bone region and a second bone region; mapping the bone model including the model region to the first bone region based on the plurality of model features located in the first coordinate system, such that a region for the first bone region is generated; receiving input from a medical professional, the input indicating a corrected pose of the region of the first bone region in the second coordinate system; and generating a region for the second bone region based on the corrected pose of the region of the first bone region.

[0156] Clause 2—A method for mapping a region for a surgical instrument to a three-dimensional medical image, the method comprising: retrieving a three-dimensional bone model in a first coordinate system, the three-dimensional bone model including a plurality of model features positioned in the first coordinate system and an orientation of a model region for a surgical instrument in the first coordinate system; retrieving a three-dimensional medical image having a first bone region and a second bone region in a second coordinate system; mapping the bone model including the model region to the first bone region to generate a region for the first bone region and a region for the second bone region; receiving input from a medical professional indicating a corrected orientation of the model region of the three-dimensional bone model in the first coordinate system; and propagating the corrected orientation of the model region to at least one of the regions for the first bone region and the regions for the second bone region.

[0157] Clause 3—A method for mapping a region for surgical instruments to a three-dimensional medical image, the method comprising: retrieving a three-dimensional bone model in a first coordinate system, the three-dimensional bone model including (i) a plurality of model features located in the first coordinate system and (ii) a model region for surgical instruments in the first coordinate system; retrieving a three-dimensional medical image of a first patient having at least one bone in a second coordinate system; mapping the three-dimensional bone model including the model region to the at least one bone to generate a region associated with the at least one bone; receiving input regarding a corrected pose of the region for the at least one bone; correcting the pose of the model region based on the corrected pose of the region for the at least one bone; retrieving a three-dimensional medical image of a second patient having at least one bone in a third coordinate system; and mapping the three-dimensional vertebral model including the corrected pose of the model region to the at least one bone of the second patient to generate a region for the at least one bone of the second patient.

[0158] Item 4—A method for adjusting regions for a three-dimensional medical image based on historical preferences of a medical professional, the method comprising: retrieving a three-dimensional medical image having at least one bone in a first coordinate system; receiving a three-dimensional bone model in a second coordinate system, the three-dimensional bone model including the pose of a model region for surgical instruments in the second coordinate system; mapping the bone model including the model region to the first bone based on a plurality of model features located in the second coordinate system, such that a region for the first bone is generated; receiving input from a medical professional regarding a corrected pose of the region for the at least one bone; and adjusting the pose of the model region of the three-dimensional bone model in the first coordinate system and the pose of the region for the at least one bone... The corrected pose of the region in the first coordinate system is used to determine one or more transformations; the pose of the model region in the first coordinate system based on the three-dimensional bone model and the corrected pose of the region in the first coordinate system for the at least one bone are stored in a database including transformation data for multiple patients; correction data is determined based on the transformation data for multiple patients; a three-dimensional medical image of at least one bone of a second patient is retrieved in a third coordinate system; and the three-dimensional bone model including the model region is mapped to the second bone based on the multiple model features located in the third coordinate system and based on the correction data, such that a region for the second bone is generated.

[0159] Clause 5—A method for adjusting a region for a three-dimensional medical image based on historical preferences of a medical professional, the method comprising: retrieving a three-dimensional medical image having at least one bone in a first coordinate system; receiving a three-dimensional bone model in a second coordinate system, the three-dimensional bone model including the pose of a model region for surgical instruments in the second coordinate system; mapping the bone model including the model region to a first bone region based on a plurality of model features located in the second coordinate system, such that a region for the first bone region is generated; receiving input from a medical professional regarding a corrected pose of the region for the at least one bone; determining one or more transformations based on the pose of the model region of the three-dimensional bone model in the first coordinate system and the corrected pose of the region for the at least one bone in the first coordinate system; storing the one or more transformations based on the pose of the model region of the three-dimensional bone model in the first coordinate system and the corrected pose of the region for the at least one bone in the first coordinate system in a database including transformation data for a plurality of patients; determining correction data based on the transformation data for the plurality of patients; and selectively adjusting the pose of the model region of the three-dimensional bone model based on the correction data.

