WO2025120636A1

WO2025120636A1 - Systems and methods for determining movement of one or more anatomical elements

Info

Publication number: WO2025120636A1
Application number: PCT/IL2024/051145
Authority: WO
Inventors: Ido ZUCKER; Yonatan USHPIZIN; Elad Rotman; Niv RAVE; Adi ESS
Original assignee: Mazor Robotics Ltd
Current assignee: Mazor Robotics Ltd
Priority date: 2023-12-06
Filing date: 2024-12-03
Publication date: 2025-06-12
Anticipated expiration: 2026-06-06

Abstract

Systems and methos for determining movement of one or more anatomical elements are provided. First pose information of a first anatomical element may be obtained and used to determine second pose information of a second anatomical element adjacent to the first anatomical element. An updated first pose information may be obtained and compared with the first pose information. Movement of the first anatomical element may be determined when a difference between the first pose information and the updated pose information exceeds a predetermined threshold. Movement of the second anatomical element may be determined based on the movement of the first anatomical element.

Description

SYSTEMS AND METHODS FOR DETERMINING MOVEMENT OF ONE OR MORE

ANATOMICAL ELEMENTS

BACKGROUND

[0001] The present disclosure is generally directed to obtaining pose information of one or more anatomical elements, and relates more particularly to determining movement of the one or more anatomical elements based on the pose information.

[0002] Surgical robots may assist a surgeon or other medical provider in carrying out a surgical procedure, or may complete one or more surgical procedures autonomously. Providing controllable linked articulating members allows a surgical robot to reach areas of a patient anatomy during various medical procedures.

BRIEF SUMMARY

[0003] Example aspects of the present disclosure include:

[0004] A system for determining movement of one or more anatomical elements according to at least one embodiment of the present disclosure comprises at least one processor; and at least one memory storing instructions for execution by the at least one processor that, when executed, cause the at least one processor to: obtain first pose information of a first anatomical element; determine second pose information of a second anatomical element adjacent to the first anatomical element based on the first pose information; obtain an updated first pose information; compare the updated first pose information with the first pose information; determine movement of the first anatomical element when a difference between the first pose information and the updated pose information exceeds a predetermined threshold; and determine movement of the second anatomical element based on the movement of the first anatomical element.

[0005] Any of the aspects herein, wherein the first anatomical element comprises a first vertebra and the second anatomical element comprises a second vertebra.

[0006] Any of the aspects herein, wherein the first pose information is obtained from a sensor configured to determine a pose of the first anatomical element.

[0007] Any of the aspects herein, wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to: obtain third pose information of a third anatomical element spaced from the first anatomical element; obtain updated pose information for at least one of the first pose information or the third pose information; compare the updated first pose information or third pose information with at least one of the first pose information or the third pose information; and determine if at least one of the first anatomical element or the third anatomical element has moved based on the comparison.

[0008] Any of the aspects herein, wherein movement of the second anatomical element is based on the comparison.

[0009] Any of the aspects herein, wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to: orient a reference marker at a first anatomical element, wherein the first pose information and the updated first pose information is obtained using the reference marker. [0010] Any of the aspects herein, wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to: orient a reference marker at the third anatomical element, wherein the third pose information is obtained using the reference marker.

[0011] Any of the aspects herein, wherein the second anatomical element is positioned between the first anatomical element and the third anatomical element.

[0012] Any of the aspects herein, wherein the reference marker is releasably secured to at least one of a first pedicle screw implanted in the first anatomical element or a second pedicle screw implanted in the third anatomical element.

[0013] Any of the aspects herein, wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to: register the first anatomical element and the second anatomical element based on the first pose information; and update the registration when movement of the first anatomical element is determined.

[0014] A system for determining movement of one or more anatomical elements according to at least one embodiment of the present disclosure comprises at least one processor; and at least one memory storing instructions for execution by the at least one processor that, when executed, cause the at least one processor to: obtain first pose information of a first anatomical element; determine second pose information of a second anatomical element adjacent to the first anatomical element based on the first pose information; obtain third pose information of a third anatomical element spaced from the first anatomical element; obtain updated pose information for at least one of the first pose information or the third pose information; compare the updated first pose information or third pose information with at least one of the first pose information or the third pose information; and determine if at least one of the first anatomical element or the third anatomical element has moved based on the comparison.

[0015] Any of the aspects herein, wherein the first anatomical element comprises a first vertebra, the second anatomical element comprises a second vertebra, and the third anatomical element comprises a third vertebra.

[0016] Any of the aspects herein, wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to: determine if the second anatomical element has moved based on the comparison. [0017] Any of the aspects herein, wherein the second anatomical element is positioned between the first anatomical element and the third anatomical element.

[0018] Any of the aspects herein, wherein the reference marker is releasably secured to at least one of a first pedicle screw implanted in the first anatomical element or a second pedicle screw implanted in the third anatomical element.

[0019] A method for determining movement of one or more anatomical elements according to at least one embodiment of the present disclosure comprises orienting a reference marker at a first anatomical element; obtaining first pose information of the reference marker; determining second pose information of a second anatomical element adjacent to the first anatomical element based on the first pose information; orienting the reference marker at a third anatomical element spaced from the first anatomical element; obtaining third pose information of the reference marker; orienting the reference marker at at least one of the first anatomical element or the third anatomical element; obtaining at least one of an updated first pose information or updated second pose information from the reference marker; comparing the updated first pose information or the updated second pose information with at least one of the first pose information or the third pose information; and determining if at least one of the first anatomical element or the third anatomical element has moved based on the comparison.

[0020] Any of the aspects herein, wherein the first anatomical element comprises a first vertebra, the second anatomical element comprises a second vertebra, and the third anatomical element comprises a third vertebra. [0021] Any of the aspects herein, further comprising: determining if the second anatomical element has moved based on the comparison.

[0022] Any of the aspects herein, wherein the reference marker is releasably secured to at least one of a first pedicle screw implanted in the first anatomical element or a second pedicle screw implanted in the third anatomical element.

[0023] Any of the aspects herein, wherein the second anatomical element is positioned between the first anatomical element and the third anatomical element.

[0024] Any aspect in combination with any one or more other aspects.

[0025] Any one or more of the features disclosed herein.

[0026] Any one or more of the features as substantially disclosed herein.

[0027] Any one or more of the features as substantially disclosed herein in combination with any one or more other features as substantially disclosed herein.

[0028] Any one of the aspects/features/embodiments in combination with any one or more other aspects/features/embodiments .

[0029] Use of any one or more of the aspects or features as disclosed herein.

[0030] It is to be appreciated that any feature described herein can be claimed in combination with any other feature(s) as described herein, regardless of whether the features come from the same described embodiment.

[0031] The details of one or more aspects of the disclosure are set forth in the accompanying drawings and the description below. Other features, objects, and advantages of the techniques described in this disclosure will be apparent from the description and drawings, and from the claims.

