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WO2018005907A1 - Système peropératoire basé sur une grille déformée et son procédé d'utilisation - Google Patents

Système peropératoire basé sur une grille déformée et son procédé d'utilisation Download PDF

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Publication number
WO2018005907A1
WO2018005907A1 PCT/US2017/040173 US2017040173W WO2018005907A1 WO 2018005907 A1 WO2018005907 A1 WO 2018005907A1 US 2017040173 W US2017040173 W US 2017040173W WO 2018005907 A1 WO2018005907 A1 WO 2018005907A1
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WO
WIPO (PCT)
Prior art keywords
grid
image
anatomical
dimensioned
distortion
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US2017/040173
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English (en)
Inventor
Edouard SAGET
Richard BODDINGTON
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Orthogrid Systems Sarl
Original Assignee
Orthogrid Systems Sarl
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US15/383,975 external-priority patent/US10201320B2/en
Application filed by Orthogrid Systems Sarl filed Critical Orthogrid Systems Sarl
Publication of WO2018005907A1 publication Critical patent/WO2018005907A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
    • G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
    • G09B23/30—Anatomical models
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T7/00—Image analysis
    • G06T7/30—Determination of transform parameters for the alignment of images, i.e. image registration
    • G06T7/33—Determination of transform parameters for the alignment of images, i.e. image registration using feature-based methods
    • G06T7/337—Determination of transform parameters for the alignment of images, i.e. image registration using feature-based methods involving reference images or patches
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3966—Radiopaque markers visible in an X-ray image
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/10—Image acquisition modality
    • G06T2207/10072—Tomographic images
    • G06T2207/10081—Computed x-ray tomography [CT]
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/10—Image acquisition modality
    • G06T2207/10072—Tomographic images
    • G06T2207/10088—Magnetic resonance imaging [MRI]
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/10—Image acquisition modality
    • G06T2207/10116—X-ray image
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/10—Image acquisition modality
    • G06T2207/10116—X-ray image
    • G06T2207/10121—Fluoroscopy
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/10—Image acquisition modality
    • G06T2207/10132—Ultrasound image
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/20—Special algorithmic details
    • G06T2207/20092—Interactive image processing based on input by user
    • G06T2207/20101—Interactive definition of point of interest, landmark or seed