[0160] Clause 6—A method for adjusting regions for a three-dimensional medical image based on historical preferences of a medical professional, the method comprising: retrieving a three-dimensional medical image having at least one bone in a first coordinate system; retrieving a three-dimensional bone model in a second coordinate system, the three-dimensional bone model including the pose of a model region for surgical instruments in the second coordinate system; mapping an initial pose of a region for the at least one bone in the three-dimensional medical image based on the pose of the model region of the three-dimensional bone model; receiving input from a medical professional regarding a corrected pose of the region for the at least one bone; analyzing the corrected pose of the region for the at least one bone relative to the initial pose of the region for the at least one bone; storing the analysis of the corrected pose of the region for the at least one bone relative to the initial pose of the at least one bone in a region correction database; learning the region preferences of the medical professional based on the region correction database; and adjusting the pose of a region for at least one bone for a second patient based on the learned region preferences.

[0161] Clause 7—A method for adjusting a planned implant based on historical preferences of a medical professional, the method comprising: retrieving a three-dimensional medical image of a first patient in a first coordinate system, the three-dimensional medical image including at least one bone; retrieving a three-dimensional bone model in a second coordinate system, the three-dimensional bone model including the pose of a model implant in the second coordinate system; mapping the three-dimensional bone model including the pose of the model implant to the at least one bone to generate an initial pose of the planned implant for the at least one bone in the three-dimensional medical image; receiving input from a medical professional indicating a correction of the implant, the correction including a corrected pose of the implant; determining one or more transformations based on the initial pose of the planned implant and the corrected pose of the planned implant; storing the one or more transformations based on the initial pose of the planned implant for the at least one bone and the corrected pose of the planned implant in a database including implant transformation data for a plurality of patients; determining correction data based on the implant transformation data for the plurality of patients; and selectively adjusting the pose of the model implant for the three-dimensional bone model based on the correction data.

[0162] Clause 8—A method for adjusting the pose of a planned implant based on the historical preferences of a medical professional, the method comprising: retrieving a three-dimensional medical image of a first patient in a first coordinate system, the three-dimensional medical image including at least one bone; retrieving a three-dimensional bone model in a second coordinate system, the three-dimensional bone model including the pose of a model implant in the second coordinate system; mapping the three-dimensional bone model including the pose of the model implant to the at least one bone to generate a pose of the planned implant; receiving input from a medical professional indicating corrections for the planned implant; determining one or more transformations based on the initial pose of the planned implant and the corrected pose of the planned implant; and adjusting the pose of the planned implant based on the initial pose of the model implant. The initial pose and the one or more transformations of the corrected pose are stored in a database including implant transformation data for multiple patients; correction data is determined based on the implant transformation data for the multiple patients; the correction data is stored in an implant correction database; a three-dimensional medical image of a second patient is retrieved in a third coordinate system, the three-dimensional medical image including at least one bone; the three-dimensional bone model including the pose of the model implant is mapped to the at least one bone of the three-dimensional medical image of the second patient to generate a planned implant pose for the at least one bone of the three-dimensional medical image of the second patient; and the pose of the planned implant is selectively adjusted based on the correction data.

[0163] Item 9—A method for adjusting regions based on historical preferences of a medical professional, the method comprising: retrieving a three-dimensional medical image of a first patient in a first coordinate system, the three-dimensional medical image including at least one bone; retrieving a three-dimensional bone model in a second coordinate system, the three-dimensional bone model including multiple poses of multiple model regions in the second coordinate system; retrieving one or more preferences associated with a previous surgery performed by the medical professional; and mapping the three-dimensional vertebral model including at least one pose of the at least one model region to the at least one bone based on the one or more preferences associated with the previous surgery, such that at least one region for the at least one bone is generated.