[0032] The phrases “at least one”, “one or more”, and “and/or” are open-ended expressions that are both conjunctive and disjunctive in operation. For example, each of the expressions “at least one of A, B and C”, “at least one of A, B, or C”, “one or more of A, B, and C”, “one or more of A, B, or C” and “A, B, and/or C” means A alone, B alone, C alone, A and B together, A and C together, B and C together, or A, B and C together. When each one of A, B, and C in the above expressions refers to an element, such as X, Y, and Z, or class of elements, such as Xl-Xn, Yl- Ym, and Zl-Zo, the phrase is intended to refer to a single element selected from X, Y, and Z, a combination of elements selected from the same class (e.g., XI and X2) as well as a combination of elements selected from two or more classes (e.g., Y 1 and Zo). [0033] The term “a” or “an” entity refers to one or more of that entity. As such, the terms “a” (or “an”), “one or more” and “at least one” can be used interchangeably herein. It is also to be noted that the terms “comprising”, “including”, and “having” can be used interchangeably.

[0034] The preceding is a simplified summary of the disclosure to provide an understanding of some aspects of the disclosure. This summary is neither an extensive nor exhaustive overview of the disclosure and its various aspects, embodiments, and configurations. It is intended neither to identify key or critical elements of the disclosure nor to delineate the scope of the disclosure but to present selected concepts of the disclosure in a simplified form as an introduction to the more detailed description presented below. As will be appreciated, other aspects, embodiments, and configurations of the disclosure are possible utilizing, alone or in combination, one or more of the features set forth above or described in detail below.

[0035] Numerous additional features and advantages of the present disclosure will become apparent to those skilled in the art upon consideration of the embodiment descriptions provided hereinbelow.

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS

[0036] The accompanying drawings are incorporated into and form a part of the specification to illustrate several examples of the present disclosure. These drawings, together with the description, explain the principles of the disclosure. The drawings simply illustrate preferred and alternative examples of how the disclosure can be made and used and are not to be construed as limiting the disclosure to only the illustrated and described examples. Further features and advantages will become apparent from the following, more detailed, description of the various aspects, embodiments, and configurations of the disclosure, as illustrated by the drawings referenced below.

[0037] Fig. 1 is a block diagram of a system according to at least one embodiment of the present disclosure;

[0038] Fig. 2 is an illustration of a spinal region of a patient according to at least one embodiment of the present disclosure;

[0039] Fig. 3 is a flowchart according to at least one embodiment of the present disclosure;

[0040] Fig. 4 is a flowchart according to at least one embodiment of the present disclosure; and

[0041] Fig. 5 is a flowchart according to at least one embodiment of the present disclosure. DET AIDED DESCRIPTION

[0042] It should be understood that various aspects disclosed herein may be combined in different combinations than the combinations specifically presented in the description and accompanying drawings. It should also be understood that, depending on the example or embodiment, certain acts or events of any of the processes or methods described herein may be performed in a different sequence, and/or may be added, merged, or left out altogether (e.g., all described acts or events may not be necessary to carry out the disclosed techniques according to different embodiments of the present disclosure). In addition, while certain aspects of this disclosure are described as being performed by a single module or unit for purposes of clarity, it should be understood that the techniques of this disclosure may be performed by a combination of units or modules associated with, for example, a computing device and/or a medical device. [0043] In one or more examples, the described methods, processes, and techniques may be implemented in hardware, software, firmware, or any combination thereof. If implemented in software, the functions may be stored as one or more instructions or code on a computer-readable medium and executed by a hardware-based processing unit. Alternatively or additionally, functions may be implemented using machine learning models, neural networks, artificial neural networks, or combinations thereof (alone or in combination with instructions). Computer- readable media may include non-transitory computer-readable media, which corresponds to a tangible medium such as data storage media (e.g., RAM, ROM, EEPROM, flash memory, or any other medium that can be used to store desired program code in the form of instructions or data structures and that can be accessed by a computer).

[0044] Instructions may be executed by one or more processors, such as one or more digital signal processors (DSPs), general purpose microprocessors (e.g., Intel Core i3, i5, i7, or i9 processors; Intel Celeron processors; Intel Xeon processors; Intel Pentium processors; AMD Ryzen processors; AMD Athlon processors; AMD Phenom processors; Apple A10 or 10X Fusion processors; Apple Al l, A12, A12X, A12Z, or A13 Bionic processors; or any other general purpose microprocessors), graphics processing units (e.g., Nvidia GeForce RTX 2000- series processors, Nvidia GeForce RTX 3000-series processors, AMD Radeon RX 5000-series processors, AMD Radeon RX 6000-series processors, or any other graphics processing units), application specific integrated circuits (ASICs), field programmable logic arrays (FPGAs), or other equivalent integrated or discrete logic circuitry. Accordingly, the term “processor” as used herein may refer to any of the foregoing structure or any other physical structure suitable for implementation of the described techniques. Also, the techniques could be fully implemented in one or more circuits or logic elements.

[0045] Before any embodiments of the disclosure are explained in detail, it is to be understood that the disclosure is not limited in its application to the details of construction and the arrangement of components set forth in the following description or illustrated in the drawings. The disclosure is capable of other embodiments and of being practiced or of being carried out in various ways. Also, it is to be understood that the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use of “including,” “comprising,” or “having” and variations thereof herein is meant to encompass the items listed thereafter and equivalents thereof as well as additional items. Further, the present disclosure may use examples to illustrate one or more aspects thereof. Unless explicitly stated otherwise, the use or listing of one or more examples (which may be denoted by “for example,” “by way of example,” “e.g.,” “such as,” or similar language) is not intended to and does not limit the scope of the present disclosure.

[0046] The terms proximal and distal are used in this disclosure with their conventional medical meanings, proximal being closer to the operator or user of the system, and further from the region of surgical interest in or on the patient, and distal being closer to the region of surgical interest in or on the patient, and further from the operator or user of the system.

[0047] A common challenge in surgical operations using navigation and/or robotic systems is to keep the navigation and/or robotic system registered to the anatomy. Conventional methods may involve placing an optical instrument on the anatomy which links it to the navigation system. The main challenge with this method is that the whole spine is registered to the system based on one element fixed on the spine's last segment (or other movements detected by one optical element fixed on one vertebra) while the detected movements in this position do not necessarily reflect the movements in each vertebra separately. This assumption might decrease the accuracy of a single vertebra and the accuracy of the entire system. In other conventional methods, multiple reference markers may be fixed to multiple vertebrae. In such methods, the reference markers may be fixed to the vertebrae throughout the surgical procedure, which may obstruct or clutter the surgical space. [0048] Thus, embodiments as described in the present disclosure provide for a method that enables indication(s) of each vertebra’s movement separately. A tracker such as a reference marker can be attached or assembled and detached or disassembled from pedicle screws inserted or implanted into one or more vertebrae of a patient. Thus, the reference marker(s) can be removed during operation and can be attached when feedback on the vertebra position is required. The interface shall be rigid and repeatable such that the tracker will return to the same position in a sub-millimetric accuracy.

