3D Skeletal Image Overlay for Low-Radiation Surgical Guidance

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Solution Overview

Problem

Existing surgical procedures, particularly minimally-invasive and minimally-invasive spine surgeries, rely heavily on fluoroscopic guidance, exposing patients and medical staff to significant radiation, and require expensive Computer Aided Surgery (CAS) systems that limit tool selection and calibration, complicating the navigation process.

Innovation Solution

A method and apparatus that utilize 3D image data registration with unregistered 2D x-ray images to guide surgical tools, enabling precise navigation without continuous line-of-sight tracking, using steerable arms and image processing to align tool positions with pre-planned trajectories, reducing the need for costly CAS systems.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Reliability

If fluoroscopic guidance is used for minimally-invasive surgery, then surgical guidance is achieved, but radiation exposure to patients and medical staff increases significantly

Engineering Contradiction:

Improvesurgical guidanceVSAvoidradiation exposure

Core Design Contradiction:

ReliabilityVSObject-affected harmful factors

Solution Approach 1:

The system creates a virtual copy of the patient's anatomy using pre-operative CT or MRI data to form a 3D model. This virtual model serves as a substitute for continuous fluoroscopic imaging, allowing surgeons to navigate and plan procedures without repeated radiation exposure. The 3D model is registered with the patient's actual anatomy through surface matching algorithms, enabling accurate guidance without ionizing radiation.

Inventive Principle:

Principle #26Copying

Solution Approach 2:

The system performs all necessary imaging and 3D model creation before the surgery begins using CT or MRI scans. The surgical plan is developed in advance using the virtual 3D model, and the model is registered with the patient's anatomy prior to the procedure. This preliminary preparation eliminates the need for continuous intraoperative fluoroscopic imaging, thereby reducing radiation exposure while maintaining surgical guidance.

Inventive Principle:

Principle #10Preliminary action

2Measurement precision

If Computer Aided Surgery (CAS) systems are used for navigation, then surgical precision is improved, but system cost and device complexity increase significantly

Engineering Contradiction:

Improvesurgical precisionVSAvoidsystem cost

Core Design Contradiction:

Measurement precisionVSDevice complexity

Solution Approach 1:

The system extracts only the essential navigation functionality from complex CAS systems by using surface matching algorithms that compare pre-acquired 3D images with intraoperative 2D x-ray images. This extraction approach eliminates the need for expensive robotic arms, electromagnetic tracking systems, and complex registration procedures, achieving surgical precision through a simplified, cost-effective method.

Inventive Principle:

Principle #2Taking out (Extraction)

Solution Approach 2:

The system replaces complex mechanical tracking systems and robotic navigation with a computational approach based on image registration and surface matching. Instead of using expensive mechanical CAS infrastructure, the invention uses software-based 3D model registration with 2D x-ray images, substituting mechanical complexity with algorithmic processing to achieve comparable or superior navigation accuracy.

Inventive Principle:

Principle #28Mechanics substitution (Replace mechanical system)

3Speed

If 2D x-ray images are used for surgical guidance, then real-time imaging is achieved, but radiation exposure increases compared to selective imaging

Engineering Contradiction:

Improvereal-time imagingVSAvoidradiation exposure

Core Design Contradiction:

SpeedVSObject-affected harmful factors

Solution Approach 1:

Instead of continuous fluoroscopic imaging, the system uses periodic, selective 2D x-ray imaging only when needed for verification or critical decision points during surgery. The pre-created 3D model provides continuous guidance between these periodic imaging events, minimizing the frequency and duration of radiation exposure while maintaining real-time surgical capability when actually imaging is performed.

Inventive Principle:

Principle #19Periodic action

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 surgical precision and reduces radiation exposure by allowing precise tool guidance using unregistered imaging devices and steerable arms, improving procedural accuracy and safety while minimizing equipment costs.

Implementation Method 1

a second imaging device to acquire a first 2D x-ray image

Methodology Applied

Scientific EffectX-ray: X-Ray

Data Source

PatentUS12558165B2Apparatus and methods for use with image-guided skeletal procedures

Publication Date: 2026.02.24 SIEMENS HEALTHINEERS AG

AI summary

Radiopaque elements are positioned with respect to a subject's body. Using two x-rays from respective views of the radiopaque elements and a skeletal portion within the body, the location of the radiopaque elements with respect to 3D image data of the skeletal portion is determined. The location of the radiopaque elements within an optical image is identified. The 3D image data is overlaid upon the optical image by aligning (a) the location of the radiopaque elements within the 3D image data with (b) the location of the radiopaque elements within the optical image. A tool is moved to a new location with respect to the skeletal portion and an additional optical image is acquired. The 3D image data is overlaid on the additional optical image and the new location of the tool displayed with respect to the 3D image data. Other applications are also described.