[0164] The foregoing description is illustrative in nature and is in no way intended to limit this disclosure, its application, or its use. The broad teachings of this disclosure can be implemented in various forms. Therefore, while this disclosure includes specific examples, its true scope should not be limited thereto, as other modifications will become apparent upon examination of the drawings, description, and appended claims. It should be understood that one or more steps within the method can be performed in a different order (or simultaneously) without altering the principles of this disclosure. Furthermore, although each example above is described as having certain features, any one or more of those features described with respect to any example of this disclosure can be implemented in any other example and / or combined with features of any other example, even if such combination is not explicitly described. In other words, the described examples are not mutually exclusive, and the permutations and combinations of one or more examples with each other still indicate the scope of this disclosure.

[0165] Spatial and functional relationships between components (e.g., between controllers, circuit elements, semiconductor layers, etc.) are described using various terms, including “connection,” “joint,” “coupled,” “adjacent,” “closely adjacent,” “top,” “above,” “below,” and “set.” Unless explicitly described as “direct,” when describing the relationship between a first component and a second component in the foregoing disclosure, the relationship can be a direct relationship in which no other intermediate components exist between the first component and the second component, or an indirect relationship in which one or more intermediate components (spatial or functional) exist between the first component and the second component.

[0166] As used herein, the phrase "at least one of A, B, and C" should be interpreted as meaning the logic of using non-exclusive OR (A or B or C), and should not be interpreted as meaning "at least one of A, at least one of B, and at least one of C". A subset of terms does not necessarily require an appropriate subset. In other words, a first subset of the first set can be completely consistent with (equal to) the scope of the first set.

[0167] In a diagram, the direction of the arrows (as indicated by the arrows) typically shows the flow of information (e.g., data or instructions) that is relevant to the illustration. For example, when components A and B exchange various types of information, but the information transmitted from component A to component B is relevant to the illustration, the arrow can point from component A to component B. This unidirectional arrow does not imply that no other information is transmitted from component B to component A. Furthermore, for information sent from component A to component B, component B can send a request for that information or an acknowledgment of receipt of that information to component A.

[0168] In this application, which includes the definitions below, the terms "controller" or "module" may be replaced by the term "circuit". The term "controller" may refer to, be part of, or include the following: application-specific integrated circuit (ASIC); programmable system-on-chip (PSoC); digital, analog, or mixed-signal / digital discrete circuit; digital, analog, or mixed-signal / digital integrated circuit; combinational logic circuit; field-programmable gate array (FPGA); processor circuitry (shared, dedicated, or group) that executes code; memory circuitry (shared, dedicated, or group) that stores code executed by the processor circuitry; other suitable hardware components that provide the described functionality; or combinations of some or all of the foregoing, such as in a system-on-chip.

[0169] The controller may include one or more interface circuits having one or more transceivers. In some examples, the interface circuitry may implement a wired or wireless interface for connection to a local area network (LAN) or a wireless personal area network (WPAN). Examples of LANs are IEEE standards 802.11-2016 (also known as the Wi-Fi wireless network standard) and IEEE standard 802.3-2015 (also known as the Ethernet wired network standard). Examples of WPANs are the Bluetooth Special Interest Group's BLUETOOTH wireless network standard and IEEE standard 802.15.4.

[0170] The controller can communicate with other controllers using interface circuitry. Although the controller may be depicted in this disclosure as communicating logically directly with other controllers, in many embodiments, the controller may actually communicate via a communication system. The communication system may include physical and / or virtual network devices such as hubs, switches, routers, gateways, and transceivers. In some embodiments, the communication system is connected to or traverses a wide area network (WAN) such as the Internet. For example, the communication system may include multiple LANs interconnected via the Internet or peer-to-peer leased lines using technologies including Multiprotocol Label Switching (MPLS) and Virtual Private Networks (VPNs).

[0171] In various implementations, the functionality of the controller can be distributed among multiple controllers connected via a communication system. For example, multiple controllers can perform the same functionality assigned by a load balancing system. In another example, the functionality of the controller can be split between a server (also known as a remote or cloud) controller and a client (or user) controller.