Definitions

  • the subject of this invention is a system for distortion adaptation for use with radiographic grid alignment apparatus (analogue or digital) and method of intra-operative use for joint replacements, spine, trauma fracture reductions and deformity correction and implant placement/alignment.
  • U.S. Patent Publication Number 20090306679 This instrument has three points. The first leg is positioned in the area of the posterior inferior acetabulum, a second leg is positioned in the area of the anterior superior iliac spine and a third leg is positioned on the ileum of the subject. U.S. Patent Publication Number 20090306679. Regarding fracture fixation, or a correction of a deformity or malunion, various devices have also been suggested to support proper reconstruction or reduction of bone fragments. For example, a distal radius volar fixation plate has been suggested to act as an invasive, intra-operative quantitative supporting buttress to fix and provide a reference to the surgeon in order to help realign the broken bony anatomy.
  • the present subject matter includes a distorted dimensioned grid alignment device made from a distortion calibration array, wherein the visualization of the dimensioned grid is deformed to accurately match the quantitative warp amount within an anatomical medical image.
  • the present subject matter includes a method to correct for distortion of an anatomical image captured from an imaging system by registering an anatomical image to a dimensioned grid by selecting at least one anatomical landmark to provide a dimensioned grid with at least one grid indicator; calibrating the dimensioned grid to the image of a patient's anatomy to provide a calibrated dimensioned grid; and deforming the calibrated dimensioned grid to correct for the distortion of the anatomical image to generate a deformed calibrated dimensioned grid image.
  • the method further includes the step of: intra-operatively computing a point of interest in the image of a patient's anatomy with reference to the deformed calibrated dimensioned grid.
  • a grid based intraoperative system made of a non-transitory computer-readable storage medium encoded with computer-readable instructions which form the application software and a processor to process the instructions, wherein the application software includes: a data capture module configured to capture and store a digital image acquired by an imaging device; a grid registration module configured to register an anatomical image to the grid; a distortion adaptation module configured to adapt the grid to correct for the distortion in the anatomical image; and an outcome module configured to provide at least one visual and/or auditory instruction intra-operatively to a user.
  • the data capture module can be configured to obtain data from a sensor.
  • the sensor can be in electronic communication with an augmented or mixed reality grid or trackable.
  • the outcome module in one embodiment of the invention can be an augmented reality display and the outcome module can be a 3D shape model or holographic display.
  • FIG. 1 shows a schematic over-view of an intra-operative deformed grid system.
  • FIG. 2 shows a schematic over-view of the software flow diagram of the system.
  • FIG. 3 shows an exemplary embodiment of a grid.
  • FIG. 4 shows an over- view schematic flow chart of the distortion correction method according to the present invention.
  • FIG. 5A is a screen shot image of a calibration grid and FIG. 5B is a screen shot image of a calibration grid.
  • FIG. 6 shows a schematic over-view of the distortion correction process.
  • FIGS. 7A and 7B are screen shot images of the user view of the distortion correction step.
  • FIG. 8 shows an over-view of the software flow diagram of the auto- segmentation process.
  • FIG. 9 shows an exemplary view of a screen shot of the auto-segmentation process.
  • FIG. 10 shows an exemplary view of a head-up display view of the system. DETAILED DESCRIPTION OF THE INVENTION:
  • the present disclosure begins with acquiring radiographic images, such as an X-ray images, of a patient during a surgical procedure.
  • Digital X-ray images are acquired intra-operatively, during surgical procedures, such as joint replacements, and trauma fracture reductions and deformity correction and implant placement/alignment.
  • the acquired image can be viewed or further processed on a display device.
  • a grid alignment device (analogue or digital) can be used with digital radiographic, ultrasound, CT, or other imaging system images acquired intra-operatively to facilitate alignment or placement of an implant during a surgical procedure.
  • One of the objectives of the current technology is to provide distortion adaptation process to allow the inter-operative use of digital images.
  • a grid based intra-operative system can operate in an intra-operative mode, whereby the surgeon can make use of the system, as a guide for adjusting the placement of an implant in the patient or the correction of a deformity.
  • the dimensioned grid is used to define alignment parameters of anatomy and implant placement in a patient.
  • the grid can be digitally displayed over the anatomy and the surgeon can visually determine alignment and positioning measurements.
  • an alignment grid of geometrical shapes or lines similar to or matching certain anatomical features in specific regions of interest in an anatomical image is used to establish a distortion adaptation of the grid alignment apparatus.
  • the anatomy is aligned intra-operatively, with the distorted anatomical geometrical grid, in any musculoskeletal application, which allows for real time intra-operative placement of implants relative to anatomy as guided by the distorted grid alignment device.
  • a dimensioned grid is secured within the pathway of the radiographic beam (such as attached to the image intensifier).
  • the anatomical image may or may not have distortion, but regardless of the amount of distortion present in the image, the dimensioned grid will be distorted relative to the amount of distortion present in the image, thereby providing visual quantitative analysis possible on a distorted anatomical image with the distortion-adapted dimensioned grid properly overlaid upon diverse point of interests of the anatomical image.
