Stereotactic surgery apparatus and method

Claim 2

Stereotactic frame apparatus adapted for use in performing stereotactic surgery with an X-ray CT scanner, said stereotactic frame apparatus comprising: a stereotactic frame defining a three-dimensional coordinate system which can be fixed with respect to the anatomy of a living patient, said stereotactic frame including mechanism for positioning a desired surgical device within said anatomy at any desired location defined in terms of said three-dimensional coordinate system, and X-ray detectable fiducial marker means associated with said stereotactic frame defining at least three non-collinear points within each planar cross-section therethrough, said marker means including means for determining the three-dimensional coordinates of said three points in each said cross-section whereby a scan in any single plane provides the three-dimensional coordinates of said three noncollinear points.

Claim 3

Apparatus as in claim 1 wherein said X-ray detectable fiducial markers comprise: a member having an X-ray detectable feature which intersects any said cross-section at a location which varies depending upon the relative disposition of the cross-section.

Claim 4

An improved stereotactic surgery frame of the type defining a three-dimensional coordinate system which can be fixed with respect to the anatomy of a living patient and which can thereafter position a desired surgical device within such anatomy at any desired location defined in terms of said three-dimensional coordinate system, said improvement comprising: X-ray detectable fiducial markers physically associated with said frame and defining at least three measurable noncollinear fiducial points, each having predetermined visually determinable three-dimensional coordinates within a single cross-sectional depiction taken through the combination of said anatomy and of said frame and its associated fiducial markers.

Claim 5

An improved stereotactic surgery frame of the type defining a three-dimensional coordinate system which can be fixed with respect to the anatomy of a living patient and which can thereafter position a desired surgical device within such anatomy at any desired location defined in terms of said three-dimensional coordinate system, said improvement comprising: X-ray detectable fiducial markers physically associated with said frame and defining at least three measurable noncollinear fiducial points, each having predetermined visually determinable three-dimensional coordinates within a single cross-sectional depiction taken through the combination of said anatomy and of said frame and its associated fiducial markers.

Claim 6

An improvement as in claim 3 wherein said fiducial markers comprise: a plate having a variable cross-section extending a predetermined distance with respect to a first dimension, said predetermined distance varying with respect to a second dimension which is inclined with respect to said first dimension.

Claim 7

An improvement as in claim 3 wherein said fiducial markers comprise: a member having a detectable feature which intersects any desired cross-sectional depiction at a location which varies depending upon the relative disposition of the cross-section.

Claim 8

An improvement as in any one of claim 3-5 wherein said fiducial markers are removably attachable to said stereotactic frame.

Claim 11

A method as in claim 7 wherein said scanning step is performed with an X-ray CT scanner.

Claim 12

A method as in claim 7 wherein said fixing step includes the attachment of X-ray detectable fiducial markers to said frame.

Claim 13

A method as in claim 7 wherein said second-mentioned determining step includes counting detectable features associated with said frame at predetermined relative locations and present in said cross-sectional depiction.

Claim 14

A method as in claim 7 wherein said second-mentioned determining step includes measurement of relative distances between detectable features associated with said frame at predetermined relative locations and present in said cross-sectional depiction.

Claim 15

Apparatus for performing three-dimensional stereotactic surgery within the anatomy of a living patient, said apparatus comprising: a tomographic scanner having a programmable data processing computer, a CRT display for depicting the relative densities of elemental volumes with a desired planar cross-sectional slice of matter appropriately placed within the CT scanner, and an operator console for entering data and/or instructions into said computer and for identifying the location and relative positional coordinates of any desired element or portion of said slice; a rigid frame fixably securable with respect to said anatomy and defining a multi-dimensional coordinate system in which surgical devices can be precisely positioned; said frame including plural detectable features which if included as a portion of a single said slice of matter in a single plane, will be represented in said depiction of said cross-sectional slice as a respectively corresponding set of at least three functional points in the plane having predetermined known or readily determinable three-dimensional frame coordinates; and said computer being programmed to compute the three-dimensional frame coordinates of any desired anatomical target depicted within said slice as a function of the frame coordinates of said fiducial points and of the relative positional coordinates of said target and said fiducial points within said CRT display.