[0172] Some or all of the hardware characteristics of the controller can be defined using a language for hardware description, such as IEEE Standard 1364-2005 (commonly referred to as "Verilog") and IEEE Standard 1076-2008 (commonly referred to as "VHDL"). Hardware description languages ​​can be used to manufacture and / or program hardware circuits. In some implementations, some or all of the controller's characteristics can be defined by a language such as IEEE 1666-2005 (commonly referred to as "SystemC"), which covers the code and hardware description described below.

[0173] As described above, the term "code" can include software, firmware, and / or microcode, and can refer to programs, routines, functions, classes, data structures, and / or objects. The term "shared processor circuitry" encompasses a single processor circuitry that executes some or all of the code from multiple controllers. The term "group processor circuitry" includes processor circuitry that executes some or all of the code from one or more controllers in combination with additional processor circuitry. The reference to "multiple processor circuitry" encompasses multiple processor circuitry on a discrete die, multiple processor circuitry on a single die, multiple cores of a single processor circuitry, multiple threads of a single processor circuitry, or a combination thereof. The term "shared memory circuitry" encompasses a single memory circuitry that stores some or all of the code from multiple controllers. The term "group memory circuitry" encompasses memory circuitry that stores some or all of the code from one or more controllers in combination with additional memory.

[0174] The term memory circuitry is a subset of the term computer-readable medium. As used herein, the term computer-readable medium does not cover transient electrical or electromagnetic signals propagating through a medium (e.g., on a carrier wave); therefore, the term computer-readable medium can be considered tangible and non-transient. Non-limiting examples of non-transient computer-readable media are non-volatile memory circuitry (e.g., flash memory circuitry, erasable programmable read-only memory circuitry, or mask read-only memory circuitry), volatile memory circuitry (e.g., static random access memory circuitry or dynamic random access memory circuitry), magnetic storage media (e.g., analog or digital magnetic tape or hard disk drives), and optical storage media (e.g., CDs, DVDs, or Blu-ray discs).

[0175] The apparatus and methods described in this application can be implemented, partially or entirely, by a special-purpose computer created by configuring a general-purpose computer to perform one or more specific functions embodied in a computer program. The aforementioned function blocks and flowchart elements can be used as software specifications, which can be converted into computer programs through the routine work of skilled technicians or programmers.

[0176] A computer program includes processor-executable instructions stored on at least one non-transitory computer-readable medium. A computer program may also include or depend on stored data. A computer program may include a basic input / output system (BIOS) for interacting with the hardware of a special-purpose computer, device drivers for interacting with specific devices of the special-purpose computer, one or more operating systems, user applications, background services, background applications, etc.

[0177] Computer programs can include: (i) descriptive text to be parsed, such as HTML (Hypertext Markup Language), XML (Extensible Markup Language), or JSON (JavaScript Object Representation); (ii) assembly code; (iii) object code generated from source code by a compiler; (iv) source code executed by an interpreter; and (v) source code compiled and executed by a just-in-time (JIT) compiler, etc. As examples only, programs from languages ​​including C, C++, C#, Objective-C, Swift, Haskell, Go, SQL, R, and Lisp can be used. Fortran, Perl, Pascal, Curl, OCaml, HTML5 (Hypertext Markup Language, Fifth Revision), Ada, ASP (Active Server Pages), PHP (PHP: Hypertext Preprocessor), Scala, Eiffel, Smalltalk, Erlang, Ruby, Visual Lua, MATLAB, SIMULINK and We use the syntax of languages ​​including [the language name] to write source code.