  • the process allows for the acquisition of a pre-operative or intra-operative initial image and that are subjected to a transformation process, such as for example Affine Transformation, thereby adjusting the anatomical points to rotation, translation, and scaling.
  • a transformation process such as for example Affine Transformation
  • another process transformation such as B-spline metric of fit
  • the grid lines of the dimensioned grid are adapted real-time intra-operatively to fit the anatomy, thus producing distorted lines curving to match or fit the musculoskeletal anatomy or shape of the implant or trauma.
  • a grid or a distortion calibration array based intra-operative system 100 for providing a distorted dimensioned grid, such as lines curving to match or fit the musculoskeletal anatomy or the shape of the implant, as shown in distorted intraoperative images.
  • the grid or distortion calibration array based intra-operative system 100 includes a computer workstation 104.
  • the computer workstation 104 is made of: an image data capture unit 106; an image data generating unit 108; a non-transitory computer-readable image data storage medium 110; a processor 112; and computer-readable instructions 120.
  • the non-transitory computer-readable storage medium 110 is encoded with computer-readable instructions, which form the application software 120.
  • the computer workstation 104 also includes an input device 118 such as, a key-board and a display 114, such as a monitor.
  • the grid distortion calibration array based intra-operative system 100 can optionally include a motion-tracking device 116.
  • an image capture unit 106; an image data generating unit 108 and data can be acquired and displayed on AR/Holo lenses, glasses, or heads-up display.
  • the computer workstation 104 is electronically connected to an imaging system 220, such as for example C-arm and flat plate.
  • An object such as a patient 204 is positioned on a table 206 within the imaging system 220.
  • a distortion calibration array 200 such an analogue embodiment, is attached to an image intensifier 208 of the imaging system 220.
  • the dimensioned grid 200 allows the application software 120 to generate a digital representation of the dimensioned grid.
  • the application software 120 includes an image capturing module 300 that captures and stores the digital image acquired by an imaging device 220.
  • the image is in the DICOM image format.
  • the acquired image is sent to the distortion calibration array registration module 400 for registration.
  • the registered distortion calibration array is sent to the distortion adaptation module 500 for adaption of the dimensioned grid.
  • At least one visual and/or auditory instruction is then sent to an outcome module 600.
  • This module presents at least one instruction for the surgeon to adjust the implant placement and/or alignment until the surgeon is satisfied. The functionalities of these software modules will be discussed in detail below.
  • the application software 120 is organized into modules and each module has at least one function block as shown in this figure.
  • a hip alignment embodiment is used as an exemplary surgical procedure to illustrate the detailed operations of each block.
  • the distortion calibration array based intra-operative system 100 disclosed here is not limited to perform only this surgical operation.
  • the present invention may be applicable to other musculoskeletal applications such as arthroplasty surgery for hip, knee, spine, ankle and shoulder as well as trauma surgery for musculoskeletal repair. It will be clear to one skilled in the art that the present invention may be practiced with variations of the specific details described hereinafter.
  • the application software 120 adapts the digital dimensioned grid patterns in real-time intra-operatively to fit the subject's anatomy, thus producing distorted patterns to match or fit the musculoskeletal anatomy or shape of the implant or trauma and producing at least one visual and/or auditory instruction or feedback intra-operatively to a user, such as a surgeon 202.
  • the user 202 reviews the registered anatomical image with the distortion adjusted dimensioned grid. If adjustment of the patient or the diagnostic equipment is required, then the surgeon selects points on the patient anatomy, inputs the selected anatomical points into the work station, such as through the use of an input device 112, or an alternate auto-segmentation can be selected by the surgeon. Once the points are inputted they become pattern indicators for placement of the dimensioned grid.
  • a dimensioned grid 200 is shown.
  • the dimensioned grid 200 can be either analogue or produced digitally. With respect to an embodiment of an analogue dimensioned grid 200, it has a plurality of dimensioned radio-opaque lines, e.g. 230 relating to surgical variables.
  • the portion of the dimensioned grid 200 that is not opaque is radiolucent.
  • the dimensioned grid 200 can include any shape or pattern of geometric nature or text to reference angles, length positioning or targeting.
  • the dimensioned grid 200 can be a single line, a geometrical pattern, number, letter or a complex pattern of multiple lines and geometries that correspond to surgical variables.
  • the grid patterns can be predesigned or constructed intra-operatively in real-time based upon the surgeon's knowledge of anatomy and clinical experience including interpretation of morphometric literature and studies identifying key relationships and dimensions between anatomical landmarks and its application in supporting good surgical technique as it relates to specific procedures.
  • the analogue dimensioned grid 200 is used with an object being imaged intraoperatively with an imaging system 220, such as for example C-arm and flat plate. With respect to a digital dimensioned grid, this form of the dimensioned grid 200 is generated by the application software 120.
  • FIGS. 1 and 4 show a detailed flow diagram of the method of this invention.
  • a digital image is transmitted to a computer workstation 104 with a display to project the digital image.
  • the digital image can be radiographic, MRI or an ultrasound image.
  • the digital image is taken at the command of the surgeon or in one embodiment, the digital image is continuously taken at a predefined interval during the entire operation.