[0049] Embodiments of the present disclosure provide technical solutions to one or more of the problems of (1) determining movement of one or more vertebrae in a spinal cord, (2) determine movement of one or more anatomical elements, (3) increasing patient and operating team safety. [0050] Turning first to Fig. 1, a block diagram of a system 100 according to at least one embodiment of the present disclosure is shown. The system 100 may be or comprise a surgical system in some cases. In some implementations, a robot 112 or robotic platform may be included in the system 100. While the description provided herein describes a robot 112 or robotic platform, it should be appreciated that the claimed systems and methods may not be limited to use with a robot 112 or robotic platform and that the same or similar systems and methods may be implemented in relation to other platforms and devices.

[0051] The system 100 comprises a computing device 102, one or more imaging devices 112, a robot 114, a navigation system 118, a database 130, and/or a cloud or other network 134. Systems according to other embodiments of the present disclosure may comprise more or fewer components than the system 100. For example, the system 100 may not include the imaging device 112, the robot 114, the navigation system 118, one or more components of the computing device 102, the database 130, and/or the cloud 134.

[0052] The computing device 102 comprises a processor 104, a memory 106, a communication interface 108, and a user interface 110. Computing devices according to other embodiments of the present disclosure may comprise more or fewer components than the computing device 102. [0053] The processor 104 of the computing device 102 may be any processor described herein or any similar processor. The processor 104 may be configured to execute instructions stored in the memory 106, which instructions may cause the processor 104 to carry out one or more computing steps utilizing or based on data received from the imaging device 112, the robot 114, the navigation system 118, the database 130, and/or the cloud 134. [0054] The memory 106 may be or comprise RAM, DRAM, SDRAM, other solid-state memory, any memory described herein, or any other tangible, non-transitory memory for storing computer-readable data and/or instructions. The memory 106 may store information or data useful for completing, for example, any step of the methods 300, 400, and/or 500 described herein, or of any other methods. The memory 106 may store, for example, instructions and/or machine learning models that support one or more functions of the robot 114. For instance, the memory 106 may store content (e.g., instructions and/or machine learning models) that, when executed by the processor 104, enable image processing 120, signal processing 122, and/or registration 124.

[0055] The image processing 120 enables the processor 104 to process image data of an image (received from, for example, the imaging device 112, an imaging device of the navigation system 118, or any imaging device) for the purpose of, for example, identifying information about at least one reference marker such as reference marker 126 depicted in the image. The information may comprise, for example, a pose of the reference marker 126. The reference marker 126 may be attached to an anatomical element such that the pose of the reference marker 126 can be used to determine a pose of the anatomical element. The information obtained from the image processing 120 may enable the system 100 and/or the navigation system 118 to track and/or determine movement of the reference marker 126 and the corresponding anatomical element to which the reference marker 126 is attached or coupled to.

[0056] The sensor processing 122 enables the processor 104 to process sensor data received from, for example, a sensor 128. The sensor data may be processed to obtain, for example, pose information of an anatomical element and/or the reference marker 126 in embodiments where the reference marker 126 is, for example, an electromagnetic marker.

[0057] The registration 124 enables the processor 104 to correlate an image with another image. The registration 124 may enable the processor 104 to also correlate or map identified anatomical elements in one image with identified anatomical elements in another image. The registration 124 also enables the processor 104 to register different coordinate spaces with each other (e.g., navigation coordinate space, patient coordinate space, robotic coordinate space, imaging device coordinate space, etc.).

[0058] Such content, if provided as in instruction, may, in some embodiments, be organized into one or more applications, modules, packages, layers, or engines. Alternatively or additionally, the memory 106 may store other types of content or data (e.g., machine learning models, artificial neural networks, deep neural networks, etc.) that can be processed by the processor 104 to carry out the various method and features described herein. Thus, although various contents of memory 106 may be described as instructions, it should be appreciated that functionality described herein can be achieved through use of instructions, algorithms, and/or machine learning models. The data, algorithms, and/or instructions may cause the processor 104 to manipulate data stored in the memory 106 and/or received from or via the imaging device 112, the robot 114, the database 130, and/or the cloud 134.

[0059] The computing device 102 may also comprise a communication interface 108. The communication interface 108 may be used for receiving image data or other information from an external source (such as the imaging device 112, the robot 114, the navigation system 118, the database 130, the cloud 134, and/or any other system or component not part of the system 100), and/or for transmitting instructions, images, or other information to an external system or device (e.g., another computing device 102, the imaging device 112, the robot 114, the navigation system 118, the database 130, the cloud 134, and/or any other system or component not part of the system 100). The communication interface 108 may comprise one or more wired interfaces (e.g., a USB port, an Ethernet port, a Firewire port) and/or one or more wireless transceivers or interfaces (configured, for example, to transmit and/or receive information via one or more wireless communication protocols such as 802.11a/b/g/n, Bluetooth, NFC, ZigBee, and so forth). In some embodiments, the communication interface 108 may be useful for enabling the device 102 to communicate with one or more other processors 104 or computing devices 102, whether to reduce the time needed to accomplish a computing-intensive task or for any other reason.

[0060] The computing device 102 may also comprise one or more user interfaces 110. The user interface 110 may be or comprise a keyboard, mouse, trackball, monitor, television, screen, touchscreen, and/or any other device for receiving information from a user and/or for providing information to a user. The user interface 110 may be used, for example, to receive a user selection or other user input regarding any step of any method described herein. Notwithstanding the foregoing, any required input for any step of any method described herein may be generated automatically by the system 100 (e.g., by the processor 104 or another component of the system 100) or received by the system 100 from a source external to the system 100. In some embodiments, the user interface 110 may be useful to allow a surgeon or other user to modify instructions to be executed by the processor 104 according to one or more embodiments of the present disclosure, and/or to modify or adjust a setting of other information displayed on the user interface 110 or corresponding thereto.

[0061] Although the user interface 110 is shown as part of the computing device 102, in some embodiments, the computing device 102 may utilize a user interface 110 that is housed separately from one or more remaining components of the computing device 102. In some embodiments, the user interface 110 may be located proximate one or more other components of the computing device 102, while in other embodiments, the user interface 110 may be located remotely from one or more other components of the computer device 102.