Claims

1. A method for mapping a zone for monitoring the position of a surgical instrument to a three-dimensional medical image of a patient's vertebrae during surgery, the method comprising: receiving a three-dimensional vertebral model in a first coordinate system, the three-dimensional vertebral model including a plurality of model features positioned in the first coordinate system and a pose of a model region for the surgical instrument in the first coordinate system; receiving a three-dimensional image in a second coordinate system, the three-dimensional image representing a first vertebra and a second vertebra of the patient; mapping the three-dimensional vertebral model including the model region to the first vertebra based on the plurality of model features positioned in the first coordinate system such that a region for the first vertebra is generated in the second coordinate system; receiving input from a medical professional indicating a revised pose of the zone for the first vertebra in the second coordinate system; as well as A zone for the second vertebra is generated based on the revised pose of the zone for the first vertebra.

2. The method of claim 1, wherein: Generating the zone for the second vertebra based on the revised pose of the zone for the first vertebra includes: mapping the three-dimensional vertebral model including the model region to the second vertebra based on the plurality of model features positioned in the first coordinate system such that the region for the second vertebra is generated in the second coordinate system; and The zone for the second vertebra is edited based on the revised pose of the zone for the first vertebra.

3. The method according to claim 1 or 2, wherein: The zone for the first vertebra and the zone for the second vertebra are defined by a first boundary associated with a critical structure and a second boundary spaced a first distance from the first boundary, the first boundary and the second boundary defining a volume representing the zone.

4. The method according to any one of claims 1 to 3, wherein: The zone for the first vertebra is provided as a user-selectable object, the input corresponding to a manipulation of the user-selectable object.

5. The method of claim 4, wherein: The three-dimensional vertebral model including the model region is mapped to the first vertebra based on the plurality of model features positioned in the first coordinate system such that generating the region for the first vertebra in the second coordinate system includes segmenting the first vertebra within the three-dimensional image.

6. The method according to any one of claims 1 to 5, wherein: The method comprises: Tracking the posture of the surgical instrument; and At least one of controlling a parameter of the surgical instrument and providing an alert is performed based on the tracked pose of the surgical instrument relative to the zone for the first vertebra and the zone for the second vertebra.

7. The method according to any one of claims 1 to 6, wherein: The zone for the first vertebra and the zone for the second vertebra are provided as a grid.

8. The method according to any one of claims 1 to 7, wherein: The three-dimensional medical image represents a third vertebra and a fourth vertebra, and the method comprises: receiving input regarding at least one of the third vertebra and the fourth vertebra; and In response to the input regarding the at least one of the third vertebra and the fourth vertebra and based on the revised pose of the zone for the first vertebra, a zone for the third vertebra or a zone for the fourth vertebra is generated.

9. The method according to any one of claims 1 to 8, wherein: The model region is defined as a first model region, the region for the first vertebra is defined as a first region for the first vertebra, indicating that the three-dimensional vertebral model in the first coordinate system includes a pose of a second model region of the surgical instrument in the first coordinate system, and the second model region has a different pose in the first coordinate system than the first model region, the method comprising: mapping the second model zone to the first vertebra based on the plurality of model features positioned in the first coordinate system such that a second zone for the first vertebra is generated in the second coordinate system, the second zone for the first vertebra having a different pose than the first zone for the first vertebra; receiving input from the medical professional indicating a revised pose for the second region of the first vertebra in the second coordinate system; and A second zone for the second vertebra is generated based on the revised pose for the second zone of the first vertebra.

10. The method according to any one of claims 1 to 9, wherein: The method includes updating the pose of the model region in the first coordinate system based on the revised pose for the region of the first vertebra.

11. A method for mapping a zone for monitoring the position of a surgical instrument to a three-dimensional medical image of a patient's vertebrae during surgery, the method comprising: receiving a three-dimensional vertebral model in a first coordinate system, the three-dimensional vertebral model including a plurality of model features positioned in the first coordinate system and a pose of a model region for the surgical instrument in the first coordinate system; receiving a three-dimensional image having a first vertebra and a second vertebra of the patient in a second coordinate system; mapping the three-dimensional vertebral model including the model regions to the first vertebra based on the plurality of model features positioned in the first coordinate system to generate a region for the first vertebra and a region for the second vertebra in the second coordinate system; receiving input from a medical professional indicating a revised pose of the model region of the three-dimensional vertebral model in the first coordinate system; as well as The modified pose of the model region is propagated to at least one of the region for the first vertebra and the region for the second vertebra.