  • the grid based intra-operative system 100 includes a display 114, such as a monitor screen, that is configured to display the digital image, other relevant text and graphic information to the surgeon. It can also be coupled to an input device 112, such as keyboard, mouse, trackball or similar pointing devices, such as an infrared wand, as well as network communication peripherals (not shown) so that it can communicate with other external servers and computers.
  • a display 114 such as a monitor screen
  • an input device 112 such as keyboard, mouse, trackball or similar pointing devices, such as an infrared wand, as well as network communication peripherals (not shown) so that it can communicate with other external servers and computers.
  • grid or distortion calibration array based intraoperative system 100 receives DICOM images from an imaging system 220, such as a C-Arm, from the operative side and DICOM images of the contra-lateral side of the patient. However, in some applications, such as surgery on a pelvis, only an X-ray image of one side is required.
  • an image of an anatomical portion of a patient is captured from Radiographic/CT/MRI/Ultrasound(Step 410) in real time intra-operatively or pre-operatively by a system that processes the image to provide an anatomical image model generation, saves the image and displays the image on a visualization screen (Step 420).
  • a user 202 selects at least one anatomical landmark 310 in the anatomical image on a visualization screen.
  • the display is visually available for surgeon by viewing on a display medium, such as a computer/tablet monitor, imaging system monitor, TV monitor, HUD, mixed reality glasses, augmented reality or holographic device, such as glasses or contact lenses.
  • the digital image can be 2D or a 3D generated shape model.
  • Anatomical landmark 310 selection can be accomplished by a various methods including but not limited to: auto-segmentation where the software uses feature/pattern recognition process to auto-detect known and targeted anatomical landmarks; use of remote infrared device, such as a gyro mouse; voice command; air gestures; gaze (surgeon uses gaze and direction of eye or head motion to control targeting or touching the visualization screen at the selected anatomical landmarks 310.
  • the surgeon inputs the selection of the anatomical landmarks 310 to the workstation 104 manually or through the use of a variety of input devices 112 such as, an infrared wand or an augmented reality device.
  • the application software registers a dimensioned grid 200 with the selected anatomical landmarks 310.
  • the method includes the step of registering an anatomical image to a dimensioned grid by selecting at least one anatomical landmark 310 to provide a dimensioned grid with at least one grid indicator (Step 430).
  • a registration procedure is used to compute the deformation of the digital grid indicators.
  • the initial step in the registration process is calibration (Step 440).
  • the software identifies and recognizes calibration points 520 that are radiopaque in the image. These are of known dimensioned geometries. A grouping of these points is a distortion calibration array 522.
  • the distortion calibration array 522 is placed on the image intensifier 208 or in the field of view of any imaging system 220 so that the known distortion calibration array lines/points are identified when an image is taken and captured. These known patterns are saved for use in the distortion adaptation/correction process (Step 450).
  • the distortion calibration array 522 is removed from visualization on the display medium in order to not obscure and clutter the image with unnecessary lines/points (Step 450).
  • a distortion calibration array 522 in this illustrative embodiment is made a series of lines or points that are placed in order to support the distortion adaptation of the dimensioned grid 200.
  • the distortion calibration array points or lines 520 are radiopaque so that the distortion process can calculate the location of these points/lines 522 relative to the anatomy and quantify the amount of distortion during each image taken. Once these points/lines are identified and used in the distortion process, there is another process that removes the visualization of these points/lines from the anatomical image so that they are not obstructing the surgeons view when he sees the dimensioned grid 200 and the anatomical image.
  • the registration process involves manually or automatically detecting grid landmarks (such as grid line intersections, points, and line segments) on the dimensioned grid 200 superimposed on the anatomical image and then aligning those landmarks via an Affine Registration and a deformation field with corresponding landmarks on a distortion calibration array 522 of known geometry, which is a represented digitally.
  • the method includes the step of deforming the calibrated dimensioned grid to correct for the distortion of the anatomical image to generate a deformed calibrated dimensioned grid image.
  • Known radiopaque lines/points (from distortion calibration array 520) are used to provide a measure of EM distortion in each anatomical image.
  • the distortion is quantified and then the software generated virtual grid is adapted to match the distorted anatomy in each anatomical image 240 (Step 460).
  • the distortion calibration array 200 is of non-uniform design, such that the selected anatomical landmarks 310 are clustered more densely in regions of interest to the surgeon, in order that the deformation correction may be estimated with greater precision in those regions.
  • the deformation estimation proceeds as follows: once selected anatomical landmarks 310 have been identified (either manually or automatically) on the array image, an Affine Transformation that produces the best mapping between corresponding selected anatomical landmarks 310 from the dimensioned grid 200 to the array image is computed.
  • the dimensioned grid is adapted in real-time intra-operatively to fit the patient anatomy, thus producing a distorted grid indicator, such as lines curving that can be used to match or fit the musculoskeletal anatomy or the shape of the implant.
  • the deformation of the grid indicators is then applied in real-time by first applying the Affine Transformation and then warping the grid indicators along the Deformation Field.