[0062] The imaging device 112 may be operable to image anatomical feature(s) (e.g., a bone, veins, tissue, etc.) and/or other aspects of patient anatomy to yield image data (e.g., image data depicting or corresponding to a bone, veins, tissue, etc.). “Image data” as used herein refers to the data generated or captured by an imaging device 112, including in a machine-readable form, a graphical/visual form, and in any other form. In various examples, the image data may comprise data corresponding to an anatomical feature of a patient, or to a portion thereof. The image data may be or comprise a preoperative image, an intraoperative image, a postoperative image, or an image taken independently of any surgical procedure. In some embodiments, a first imaging device 112 may be used to obtain first image data (e.g., a first image) at a first time, and a second imaging device 112 may be used to obtain second image data (e.g., a second image) at a second time after the first time. The imaging device 112 may be capable of taking a 2D image or a 3D image to yield the image data. The imaging device 112 may be or comprise, for example, an ultrasound scanner (which may comprise, for example, a physically separate transducer and receiver, or a single ultrasound transceiver), an 0-arm, a C-arm, a G-arm, or any other device utilizing X-ray-based imaging (e.g., a fluoroscope, a CT scanner, or other X-ray machine), a magnetic resonance imaging (MRI) scanner, an optical coherence tomography (OCT) scanner, an endoscope, a microscope, an optical camera, a thermographic camera (e.g., an infrared camera), a radar system (which may comprise, for example, a transmitter, a receiver, a processor, and one or more antennae), or any other imaging device 112 suitable for obtaining images of an anatomical feature of a patient. The imaging device 112 may be contained entirely within a single housing, or may comprise a transmitter/emitter and a receiver/detector that are in separate housings or are otherwise physically separated. [0063] In some embodiments, the imaging device 112 may comprise more than one imaging device 112. For example, a first imaging device may provide first image data and/or a first image, and a second imaging device may provide second image data and/or a second image. In still other embodiments, the same imaging device may be used to provide both the first image data and the second image data, and/or any other image data described herein. The imaging device 112 may be operable to generate a stream of image data. For example, the imaging device 112 may be configured to operate with an open shutter, or with a shutter that continuously alternates between open and shut so as to capture successive images. For purposes of the present disclosure, unless specified otherwise, image data may be considered to be continuous and/or provided as an image data stream if the image data represents two or more frames per second.

[0064] The robot 114 may be any surgical robot or surgical robotic system. The robot 114 may be or comprise, for example, the Mazor X™ Stealth Edition robotic guidance system. The robot 114 may be configured to position the imaging device 112 at one or more precise position(s) and orientation(s), and/or to return the imaging device 112 to the same position(s) and orientation(s) at a later point in time. The robot 114 may additionally or alternatively be configured to manipulate a surgical tool (whether based on guidance from the navigation system 118 or not) to accomplish or to assist with a surgical task. In some embodiments, the robot 114 may be configured to hold and/or manipulate an anatomical element during or in connection with a surgical procedure. The robot 114 may comprise one or more robotic arms 116. In some embodiments, the robotic arm 116 may comprise a first robotic arm and a second robotic arm, though the robot 114 may comprise more than two robotic arms. In some embodiments, one or more of the robotic arms 116 may be used to hold and/or maneuver the imaging device 112. In embodiments where the imaging device 112 comprises two or more physically separate components (e.g., a transmitter and receiver), one robotic arm 116 may hold one such component, and another robotic arm 116 may hold another such component. Each robotic arm 116 may be positionable independently of the other robotic arm. The robotic arms 116 may be controlled in a single, shared coordinate space, or in separate coordinate spaces.

[0065] The robot 114, together with the robotic arm 116, may have, for example, one, two, three, four, five, six, seven, or more degrees of freedom. Further, the robotic arm 116 may be positioned or positionable in any pose, plane, and/or focal point. The pose includes a position and an orientation. As a result, an imaging device 112, surgical tool, or other object held by the robot 114 (or, more specifically, by the robotic arm 116) may be precisely positionable in one or more needed and specific positions and orientations.

[0066] The robotic arm(s) 116 may comprise one or more sensors that enable the processor 104 (or a processor of the robot 114) to determine a precise pose in space of the robotic arm (as well as any object or element held by or secured to the robotic arm).

[0067] The navigation system 118 may provide navigation for a surgeon and/or a surgical robot during an operation. The navigation system 118 may be any now-known or future-developed navigation system, including, for example, the Medtronic StealthStation™ S8 surgical navigation system or any successor thereof. The navigation system 118 may include one or more cameras or other sensor(s) for tracking one or more reference markers, navigated trackers, or other objects within the operating room or other room in which some or all of the system 100 is located. The one or more cameras may be optical cameras, infrared cameras, or other cameras. In some embodiments, the navigation system 118 may comprise one or more electromagnetic sensors. In various embodiments, the navigation system 118 may be used to track a position and orientation (e.g., a pose) of the imaging device 112, the robot 114 and/or robotic arm 116, and/or one or more surgical tools (or, more particularly, to track a pose of a navigated tracker attached, directly or indirectly, in fixed relation to the one or more of the foregoing). The navigation system 118 may include a display for displaying one or more images from an external source (e.g., the computing device 102, imaging device 112, or other source) or for displaying an image and/or video stream from the one or more cameras or other sensors of the navigation system 118. In some embodiments, the system 100 can operate without the use of the navigation system 118.

The navigation system 118 may be configured to provide guidance to a surgeon or other user of the system 100 or a component thereof, to the robot 114, or to any other element of the system 100 regarding, for example, a pose of one or more anatomical elements, whether or not a tool is in the proper trajectory, and/or how to move a tool into the proper trajectory to carry out a surgical task according to a preoperative or other surgical plan.

[0068] In some embodiments, reference markers 126 (e.g., navigation markers) may be used by the navigation system 118. The reference marker 126 may be used to, for example, determine if an anatomical element has moved. In such embodiments, at least one reference marker 126 may be used to determine a pose of each anatomical element of a plurality of anatomical elements. After the pose of each anatomical element is obtained, the reference marker 126 may be repositioned on any anatomical element to obtain updated pose information. The updated pose information can be used to determine if the anatomical element has moved. In such embodiments, the reference marker 126 may be releasably attached to an implant such as, for example, a pedicle screw implanted in the patient. In any embodiment, an interface between the reference marker 126 and the implant (or any device or anatomical element to which the reference marker 126 is attached to) is rigid to enable repeatable positioning of the reference marker 126 in the same position relative to the implant. Such repeatability beneficially enables the use of the reference marker 126 to determine the pose of multiple anatomical elements and avoids, for example, having multiple reference markers placed on a patient for each anatomical element which may interfere with a surgical procedure. In embodiments where multiple reference markers 126 are used, the reference marker 126 beneficially enables the removal of the reference markers 126 during the surgical procedure. In such embodiments, one or more reference markers 126 may be reattached as needed to verify or check pose(s) of one or more anatomical elements.

[0069] In other embodiments it will be appreciated that reference markers 126 may be placed on the robot 114 (including, e.g., on the robotic arm 116), the imaging device 112, or any other object in the surgical space. The reference markers 126 may include one or more active markers, one or more passive markers, or a combination of active and passive markers. The reference markers 126 may be, for example, light emitting diodes, infrared light emitting diodes, reflective markers, electromagnetic markers, or the like. The reference markers 126 may be tracked by the navigation system 118, and the results of the tracking may be used by the robot 114 and/or by an operator of the system 100 or any component thereof. In some embodiments, the navigation system 118 can be used to track other components of the system (e.g., imaging device 112) and the system can operate without the use of the robot 114 (e.g., with the surgeon manually manipulating the imaging device 112 and/or one or more surgical tools, based on information and/or instructions generated by the navigation system 118, for example).