12. A method for mapping a zone for monitoring the position of a surgical instrument to a three-dimensional image of at least one patient's vertebra during surgery, the method comprising: receiving a three-dimensional vertebral model in a first coordinate system, the three-dimensional vertebral model including a plurality of model features positioned in the first coordinate system and a pose of a model region for the surgical instrument in the first coordinate system; receiving a three-dimensional image of at least one vertebra of a first patient in a second coordinate system; mapping the three-dimensional vertebral model including the model region to the at least one vertebra based on the plurality of model features positioned in the first coordinate system to generate a region for the at least one vertebra in the second coordinate system; receiving input regarding a revised pose of the zone for the at least one vertebra in the second coordinate system; modifying the pose of the model region in the first coordinate system based on the modified pose of the region for the at least one vertebra; receiving a three-dimensional image of at least one vertebra of a second patient in a third coordinate system; as well as The three-dimensional vertebral model including the modified pose of the model zone is mapped to the at least one vertebra of the second patient based on the plurality of model features positioned in the first coordinate system to generate a zone for the at least one vertebra of the second patient in the third coordinate system.

13. A method for adjusting a region of a three-dimensional image for at least one patient vertebra according to a medical professional's historical preferences for use in monitoring the position of a surgical instrument during surgery, the method comprising: receiving a three-dimensional image having at least one vertebra of a first patient in a first coordinate system; receiving a three-dimensional vertebral model in a second coordinate system, the three-dimensional vertebral model including a plurality of model features positioned in the second coordinate system and a pose of a model region for the surgical instrument in the second coordinate system; mapping the three-dimensional vertebral model including the model region to the at least one vertebra based on the plurality of model features positioned in the second coordinate system such that a region for the at least one vertebra is generated in the first coordinate system; receiving input from the medical professional regarding a revised pose of the zone for the at least one vertebra in the first coordinate system; determining one or more transformations based on the pose of the model region of the three-dimensional vertebral model in the second coordinate system and the modified pose of the region for the at least one vertebra in the first coordinate system; storing the one or more transformations based on the pose of the model region for the three-dimensional vertebral model in the second coordinate system and the modified pose of the region for the at least one vertebra in the first coordinate system in a database including transformation data for a plurality of patients; determining correction data based on the transformed data for the plurality of patients; receiving a three-dimensional image having at least one vertebra of a second patient in a third coordinate system; as well as The three-dimensional vertebral model including the model region is mapped to the at least one vertebra of the second patient based on the plurality of model features positioned in the second coordinate system and based on the correction data such that a region for the at least one vertebra of the second patient is generated in the third coordinate system.

14. The method of claim 13, wherein: Determining the correction data includes: receiving the transformed data for the plurality of patients from the database; and An average transform is determined based on the transform data.

15. The method according to claim 13 or 14, wherein: Determining the correction data based on the transformed data is performed by a machine learning algorithm.

16. A method for adjusting a region of a three-dimensional image for at least one patient vertebra according to a medical professional's historical preferences for use in monitoring the position of a surgical instrument during surgery, the method comprising: receiving a three-dimensional image having at least one vertebra of a patient in a first coordinate system; receiving a three-dimensional vertebral model in a second coordinate system, the three-dimensional vertebral model including a plurality of model features positioned in the second coordinate system and a pose of a model region for the surgical instrument in the second coordinate system; mapping the three-dimensional vertebral model including the model region to the at least one vertebra based on the plurality of model features positioned in the second coordinate system such that a region for the at least one vertebra is generated in the first coordinate system; receiving input from the medical professional regarding a revised posture for the zone of the at least one vertebra; determining one or more transformations based on the pose of the model region of the three-dimensional vertebral model in the second coordinate system and the modified pose of the region for the at least one vertebra in the first coordinate system; storing the one or more transformations based on the pose of the model region for the three-dimensional vertebral model in the second coordinate system and the modified pose of the region for the at least one vertebra in the first coordinate system in a database including transformation data for a plurality of patients; determining correction data based on the transformed data for the plurality of patients; as well as The pose of the model region of the three-dimensional vertebral model is selectively adjusted based on the correction data.