Claim 16

Apparatus for performing three-dimensional stereotactic surgery within the anatomy of a living patient, said apparatus comprising: a tomographic scanner having a programmable data processing computer, a CRT display for depicting the relative densities of elemental volumes with a desired planar cross-sectional slice of matter appropriately placed within the CT scanner, and an operator console for entering data and/or instructions into said computer and for identifying the location and relative positional coordinates of any desired element or portion of said slice; a rigid frame fixably securable with respect to said anatomy and defining a multi-dimensional coordinate system in which surgical devices can be precisely positioned; said frame including plural detectable features which if included as a portion of a single said slice of matter in a single plane, will be represented in said depiction of said cross-sectional slice as a respectively corresponding set of at least three functional points in the plane having predetermined known or readily determinable three-dimensional frame coordinates; and said computer being programmed to compute the three-dimensional frame coordinates of any desired anatomical target depicted within said slice as a function of the frame coordinates of said fiducial points and of the relative positional coordinates of said target and said fiducial points within said CRT display.

Claim 17

Apparatus as in claim 12 wherein said rigid frame includes at least one detectable feature disposed along a path connecting dissimilar portions of similar spaced-apart frame structures.

Claim 18

Apparatus as in claim 12 or 13 wherein said rigid frame includes an inclined rod connected between dissimilar portions of two spaced-apart parallel posts.

Claim 21

A method as in claim 15 wherein said scanning step is performed with an x-ray CT scanner.

Claim 22

A method as in claim 15 wherein said fixing step includes the attachment of x-ray detectable fiducial markers to said frame.

Claim 23

A method as in claim 15 wherein said determining step includes counting detectable features associates with said frame at predetermined relative locations and present in said cross-sectional depiction.

Claim 24

A method as in claim 15 wherein said determining step includes measurement of relative distances between detectable features associated with said frame at predetermined relative location and present in said cross-sectional depiction.

Claim 25

An improved stereotactic surgery frame of the type defining a multi-dimensional coordinate system which can be fixed with respect to the anatomy of a living patient and which can thereafter position a desired surgical device within such anatomy at any desired location defined in terms of said multi-dimensional coordinate system, said improvement comprising: fiducial markers physically associated with said frame and defining at least three unique non-collinear measurable fiducial points having determinable three-dimensional coordinates with respect to said frame with a single planar cross-sectional depiction taken through the combination of said anatomy and of said frame and its associated fiducial markers.

Claim 26

An improved stereotactic surgery frame of the type defining a multi-dimensional coordinate system which can be fixed with respect to the anatomy of a living patient and which can thereafter position a desired surgical device within such anatomy at any desired location defined in terms of said multi-dimensional coordinate system, said improvement comprising: fiducial markers physically associated with said frame and defining at least three unique non-collinear measurable fiducial points having determinable three-dimensional coordinates with respect to said frame with a single planar cross-sectional depiction taken through the combination of said anatomy and of said frame and its associated fiducial markers.

Claim 27

Apparatus for use in performing stereotactic surgery, said apparatus comprising: an X-ray CT scanner capable of measuring relative X-ray absorption within elemental volumes of a desired planar cross-section of the anatomy of a living patient and which CT scanner also defines a first multi-dimensional CT scanner coordinate system relative to its own geometrical structure for locating specific anatomical positions with said planar cross-section relative to said first coordinate system, a stereotactic frame defining a second multi-dimensional coordinate system which can be fixed with respect to the anatomy of a living patient, said stereotactic frame including mechanism for positioning a desired surgical device within said anatomy at any desired location defined in terms of said second multi-dimensional coordinate system, and X-ray detectable fiducial markers associated with said stereotactic frame defining plural points within each of said planar cross-sections, each point having determinable coordinates in both said first and said second coordinate systems said CT scanner including means for transforming the measured CT scan coordinates in three dimensions of a desired portion of the anatomy to corresponding three-dimensional coordinates in said second coordinate system thereby facilitating the use of said stereotactic frame during stereotactic surgery.