[0070] Sensor(s) 128 may be used to track and/or sense movement of at least one object or anatomical element (whether by tracking the anatomical element itself and/or the reference marker 126). The movement may be detected by a change in positional data (whether determined visually by, for example, cameras, or by lasers, electromagnetic trackers, etc.). In some examples, the sensor 128 may trigger the computing device 102 to determine a position of the reference marker 126 and/or an anatomical element based on the sensor data and compare the determined position with an expected position of the reference marker 126 and/or the anatomical element to determine if the reference marker 126 and/or the anatomical element has moved.

[0071] The database 130 may store information that correlates one coordinate system to another (e.g., one or more robotic coordinate systems to a patient coordinate system and/or to a navigation coordinate system). The database 130 may additionally or alternatively store, for example, one or more surgical plans (including, for example, pose information about a target and/or image information about a patient’s anatomy at and/or proximate the surgical site, for use by the robot 114, the navigation system 118, and/or a user of the computing device 102 or of the system 100); one or more images useful in connection with a surgery to be completed by or with the assistance of one or more other components of the system 100; and/or any other useful information. The database 130 may be configured to provide any such information to the computing device 102 or to any other device of the system 100 or external to the system 100, whether directly or via the cloud 134. In some embodiments, the database 130 may be or comprise part of a hospital image storage system, such as a picture archiving and communication system (PACS), a health information system (HIS), and/or another system for collecting, storing, managing, and/or transmitting electronic medical records including image data.

[0072] The cloud 134 may be or represent the Internet or any other wide area network. The computing device 102 may be connected to the cloud 134 via the communication interface 108, using a wired connection, a wireless connection, or both. In some embodiments, the computing device 102 may communicate with the database 130 and/or an external device (e.g., a computing device) via the cloud 134.

[0073] The system 100 or similar systems may be used, for example, to carry out one or more aspects of any of the methods 300, 400, and/or 500 described herein. The system 100 or similar systems may also be used for other purposes.

[0074] Turning to Fig. 2, a system 200 where a portion of a patient 202 is shown with a reference marker such as the reference marker 126 positioned on the patient according to at least one embodiment of the present disclosure. The system 200 may use or include any component from the system 100 such as, for example, the reference marker 126, the navigation system 118, the robot 114, the computing device 102, etc. It will be appreciated that the reference marker 126 shown in the Fig. 2 is an example reference marker 126. [0075] As will be described in more detail below, in at least one embodiment the reference marker 126 is used to obtain a pose of one or more anatomical elements. In the illustrated embodiment, the one or more anatomical elements comprise a spinal cord having a sacral base S 1 and a plurality of vertebrae L5, L4, L3, etc. Prior to or during a surgical operation, the reference marker 126 may be placed at each vertebrae L5, L4, L3, etc. and/or at the sacral base SI to obtain pose information of each vertebrae and the sacral base. The same reference marker 126 can be used to obtain the pose information for each vertebrae L5, L4, L3, etc. and/or at the sacral base SI by detaching the reference marker 126 from one anatomical element and attaching it to the next anatomical element. In other embodiments, multiple reference markers 126 can be used to obtain the pose information for each vertebrae L5, L4, L3, etc. and/or at the sacral base SI. In such embodiments, the reference markers 126 can be removed during surgical procedure and reinserted when feedback about one or more vertebrae is needed.

[0076] It will be appreciated that in some embodiments, the pose information may be obtained for the vertebrae and not the sacral base. After the pose information for each vertebrae and/or the sacral base are obtained, the reference marker 126 may be placed on any vertebra and/or the sacral base to obtain updated pose information. Such updated pose information may be compared with the initial pose information to determine if the corresponding vertebra and/or the sacral base has moved.

[0077] In some embodiments, the reference marker 126 may be attached to a first anatomical element of a plurality of anatomical elements and first pose information may be obtained for the first anatomical element. In embodiments where the plurality of anatomical elements is a plurality of vertebrae, the first anatomical element may be a first vertebra. The first pose information of the first vertebra may be used to determine a second pose information of a second vertebra adjacent to the first vertebrae as a relative distance between the first vertebra and the second vertebra can be measured or otherwise determined. Further, it can be assumed that the first vertebra and the second vertebra move together. Thus, by measuring or otherwise knowing a relative distance between the first vertebra and the second vertebra, movement of the first vertebra can indicate movement of the second vertebra. The second vertebra can be assumed to move the same or similar distances as the first vertebra. Similarly, the reference marker 126 may be attached to the second anatomical element and second pose information of the second vertebra may be used to determine a third pose information of a third vertebra adjacent to the second vertebrae as a relative distance between the second vertebra and the third vertebra can be measured or otherwise determined. Further, it can be assumed that the second vertebra and the third vertebra move together.

[0078] In any embodiments, the system 200 may be used to obtain pose information of one or more anatomical elements and/or to determine if the one or more anatomical elements have moved using fewer reference markers than in conventional systems. Further, by attaching and detaching the reference marker as needed, more space in the surgical space of freed up and more clear of obstructions than conventional systems.

[0079] Fig. 3 depicts a method 300 that may be used, for example, for determining movement of one or more anatomical elements.

[0080] The method 300 (and/or one or more steps thereof) may be carried out or otherwise performed, for example, by at least one processor. The at least one processor may be the same as or similar to the processor(s) 104 of the computing device 102 described above. The at least one processor may be part of a robot (such as a robot 114) or part of a navigation system (such as a navigation system 118). A processor other than any processor described herein may also be used to execute the method 300. The at least one processor may perform the method 300 by executing elements stored in a memory such as the memory 106. The elements stored in memory and executed by the processor may cause the processor to execute one or more steps of a function as shown in method 300. One or more portions of a method 300 may be performed by the processor executing any of the contents of memory, such as an image processing 120, a sensor processing 122, and/or a registration 124.

[0081] The method 300 comprises obtaining first pose information of a first anatomical element (step 304). The first pose information may be obtained from a first imaging device, which may be the same as or similar to the imaging device 112 or may be an imaging device of a navigation system such as the navigation system 118. In some embodiments, a processor such as the processor 104 may use image processing such as the image processing 120 to identify first pose information from image data received from the imaging device. The first pose information may correlate to a pose of the first anatomical element (which may be a first anatomical element of a plurality of anatomical elements) itself and/or may correlate to a pose of a reference marker such as the reference marker 126 releasably attached to the first anatomical element. Additionally or alternatively, the first pose information may be obtained from, for example, a sensor such as the sensor 128. Data from the sensor may be processed by the processor using sensor processing such as the sensor processing 122. The sensor data may be processed to obtain, for example, pose information of the first anatomical element and/or the reference marker 126 in embodiments where the reference marker 126 is, for example, an electromagnetic marker.