17. The method of claim 16, wherein: The method includes comparing a number of the plurality of patients for which the correction data has been obtained to a threshold, and selectively adjusting the pose of the model region of the three-dimensional vertebral model based on the correction data in response to the number of the plurality of patients exceeding the threshold.

18. The method according to claim 16 or 17, wherein: The three-dimensional image is defined as a first three-dimensional image, and the method comprises: receiving a second three-dimensional image having at least one vertebra in a third coordinate system; receiving the three-dimensional vertebral model in the second coordinate system, the three-dimensional vertebral model including an adjusted pose of the model region of the surgical instrument in the second coordinate system; and The three-dimensional vertebral model including the adjusted pose of the model region is mapped to the at least one vertebra in the third coordinate system such that a region is generated for the at least one vertebra of the second three-dimensional image.

19. The method according to any one of claims 16 to 18, wherein: The transformation data are defined as first transformation data, the correction data are defined as first correction data, the region of the three-dimensional image for the at least one vertebra is defined as a first region, and the three-dimensional vertebral model comprises a pose of a second model region for the surgical instrument in the second coordinate system, the method comprising: mapping the pose of the second model region to the at least one vertebra of the three-dimensional image in the first coordinate system so as to generate a second region having different coordinates than the first region; receiving input from the medical professional regarding a revised posture of the second zone for the at least one vertebra; determining second transformation data based on the pose of the second model region for the at least one vertebra and the revised pose of the second region; determining second correction data based on the number of transformed data for the plurality of patients; and The pose of the second model region of the three-dimensional vertebral model is selectively adjusted based on the second correction data.

20. The method according to any one of claims 16 to 19, wherein: The at least one vertebra of the three-dimensional image is defined as a first vertebra, the transformation data is defined as first transformation data, and the three-dimensional image includes a second vertebra in the first coordinate system, the method comprising: generating a pose of a second region for the second vertebra in the first coordinate system of the three-dimensional image based on the pose of the model region of the three-dimensional vertebral model; receiving input from the medical professional regarding a revised posture for the second zone of the second vertebra; determining second transformation data based on the pose of the model region and the revised pose of the second region for the second vertebra; determining second correction data based on the second transformed data; and The pose of the zone of at least one vertebra of the second patient is adjusted based on the second correction data.

21. A method for adjusting a region of a three-dimensional image for at least one patient vertebra according to a medical professional's historical preferences for use in monitoring the position of a surgical instrument during surgery, the method comprising: receiving a three-dimensional image having at least one vertebra of a patient in a first coordinate system; receiving a three-dimensional vertebral model in a second coordinate system, the three-dimensional vertebral model including a pose of a model region for the surgical instrument in the second coordinate system; generating an initial pose of a region of the three-dimensional image for the at least one vertebra in the first coordinate system based on the pose of the model region of the three-dimensional vertebral model; receiving input from the medical professional regarding a revised posture for the zone of the at least one vertebra; comparing the revised pose for the zone of the at least one vertebra to the initial pose for the zone of the at least one vertebra; storing said comparison of said revised pose for said zone of said at least one vertebra with said initial pose for said zone of said at least one vertebra in a zone correction database; learning the medical professional's zone preferences based on the zone correction database; as well as A posture of a zone for at least one vertebra of a second patient is adjusted based on the learned zone preference.

