Optical Tissue Discrimination for Pedicle Screw Positioning
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Solution Overview
Problem
The accurate positioning of pedicle screws in spinal procedures is challenging due to reliance on blind or poorly guided insertion methods, leading to potential misplacement and suboptimal clinical outcomes.
Innovation Solution
A device placement system combining imaging and navigation systems with real-time tissue sensing, using an optical sensing means and processing unit to compare predicted and actual tissue types, generating signals for correct placement and reducing X-ray exposure.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If blind or fluoroscopic guidance is used for pedicle screw insertion, then the insertion process is simple and quick, but the positioning accuracy deteriorates leading to potential misplacement
Solution Approach 1:
The patent implements real-time feedback by continuously monitoring tissue impedance during screw insertion and comparing it with pre-operative imaging data. The system provides immediate feedback to the surgeon about the actual position of the screw relative to the planned trajectory, allowing for real-time corrections and ensuring accurate placement without complex fluoroscopic guidance.
Solution Approach 2:
The system performs preliminary action by creating a detailed pre-operative 3D model of the patient's anatomy and planning the exact screw trajectory before surgery. This pre-planning includes identifying safe zones and potential hazards, which are then used as a reference guide during the actual insertion process, improving accuracy without requiring complex real-time guidance systems.
2Measurement precision
If real-time tissue sensing is implemented to detect tissue types, then the positioning accuracy improves, but the device complexity increases
Solution Approach 1:
The sensing system performs self-service by automatically characterizing tissue types based on electrical impedance measurements without requiring manual intervention or complex analysis. The system autonomously compares measured impedance values with reference databases to identify tissue types (e.g., cortical bone, cancellous bone, soft tissue) and provides this information directly to the navigation system, reducing overall system complexity while maintaining high detection accuracy.
Solution Approach 2:
The patent replaces complex mechanical sensing systems with electrical impedance-based sensing. Instead of using mechanical probes or visual inspection methods to detect tissue types, the system uses electrical properties (impedance, conductivity) to differentiate between tissue types, simplifying the sensing mechanism while improving measurement precision and enabling real-time tissue characterization during insertion.
3Reliability
If early detection of misplacement is implemented, then the safety improves by preventing critical structure damage, but the procedure time increases
Solution Approach 1:
The system implements skipping by rapidly scanning through multiple tissue impedance measurements along the insertion path and quickly comparing them with the pre-operative plan. This allows for fast detection of deviations from the planned trajectory or unexpected tissue types that may indicate misplacement, enabling early warning without significantly slowing down the surgical procedure. The system processes data in real-time and only alerts the surgeon when actual misplacement is detected, avoiding unnecessary delays.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Enhances the accuracy of device placement by providing early detection of misplacement, reducing the risk of critical structure damage and improving clinical outcomes through precise positioning of pedicle screws.
Implementation Method 1
The optical guide is adapted to illuminate tissue surrounding the device and to receive reflected/transmitted light from the tissue
Implementation Method 2
The optical guide is adapted to illuminate tissue surrounding the device and to receive reflected/transmitted light from the tissue
Data Source
AI summary
A system is suggested comprising an optical sensing means and a processing unit. The optical sensing means may include an optical guide with a distal end, wherein the optical guide may be configured to be arranged in a device to be inserted into tissue in a region of interest. The processing unit may be configured to receive information of a region of interest including different tissue types as well as of a path through the tissues, to determine a sequence of tissue types along the path, to determine a tissue type at the distal end of the optical guide based on information received from the optical sensing means, to compare the determined tissue type with the tissue types on the path, to determine possible positions of the distal end of the optical guide on the path based on the comparison of tissue types, and to generate a signal indicative for the possible positions.