[0082] The method 300 also comprises determining second pose information of a second anatomical element (step 308). The second anatomical element may be adjacent to the first anatomical element. In such instances, the second pose information can be determined based on the first pose information. In embodiments where the plurality of anatomical elements is a plurality of vertebrae, the first anatomical element may be a first vertebra. The first pose information of the first vertebra may be used to determine a second pose information of a second vertebra adjacent to the first vertebrae as a relative distance between the first vertebra and the second vertebra can be measured or otherwise determined.

[0083] The method 300 also comprises obtaining updated first pose information (step 312). The step 312 may be the same as or similar to the step 304. The updated pose information may be obtained after the first pose information. The updated pose information may be obtained prior to and/or after, for example, a surgical step. For example, it may be desirable to check whether a vertebra has moved after insertion of a pedicle screw into the vertebra. If the vertebra has not moved, then the surgical operation may proceed and if the vertebra has moved, then a surgical plan, a registration, etc. may need updating prior to proceeding or continuing with the surgical operation.

[0084] The method 300 also comprises comparing the first pose information and the updated pose information (step 316). The first pose information and the updated pose information may be compared by, for example, the processor. The first pose information and the updated pose information may be compared to determine a difference between the first pose information and the updated pose information. The difference may indicate whether the anatomical element or the reference marker as attached to the first anatomical element has moved (and thus whether the first anatomical element has moved). The difference may be determined by subtracting one or more components of the first pose information from the corresponding components of the second pose information. The one or more components may comprise an x-coordinate, a y-coordinate, a z- coordinate, and/or an orientation (e.g., an angle of the reference marker and/or anatomical element). For example, the x-coordinate of the first pose information may be subtracted from the x-coordinate of the second pose information. Similarly, in other examples, a vector or a matrix of the first pose information may be subtracted from a corresponding vector or matrix of the second pose information.

[0085] The method 300 also comprises determining movement of the first anatomical element (step 320). The first anatomical element may be determined to have moved when the difference obtained during the comparison of the first pose information and the updated pose information meets or exceeds a predetermined threshold. When the first anatomical element has been determined to have moved, then this may indicate that a surgical plan, a registration, etc. may need updating prior to proceeding or continuing with the surgical operation.

[0086] The method 300 also comprises determining movement of the second anatomical element (step 324). The movement of the second anatomical element can be based on movement of the first anatomical element. In embodiments where the first anatomical element and the second anatomical elements are vertebrae, it can be assumed that the first vertebra and the second vertebra move together. Thus, by measuring or otherwise knowing a relative distance between the first vertebra and the second vertebra, movement of the first vertebra can indicate movement of the second vertebra. The second vertebra can be assumed to move the same or similar distances as the first vertebra.

[0087] The method 300 also comprises register the first anatomical element and the second anatomical element (step 328). The first anatomical element and the second anatomical element may be registered using a registration such as the registration 124. As previously described, the registration enables the processor to correlate an image with another image and/or to also correlate identified anatomical elements and/or individual objects (e.g., reference marker(s)) in one image with identified anatomical elements and/or individual objects in another image.

[0088] The method 300 also comprises updating the registration when movement of the first anatomical element is determined (step 332). The step 332 may be the same as or similar to the step 328, except that the updated first pose information may be used by the processor to update the registration when movement is detected in, for example, the step 320.

[0089] The present disclosure encompasses embodiments of the method 300 that comprise more or fewer steps than those described above, and/or one or more steps that are different than the steps described above. The method 300 may also repeat any steps. For example, the steps 312, 316, or 320 may be repeated continuously, in intervals, or based on user input to repeat the steps 312, 316, or 320 to check if the first anatomical element has moved.

[0090] Fig. 4 depicts a method 400 that may be used, for example, for determining movement of one or more anatomical elements.

[0091] The method 400 (and/or one or more steps thereof) may be carried out or otherwise performed, for example, by at least one processor. The at least one processor may be the same as or similar to the processor(s) 104 of the computing device 102 described above. The at least one processor may be part of a robot (such as a robot 114) or part of a navigation system (such as a navigation system 118). A processor other than any processor described herein may also be used to execute the method 400. The at least one processor may perform the method 400 by executing elements stored in a memory such as the memory 106. The elements stored in memory and executed by the processor may cause the processor to execute one or more steps of a function as shown in method 400. One or more portions of a method 400 may be performed by the processor executing any of the contents of memory, such as an image processing 120, a sensor processing 122, and/or a registration 124.

[0092] The method 400 comprises obtaining first pose information of a first anatomical element (step 404). The step 404 may be similar to or the same as the step 304 of the method 300 above.

[0093] The method 400 also comprises determining second pose information of a second anatomical element (step 408). The step 408 is similar to or the same as the step 308 of the method 300 above.

[0094] The method 400 also comprises obtaining third pose information of a third anatomical element (step 412). The step 412 may be similar to or the same as the step 304 of the method 300 above. The third anatomical element may be spaced from the first anatomical element. In some embodiments, the second anatomical element may be positioned between the first anatomical element and the second anatomical element.

[0095] In embodiments where the third pose information is obtained by using a reference marker such as the reference marker 126, the same reference marker may be used to obtain the first pose information and the second pose information. In such embodiments, the reference marker may be releasably attached to an implant such as, for example, a pedicle screw implanted in the patient. In any embodiment, an interface between the reference marker and the implant (or any device or anatomical element to which the reference marker is attached to) is rigid to enable repeatable positioning of the reference marker in the same position relative to the implant.

[0096] In other embodiments, multiple reference markers can be used to obtain the pose information for the first anatomical element, the second anatomical element, and/or the third anatomical element (or any other anatomical element). In such embodiments, the reference markers can be removed during surgical procedure and reinserted when feedback about one or more anatomical elements is needed.

[0097] The method 400 also comprises obtaining an updated first pose information and/or an updated third pose information (step 416). The step 416 may be similar to or the same as the step 312 of the method 300 above except that updated pose information may be alternatively or additionally obtained for the third anatomical element.

[0098] The method 400 also comprises comparing the updated first pose information with the first pose information and/or the updated third pose information with the third pose information (step 420). The step 420 may be similar to or the same as the step 316 of the method 300 above except that updated third pose information may be alternatively or additionally compared with the third pose information.

[0099] The method 400 also comprises determining if the first anatomical element or the third anatomical element has moved based on the comparison (step 424). The step 424 may be similar to or the same as the step 320 of the method 300 above except that movement of the third anatomical element may be alternatively or additionally determined.

[0100] The method 400 also comprises determining movement of the second anatomical element (step 428). The step 428 may be similar to or the same as the step 324 of the method 300 above except that movement of the second anatomical element may be alternatively or additionally based on movement of the third anatomical element.

[0101] The present disclosure encompasses embodiments of the method 400 that comprise more or fewer steps than those described above, and/or one or more steps that are different than the steps described above. The method 400 may also repeat any steps. For example, the steps 416, 420, and 424 may be repeated continuously, in intervals, or based on user input to repeat the step 416, 420, and 424 to check if the first anatomical element or the third anatomical element has moved. [0102] Fig. 5 depicts a method 500 that may be used, for example, for determining movement of one or more anatomical elements.