Claim 28

Apparatus for use in performing stereotactic surgery, said apparatus comprising: an X-ray CT scanner capable of measuring relative X-ray absorption within elemental volumes of a desired planar cross-section of the anatomy of a living patient and which CT scanner also defines a first multi-dimensional CT scanner coordinate system relative to its own geometrical structure for locating specific anatomical positions with said planar cross-section relative to said first coordinate system, a stereotactic frame defining a second multi-dimensional coordinate system which can be fixed with respect to the anatomy of a living patient, said stereotactic frame including mechanism for positioning a desired surgical device within said anatomy at any desired location defined in terms of said second multi-dimensional coordinate system, and X-ray detectable fiducial markers associated with said stereotactic frame defining plural points within each of said planar cross-sections, each point having determinable coordinates in both said first and said second coordinate systems said CT scanner including means for transforming the measured CT scan coordinates in three dimensions of a desired portion of the anatomy to corresponding three-dimensional coordinates in said second coordinate system thereby facilitating the use of said stereotactic frame during stereotactic surgery.

Claim 29

An improved stereotactic surgery frame of the type defining a three-dimensional coordinate system which can be fixed with respect to the anatomy of a living patient and which can thereafter position a desired surgical device within such anatomy at any desired location defined in terms of said three-dimensional coordinate system, said improvement comprising: fiducial markers physically associated with said frame and defining at least three measurable non-collinear fiducial points within a cross-sectional depiction taken through the combination of said anatomy and of said frame and its associated fiducial markers. said fiducial markers including a plate having a variable cross-section extending a predetermined distance with respect to a first dimension, said predetermined distance varying with respect to a second dimension which is inclined with respect to said first dimension, and said plate having a series of parallel elongated structures with different respective lengths.

Claim 30

An improved stereotactic surgery frame of the type defining a three-dimensional coordinate system which can be fixed with respect to the anatomy of a living patient and which can thereafter position a desired surgical device within such anatomy at any desired location defined in terms of said three-dimensional coordinate system, said improvement comprising: fiducial markers physically associated with said frame and defining at least three measurable non-collinear fiducial points within a cross-sectional depiction taken through the combination of said anatomy and of said frame and its associated fiducial markers. said fiducial markers including a plate having a variable cross-section extending a predetermined distance with respect to a first dimension, said predetermined distance varying with respect to a second dimension which is inclined with respect to said first dimension, and said plate having a series of parallel elongated structures with different respective lengths.

Claim 31

An improved stereotactic surgery frame of the type defining a three-dimensional coordinate system which can be fixed with respect to the anatomy of a living patient and which can thereafter position a desired surgical device within such anatomy at any desired location defined in terms of said three-dimensional coordinate system, said improvement comprising: fiducial markers physically associated with said frame and defining at least three measurable non-collinear fiducial points within a cross-sectional depiction in a plane taken through the combination of said anatomy and of said frame and its associated fiducial markers, said fiducial markers including a member having an X-ray detectable feature which intersects any desired cross-sectional depiction at a location which varies depending upon the relative disposition of the cross-section, and said member comprising a plate having a series of parallel elongated structures with different respective lengths.

Claim 32

An improved stereotactic surgery frame of the type defining a three-dimensional coordinate system which can be fixed with respect to the anatomy of a living patient and which can thereafter position a desired surgical device within such anatomy at any desired location defined in terms of said three-dimensional coordinate system, said improvement comprising: fiducial markers physically associated with said frame and defining at least three measurable non-collinear fiducial points within a cross-sectional depiction in a plane taken through the combination of said anatomy and of said frame and its associated fiducial markers, said fiducial markers including a member having an X-ray detectable feature which intersects any desired cross-sectional depiction at a location which varies depending upon the relative disposition of the cross-section, and said member comprising a plate having a series of parallel elongated structures with different respective lengths.