22. A method for adjusting a planned implant for at least one vertebra based on a medical professional's historical preferences, the method comprising: receiving a three-dimensional image of a first patient in a first coordinate system, the three-dimensional image including at least one vertebra of the patient; receiving a three-dimensional vertebral model in a second coordinate system, the three-dimensional vertebral model including a pose of a model implant in the second coordinate system; mapping the three-dimensional vertebral model including the pose of the model implant to the at least one vertebra to generate an initial pose of the planned implant for the at least one vertebra of the three-dimensional image in the first coordinate system; receiving input from the medical professional indicating a revised pose of the planned implant for the at least one vertebra in the first coordinate system; determining one or more transformations based on the initial pose of the planning implant and the revised pose of the planning implant for the at least one vertebra; storing the one or more transformations based on the initial pose of the planned implant for the at least one vertebra and the revised pose of the planned implant in a database including implant transformation data for a plurality of patients; determining correction data based on the implant transformation data for the plurality of patients; and The pose of the model implant for the three-dimensional vertebral model is selectively adjusted based on the correction data.

23. The method of claim 22, wherein: The correction data includes a diameter of the planned implant, a length of the planned implant, and a guard zone or virtual boundary associated with the planned implant.

24. A method for adjusting a planned implant for at least one vertebra based on a medical professional's historical preferences, the method comprising: receiving a three-dimensional image of a first patient in a first coordinate system, the three-dimensional image including at least one vertebra of the first patient; receiving a three-dimensional vertebral model in a second coordinate system, the three-dimensional vertebral model including a pose of a model implant in the second coordinate system; mapping the three-dimensional vertebral model including the pose of the model implant to the at least one vertebra to generate an initial pose of a planned implant for the at least one vertebra in the first coordinate system; receiving input from the medical professional indicating a revised pose of the planned implant of the at least one vertebra in the first coordinate system; determining one or more transformations based on the initial pose of the planning implant and the revised pose of the planning implant for the at least one vertebra; storing the one or more transformations based on the initial pose of the planned implant for the at least one vertebra and the revised pose of the planned implant in a database including implant transformation data for a plurality of patients; determining correction data based on the implant transformation data for the plurality of patients; storing the correction data in an implant correction database; receiving a three-dimensional image of a second patient in a third coordinate system, the three-dimensional image including at least one vertebra of the second patient; mapping the three-dimensional vertebral model including the pose of the model implant to the at least one vertebra of the second patient to generate a pose of the planned implant for the at least one vertebra of the second patient in the third coordinate system; as well as The pose of the planned implant for the at least one vertebra of the second patient is selectively adjusted based on the correction data.

25. The method of claim 24, wherein: The method includes receiving input from the medical professional, the input indicating a desire to adjust the posture of the planned implant for the at least one vertebra of the second patient based on the historical preferences of the medical professional, and in response to the input of the medical professional, performing selective adjustment of the posture of the planned implant for the at least one vertebra of the second patient based on the correction data.

26. A method for adjusting a region of a three-dimensional image for at least one patient vertebra based on a medical professional's historical preferences for use in monitoring the position of a surgical instrument during surgery, the method comprising: receiving a three-dimensional image of a first patient in a first coordinate system, the three-dimensional image including at least one vertebra of the first patient; receiving a three-dimensional vertebral model in a second coordinate system, the three-dimensional vertebral model including a pose of each of a plurality of model regions for the surgical instrument in the second coordinate system; receiving one or more preferences associated with previous procedures performed by the medical professional; selecting the pose for at least one of the model regions of the surgical instrument based on the one or more preferences; as well as The three-dimensional vertebral model is mapped to the at least one vertebra based on a selected pose of at least one of the model zones such that at least one zone for the at least one vertebra is generated in the first coordinate system.

27. The method of claim 26, wherein: The one or more preferences associated with the previous procedure include selection by the medical professional of one or more model regions from the plurality of model regions.

28. The method of claim 26 or 27, wherein: The one or more preferences associated with the prior procedure include a margin for defining a region relative to a critical structure.

29. A surgical navigation system, wherein: The surgical navigation system includes one or more controllers configured to perform the method of any of claims 1-28.

30. A computer program product, wherein: The computer program product comprises a non-transitory computer readable medium storing computer executable instructions which, when executed by at least one processor or processing device, cause the at least one processor or processing device to perform the method of any one of claims 1-28.

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