[0103] The method 500 (and/or one or more steps thereof) may be carried out or otherwise performed, for example, by at least one processor. The at least one processor may be the same as or similar to the processor(s) 104 of the computing device 102 described above. The at least one processor may be part of a robot (such as a robot 114) or part of a navigation system (such as a navigation system 118). A processor other than any processor described herein may also be used to execute the method 500. The at least one processor may perform the method 500 by executing elements stored in a memory such as the memory 106. The elements stored in memory and executed by the processor may cause the processor to execute one or more steps of a function as shown in method 500. One or more portions of a method 500 may be performed by the processor executing any of the contents of memory, such as an image processing 120, a sensor processing 122, and/or a registration 124.

[0104] The method 500 comprises orienting a reference marker on a first anatomical element (step 504). The reference marker may be the same as or similar to the reference marker 126. The reference marker may be releasably attached to the first anatomical element. For example, in embodiments where the first anatomical element is a first vertebra (of a plurality of vertebrae), the reference marker may be releasably attached to an implant such as, for example, a pedicle screw implanted in the first vertebra. In any embodiment, an interface between the reference marker and the implant (or any device or anatomical element to which the reference marker is attached to) is rigid to enable repeatable positioning of the reference marker in the same position relative to the implant.

[0105] The method 500 also comprises obtaining first pose information of the first anatomical element (step 508). The step 508 may be the same as or similar to the step 304 of the method 300 described above.

[0106] The method 500 also comprises determining second pose information of a second anatomical element (step 512). The step 512 may be the same as or similar to the step 308 of the method 300 described above.

[0107] The method 500 also comprises orienting the reference marker on a third anatomical element (step 516). The step 516 may be the same as or similar to the step 504 except that the reference marker is attached to the third anatomical element (after detaching the reference marker from the first anatomical element). Thus, the same reference marker may be used on both the first anatomical element and the third anatomical element (and any other anatomical element).

[0108] In other embodiments, multiple reference markers can be used to obtain the pose information for the first anatomical element, the second anatomical element, and/or the third anatomical element (or any other anatomical element). In such embodiments, the reference markers can be removed during surgical procedure and reinserted when feedback about one or more anatomical elements is needed.

[0109] The method 500 also comprises obtaining third pose information of the third anatomical element (step 520). The step 520 may be the same as or similar to the step 304 of the method 300 above. The third anatomical element may be spaced from the first anatomical element. In some embodiments, the second anatomical element may be positioned between the first anatomical element and the second anatomical element.

[0110] The method 500 also comprises orienting the reference marker on the first anatomical element or the third anatomical element (step 524). The step 524 may be the same as or similar to the steps 504 and/or 516. It will be appreciated that in some embodiments, prior to the step 524, the reference marker may be removed from the third anatomical element such that the reference marker is not positioned on any anatomical element. Thus, the operating space may be free of the reference marker until is it desired to obtain the pose of the first anatomical element, third anatomical element, or any other anatomical element. For example, it may be desirable to check a pose of the first anatomical element after a pedicle screw is inserted into the first anatomical element. In such examples, the reference marker may be reattached to the first anatomical element to verify the pose of the first anatomical element and/or to determine if the first anatomical element has moved.

[0111] The method 500 also comprises obtaining an updated first pose information and/or an updated third pose information (step 528). The step 524 may be the same as or similar to the steps 504 and/or 516.

[0112] The method 500 also comprises comparing the updated first pose information with the first pose information and/or the updated third pose information with the third pose information (step 532). The step 432 may be similar to or the same as the step 316 of the method 300 above except that updated third pose information may be alternatively or additionally compared with the third pose information. [0113] The method 500 also comprises determining if the first anatomical element or the third anatomical element has moved based on the comparison (step 536). The step 436 may be similar to or the same as the step 320 of the method 300 above except that movement of the third anatomical element may be alternatively or additionally determined.

[0114] The present disclosure encompasses embodiments of the method 500 that comprise more or fewer steps than those described above, and/or one or more steps that are different than the steps described above. The method 500 may also repeat any steps. For example, the steps 524, 528, 532, 536 may be repeated continuously, in intervals, or based on user input to repeat the step 524, 528, 532, 536 to, for example, check if the first anatomical element or the third anatomical element has moved.

[0115] As noted above, the present disclosure encompasses methods with fewer than all of the steps identified in Figs. 3, 4, and 5 (and the corresponding description of the methods 300, 400, and 500), as well as methods that include additional steps beyond those identified in Figs. 3, 4, and 5 (and the corresponding description of the methods 300, 400, and 500). The present disclosure also encompasses methods that comprise one or more steps from one method described herein, and one or more steps from another method described herein. Any correlation described herein may be or comprise a registration or any other correlation.

[0116] The following provide non-limiting examples of systems and methods of the present disclosure.

[0117] Example 1. A system for determining movement of one or more anatomical elements, the system comprising: at least one processor; and at least one memory storing instructions for execution by the at least one processor that, when executed, cause the at least one processor to: obtain first pose information of a first anatomical element; determine second pose information of a second anatomical element adjacent to the first anatomical element based on the first pose information; obtain an updated first pose information; compare the updated first pose information with the first pose information; determine movement of the first anatomical element when a difference between the first pose information and the updated pose information exceeds a predetermined threshold; and determine movement of the second anatomical element based on the movement of the first anatomical element.

[0118] Example 2. The system of example 1, wherein the first anatomical element comprises a first vertebra and the second anatomical element comprises a second vertebra. [0119] Example 3. The system of example 1 or 2, wherein the first pose information is obtained from a sensor configured to determine a pose of the first anatomical element.

[0120] Example 4. The system of any one of the preceding examples, wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to: obtain third pose information of a third anatomical element spaced from the first anatomical element; obtain updated pose information for at least one of the first pose information or the third pose information; compare the updated first pose information or third pose information with at least one of the first pose information or the third pose information; and determine if at least one of the first anatomical element or the third anatomical element has moved based on the comparison.

[0121] Example 5. The system of example 4, wherein movement of the second anatomical element is based on the comparison.

[0122] Example 6. The system of any one of the preceding examples, wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to orient a reference marker at a first anatomical element, wherein the first pose information and the updated first pose information is obtained using the reference marker.

[0123] Example 7. The system of example 6, wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to orient a reference marker at the third anatomical element, wherein the third pose information is obtained using the reference marker.

[0124] Example 8. The system of example 4, wherein the second anatomical element is positioned between the first anatomical element and the third anatomical element.

[0125] Example 9. The system of any one of the preceding examples, wherein the reference marker is releasably secured to at least one of a first pedicle screw implanted in the first anatomical element or a second pedicle screw implanted in the third anatomical element.