Claim 33

An improvement as in claim 22 or 23 wherein said parallel elongated structures are regularly spaced and of substantially equal dimensions and wherein said respective lengths progressively increase or decrease from one structure to the next.

Claim 34

An improvement as in any of claims 22 or 23 comprising a plurality of said plates each being adapted for physical attachment to a respectively corresponding portion of said stereotactic frame.

Claim 35

Apparatus for performing three-dimensional stereotactic surgery within the anatomy of a living patient, said apparatus comprising: a tomographic scanner having a programmable data processing computer, a CRT display for depicting of the relative densities of elemental volumes within a desired planar cross-sectional slice of matter appropriately placed with the CT scanner, and an operator console for entering data and instructions into said computer and for identifying the location and relative positional coordinates of any desired element or portion of said slice; a rigid frame fixably securable with respect to said anatomy and defining a multi-dimensional coordinate system in which surgical devices can be precisely positioned; said frame including plural detectable features which, if included as a portion of said matter, will be represented in said depiction of said planar cross-sectional slice as respectively corresponding plural fiducial points having predetermined known or readily determinable frame coordinates; and said computer being programmed to compute the frame coordinates of any desired anatomical target depicted within said slice as a function of the frame coordinates of said fiducial points and of the relative positional coordinates of said target and said fiducial points with said CRT display, said rigid frame including three fiducial plates, each having a plurality of parallel elongated structures of varying length.

Claim 36

Apparatus for performing three-dimensional stereotactic surgery within the anatomy of a living patient, said apparatus comprising: a tomographic scanner having a programmable data processing computer, a CRT display for depicting of the relative densities of elemental volumes within a desired planar cross-sectional slice of matter appropriately placed with the CT scanner, and an operator console for entering data and instructions into said computer and for identifying the location and relative positional coordinates of any desired element or portion of said slice; a rigid frame fixably securable with respect to said anatomy and defining a multi-dimensional coordinate system in which surgical devices can be precisely positioned; said frame including plural detectable features which, if included as a portion of said matter, will be represented in said depiction of said planar cross-sectional slice as respectively corresponding plural fiducial points having predetermined known or readily determinable frame coordinates; and said computer being programmed to compute the frame coordinates of any desired anatomical target depicted within said slice as a function of the frame coordinates of said fiducial points and of the relative positional coordinates of said target and said fiducial points with said CRT display, said rigid frame including three fiducial plates, each having a plurality of parallel elongated structures of varying length.

Claim 37

Stereotactic frame apparatus adapted for use in performing stereotactic surgery, said apparatus comprising: an X-ray CT scanner means capable of measuring relative X-ray absorption within elemental volumes of a desired cross-section of the anatomy of a living patient and which CT scanner means defines a first three-dimensional CT scanner coordinate system relative to its own geometrical structure for locating specific anatomical positions within said cross-section relative to said first coordinate system, a stereotactic frame defining a second three-dimensional coordinate system which can be fixed with respect to the anatomy of a living patient, said stereotactic frame including mechanism for positioning a desired surgical device within said anatomy at any desired location defined in terms of said second three-dimensional coordinate system, and X-ray detectable fiducial markers associated with said stereotactic frame defining at least three non-collinear points within each of said cross-sections, each point having determinable coordinates in both said first and said second coordinate systems such that the measured CT scan coordinates of a desired portion of the anatomy can be transformed to corresponding coordinates in said second coordinate system thereby facilitating the use of said stereotactic frame during stereotactic surgery, each of said X-ray detectable fiducial markers comprising a member having a series of parallel elongated structures therein with different respective lengths and interacting any said cross-section at a location which varies depending upon the relative disposition of the cross-section.