  • a grid pattern based upon the anatomical points that was defined and targeted in landmark identification is generated.
  • the software program is configured to compute the amount of distortion in each image and it quantifies this amount relative to the anatomical image and then displays the calculated grid/Image relationship, displaying an image of the patient's anatomy with the quantitatively distorted dimensioned grid image.
  • These deformed grids are tracked in real time with each new image taken.
  • the deformed grid can be positioned relative to anatomy, implant, and fractures auto or manually by the user such as a surgeon (Step 470).
  • Step 480 Numerous equations and formulas are used within the algorithms to calculate: measurements, differences, angles, grid and implant positions, fracture deviations to determine at least one measurement of surgical variables involving the implant or trauma (Step 480).
  • the output module 500 At least one measurement of surgical variables involving the implant or trauma is presented to the user. This facilitates the placement of the implant or treatment of the trauma in the patient (Step 490).
  • the surgeon positions the subject, such as a patient, with respect to the radiographic system, such as an X-ray device.
  • the surgeon obtains a radiographic image, such as an X-ray of an area of interest.
  • the radiographic images are generated and transferred to the workstation with a display device.
  • the anatomical image is displayed and surgeon reviews the radiographic image.
  • Anatomical points are selected by the surgeon and then the grid is registered to the image using image registration based on the selected anatomical landmark points.
  • Image registration is defined as an Affine Transformation of the grid to produce a best fit between predefined landmark points on the grid and their corresponding anatomical landmark points.
  • Affine Transform parameters that produce a best fit may be defined as those parameters that produce the minimal least squares differences between predefined landmark points and anatomical landmark points, but may also include other optimization criteria.
  • an estimation of the 3D pitch and yaw of the patient anatomy may be made using inter-anatomical landmark differences and an assumption of the symmetry of the anatomy of the patient.
  • Measurements and data can also be sent to or communicated with a robotic system, haptic controlled device or touch/force sensor to a mixed/augmented/holographic reality display showing visualization, alignment, and placement of instruments, bones or implants in 2D/3D mixed/augmented/holographic reality image/shape model with the dimensioned grid in a surgical environment in real-time intra-operatively by projecting mixed/augmented reality grid data and image measurements for live mixed/augmented reality tracking of the dimensioned grid, surgical instruments and implant (step 495).
  • the auto-segmentation module is shown.
  • the at least one anatomical landmark 310 selected by the surgeon is automatically selected for each successive anatomical image.
  • Auto-segmentation allows a surgeon to work more rapidly.
  • Auto-segmentation is accomplished through a combination of one or more of the following techniques: intensity thresholding; feature detection on the intensity edges in the image, including shape detection via the Hough Transform or other methods; feature detection followed by registration of a 2D or 3D anatomical atlas with predefined landmark positions.
  • the application software 120 is organized into modules and each module has at least one function block as shown in this figure.
  • Function 810 includes automatic segmentation
  • function 820 includes automatic grid point selection
  • function 830 involves create grid from selected points
  • function 840 involves an overlay of the grid on an anatomical image.
  • the system components include an input of a series of x-ray or fluoroscopic images of a selected surgical site, a system 100 to process the surgical images and an overlay of a virtual, augmented, or holograhic dimensioned grid 200, with an input device 112 to provide manipulation of the dimensioned grid 200 by a user 202, such as a surgeon.
  • the electronic display 114 is an electronic display device, such as a computer monitor, or a heads-up display, such as Glass (Google).
  • the electronic display screen 114 is a video fpv goggle.
  • An output to an electronic display 114 is provided for the user 202 to view the overlay of the series of images and the dimensioned grid 200.
  • the augmented reality or holographic dimensioned grid 200 can be manipulated by the user 202 by looking at anatomic landmarks, then shown on the electronic display 114 that will facilitate locking on the correct alignment/placement of surgical device.
  • the system 100 allows the user 202 to see critical work information right in their field-of-view using a see through visual display and then interact with it using familiar gestures, voice commands, and motion tracking.
  • the data can be stored in data storage 110. Applications include hip, knee, shoulder, elbow, and ankle arthroplasty, trauma fractures and limb deformity correction, spine, and sports medicine procedures such as femoroacetabular impingement PAO.

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Abstract

La présente invention concerne un système et un procédé d'adaptation de distorsion destinés à être utilisés avec un appareil d'alignement de grille d'imagerie (analogique ou numérique) et un procédé d'utilisation peropératoire permettant des remplacements d'articulations, des réductions de fractures dues à des traumatismes de la colonne vertébrale, une correction d'une déformation et un positionnement/alignement d'un implant. Le système fournit une grille d'adaptation de distorsion à suivi de position dynamique en temps réel.
PCT/US2017/040173 2016-06-30 2017-06-30 Système peropératoire basé sur une grille déformée et son procédé d'utilisation Ceased WO2018005907A1 (fr)

Applications Claiming Priority (4)

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US201662357293P 2016-06-30 2016-06-30
US62/357,293 2016-06-30
US15/383,975 2016-12-19
US15/383,975 US10201320B2 (en) 2015-12-18 2016-12-19 Deformed grid based intra-operative system and method of use

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