[0126] Example 10. The system of any one of the preceding examples, wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to register the first anatomical element and the second anatomical element based on the first pose information; and update the registration when movement of the first anatomical element is determined. [0127] Example 11. A system for determining movement of one or more anatomical elements, the system comprising: at least one processor; and at least one memory storing instructions for execution by the at least one processor that, when executed, cause the at least one processor to: obtain first pose information of a first anatomical element; determine second pose information of a second anatomical element adjacent to the first anatomical element based on the first pose information; obtain third pose information of a third anatomical element spaced from the first anatomical element; obtain updated pose information for at least one of the first pose information or the third pose information; compare the updated first pose information or third pose information with at least one of the first pose information or the third pose information; and determine if at least one of the first anatomical element or the third anatomical element has moved based on the comparison.

[0128] Example 12. The system of example 11, wherein the first anatomical element comprises a first vertebra, the second anatomical element comprises a second vertebra, and the third anatomical element comprises a third vertebra.

[0129] Example 13. The system of example 11 or 12, wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to determine if the second anatomical element has moved based on the comparison.

[0130] Example 14. The system of example 13, wherein the second anatomical element is positioned between the first anatomical element and the third anatomical element.

[0131] Example 15. The system of example 11, wherein the reference marker is releasably secured to at least one of a first pedicle screw implanted in the first anatomical element or a second pedicle screw implanted in the third anatomical element.

[0132] Example 16. A method for determining movement of one or more anatomical elements, the method comprising: orienting a reference marker at a first anatomical element; obtaining first pose information of the reference marker; determining second pose information of a second anatomical element adjacent to the first anatomical element based on the first pose information; orienting the reference marker at a third anatomical element spaced from the first anatomical element; obtaining third pose information of the reference marker; orienting the reference marker at at least one of the first anatomical element or the third anatomical element; obtaining at least one of an updated first pose information or updated second pose information from the reference marker; comparing the updated first pose information or the updated second pose information with at least one of the first pose information or the third pose information; and determining if at least one of the first anatomical element or the third anatomical element has moved based on the comparison.

[0133] Example 17. The method of example 16, wherein the first anatomical element comprises a first vertebra, the second anatomical element comprises a second vertebra, and the third anatomical element comprises a third vertebra.

[0134] Example 18. The method of example 16 or 17, further comprising determining if the second anatomical element has moved based on the comparison.

[0135] Example 19. The method of any one of examples 16-18, wherein the reference marker is releasably secured to at least one of a first pedicle screw implanted in the first anatomical element or a second pedicle screw implanted in the third anatomical element.

[0136] Example 20. The method of any one of examples 16-19, wherein the second anatomical element is positioned between the first anatomical element and the third anatomical element.

[0137] The foregoing is not intended to limit the disclosure to the form or forms disclosed herein. In the foregoing Detailed Description, for example, various features of the disclosure are grouped together in one or more aspects, embodiments, and/or configurations for the purpose of streamlining the disclosure. The features of the aspects, embodiments, and/or configurations of the disclosure may be combined in alternate aspects, embodiments, and/or configurations other than those discussed above. This method of disclosure is not to be interpreted as reflecting an intention that the claims require more features than are expressly recited in each claim. Rather, as the following claims reflect, inventive aspects lie in less than all features of a single foregoing disclosed aspect, embodiment, and/or configuration. Thus, the following claims are hereby incorporated into this Detailed Description, with each claim standing on its own as a separate preferred embodiment of the disclosure.

[0138] Moreover, though the foregoing has included description of one or more aspects, embodiments, and/or configurations and certain variations and modifications, other variations, combinations, and modifications are within the scope of the disclosure, e.g., as may be within the skill and knowledge of those in the art, after understanding the present disclosure. It is intended to obtain rights which include alternative aspects, embodiments, and/or configurations to the extent permitted, including alternate, interchangeable and/or equivalent structures, functions, 1 ranges or steps to those claimed, whether or not such alternate, interchangeable and/or equivalent structures, functions, ranges or steps are disclosed herein, and without intending to publicly dedicate any patentable subject matter.

Claims

CLAIMS What is claimed is:

1. A system (100) for determining movement of one or more anatomical elements, the system comprising: at least one processor (104); and at least one memory (106) storing instructions for execution by the at least one processor that, when executed, cause the at least one processor to: obtain first pose information of a first anatomical element; determine second pose information of a second anatomical element adjacent to the first anatomical element based on the first pose information; obtain an updated first pose information; compare the updated first pose information with the first pose information; determine movement of the first anatomical element when a difference between the first pose information and the updated pose information exceeds a predetermined threshold; and determine movement of the second anatomical element based on the movement of the first anatomical element.

2. The system of claim 1, wherein the first anatomical element comprises a first vertebra and the second anatomical element comprises a second vertebra.

3. The system of claims 1 or 2, wherein the first pose information is obtained from a sensor (128) configured to determine a pose of the first anatomical element.

4. The system of any one of the preceding claims, wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to: obtain third pose information of a third anatomical element spaced from the first anatomical element; obtain updated pose information for at least one of the first pose information or the third pose information; compare the updated first pose information or third pose information with at least one of the first pose information or the third pose information; and determine if at least one of the first anatomical element or the third anatomical element has moved based on the comparison.

5. The system of claim 4, wherein movement of the second anatomical element is based on the comparison.

6. The system of any of the preceding claims, wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to: orient a reference marker (126) at a first anatomical element, wherein the first pose information and the updated first pose information is obtained using the reference marker.

7. The system of claim 6, wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to: orient a reference marker (126) at the third anatomical element, wherein the third pose information is obtained using the reference marker.

8. The system of claim 4, wherein the second anatomical element is positioned between the first anatomical element and the third anatomical element.

9. The system of any of the preceding claims, wherein the reference marker is releasably secured to at least one of a first pedicle screw implanted in the first anatomical element or a second pedicle screw implanted in the third anatomical element.

10. The system of any of the preceding claims, wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to: register the first anatomical element and the second anatomical element based on the first pose information; and update the registration when movement of the first anatomical element is determined.

11. A method for determining movement of one or more anatomical elements, the method comprising: orienting a reference marker (126) at a first anatomical element; obtaining first pose information of the reference marker; determining second pose information of a second anatomical element adjacent to the first anatomical element based on the first pose information; orienting the reference marker at a third anatomical element spaced from the first anatomical element; obtaining third pose information of the reference marker; orienting the reference marker at at least one of the first anatomical element or the third anatomical element; obtaining at least one of an updated first pose information or updated second pose information from the reference marker; comparing the updated first pose information or the updated second pose information with at least one of the first pose information or the third pose information; and determining if at least one of the first anatomical element or the third anatomical element has moved based on the comparison.

12. The method of claim 11, wherein the first anatomical element comprises a first vertebra, the second anatomical element comprises a second vertebra, and the third anatomical element comprises a third vertebra.

13. The method of claims 11 or 12, further comprising: determining if the second anatomical element has moved based on the comparison.

14. The method of any one of claims 11-13, wherein the reference marker is releasably secured to at least one of a first pedicle screw implanted in the first anatomical element or a second pedicle screw implanted in the third anatomical element.

15. The method of any of claims 11-14, wherein the second anatomical element is positioned between the first anatomical element and the third anatomical element.