Claim 38

Stereotactic frame apparatus adapted for use in performing stereotactic surgery, said apparatus comprising: an X-ray CT scanner means capable of measuring relative X-ray absorption within elemental volumes of a desired cross-section of the anatomy of a living patient and which CT scanner means defines a first three-dimensional CT scanner coordinate system relative to its own geometrical structure for locating specific anatomical positions within said cross-section relative to said first coordinate system, a stereotactic frame defining a second three-dimensional coordinate system which can be fixed with respect to the anatomy of a living patient, said stereotactic frame including mechanism for positioning a desired surgical device within said anatomy at any desired location defined in terms of said second three-dimensional coordinate system, and X-ray detectable fiducial markers associated with said stereotactic frame defining at least three non-collinear points within each of said cross-sections, each point having determinable coordinates in both said first and said second coordinate systems such that the measured CT scan coordinates of a desired portion of the anatomy can be transformed to corresponding coordinates in said second coordinate system thereby facilitating the use of said stereotactic frame during stereotactic surgery, each of said X-ray detectable fiducial markers comprising a member having a series of parallel elongated structures therein with different respective lengths and interacting any said cross-section at a location which varies depending upon the relative disposition of the cross-section.

Claim 39

Apparatus as in claim 27 wherein said parallel elongated structures are regularly spaced and of substantially equal dimensions and wherein said respective lengths progressively increase or decrease from one slot to the next.

Claim 40

Apparatus as in claim 27 or 28 comprising a plurality of said members each being adapted for physical attachment to a respectively corresponding portion of said stereotactic frame.

Claim 41

Apparatus as in claim 27 or 28 wherein said X-ray detectable fiducial markers are removably attachable to said stereotactic frame.

Claim 42

Stereotactic frame apparatus adapted for use in performing stereotactic surgery, said apparatus comprising an X-ray CT scanner means capable of measuring relative X-ray absorption within elemental volumes of a desired cross-section of the anatomy of a living patient and which CT scanner means defines a first three-dimensional CT scanner coordinate system relative to its own geometrical structure for locating specific anatomical positions within said cross-section relative to said first coordinate system, a stereotactic frame defining a second three-dimensional coordinate system which can be fixed with respect to the anatomy of a living patient, said stereotactic frame including mechanism for positioning a desired surgical device within said anatomy at any desired location defined in terms of said second three-dimensional coordinate system, X-ray detectable fiducial markers associated with said stereotactic frame defining at least three non-collinear points within each of said cross-sections, each point having determinable coordinates in both said first and said second coordinate systems such that the measured CT scan coordinates of a desired portion of the anatomy can be transformed to corresponding coordinates in said second coordinate system thereby facilitating the use of said stereotactic frame during stereotactic surgery, said frame including spaced-apart posts; and said markers including a rod extending between dissimilar portions of pairs of said spaced-apart posts.

Claim 43

Stereotactic frame apparatus adapted for use in performing stereotactic surgery, said apparatus comprising an X-ray CT scanner means capable of measuring relative X-ray absorption within elemental volumes of a desired cross-section of the anatomy of a living patient and which CT scanner means defines a first three-dimensional CT scanner coordinate system relative to its own geometrical structure for locating specific anatomical positions within said cross-section relative to said first coordinate system, a stereotactic frame defining a second three-dimensional coordinate system which can be fixed with respect to the anatomy of a living patient, said stereotactic frame including mechanism for positioning a desired surgical device within said anatomy at any desired location defined in terms of said second three-dimensional coordinate system, X-ray detectable fiducial markers associated with said stereotactic frame defining at least three non-collinear points within each of said cross-sections, each point having determinable coordinates in both said first and said second coordinate systems such that the measured CT scan coordinates of a desired portion of the anatomy can be transformed to corresponding coordinates in said second coordinate system thereby facilitating the use of said stereotactic frame during stereotactic surgery, said frame including spaced-apart posts; and said markers including a rod extending between dissimilar portions of pairs of said spaced-apart posts.