JPH0344526B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION Field of the Invention The present invention relates to an apparatus for performing surgical procedures on a target site within a patient's skull using a computerized tomography (CT) scanner.

[Conventional technology]

CT technology was developed approximately in 1972 and
It includes an X-ray diagnostic device for conducting neuroradiological examinations.

Various techniques and devices have been developed for CT to accurately detect deep-seated brain lesions.
For example, CT scans are used for guidance and in conjunction with stereotactic techniques. Commonly assigned US Pat. No. 4,463,758 discloses a stereotactic frame.

[Problem that the invention aims to solve]

Generally, stereotactic techniques require calculation of three coordinates: X coordinate (lateral direction), Y coordinate (front/back distance), and Z coordinate (vertical height from reference line). It's a hassle.

[Means for solving problems]

According to the stereotactic device according to the present invention, the rotation axis of the probe holder and the arcuate member is
Since it is placed on the same CT plane as the target area and uses a positioning laser beam, there is no need to calculate the Z coordinate (distance from the scanning reference line to the target area).

Also, by using the device according to the invention, the X and Y coordinates can be measured directly from a single image without special computer programming, calculations, or special diagrams. be able to.

[Purpose of the invention]

A first object of the present invention is to provide an improved stereo tactic device.

A second object of the present invention is to provide an apparatus that can perform surgical treatment on a target site inside a patient's skull using a CT scanner.

A third object of the present invention is to make it possible to measure coordinates in one plane within the same vertical plane of the CT image in which the target region is located, by utilizing plane approach to CT stereotaxis. The object of the present invention is to provide a device of the type described above.

A fourth object of the present invention is to ensure that the center of the probe holder and the circular attachment are in the same plane so that the two elements can be aligned in the same plane as the target region using the vertical positioning light of the CT scanner. It is an object of the present invention to provide a device of the above-mentioned type which can be arranged in a row.

A fifth object of the invention is to provide a device of the above-mentioned type, which is adapted to allow access to a target site within the skull from a lateral position.

A sixth object of the present invention is to provide a movable head holder which can be selectively moved from the plane of the CT scanner to a position to eliminate any possibility of artifacts being introduced. It is an object of the present invention to provide a device of the above-mentioned type in which the invention can be carried out.

A seventh object of the present invention is to utilize the top surface of the base,
Moreover, it is an object of the present invention to provide a device of the above-mentioned type in which a central marker is provided on the base as a reference marker so that the device can be used with any CT scanner.

The eighth object of the present invention is to perform nuclear magnetic resonance (NMR)
The object of the present invention is to provide a device of the above type that can be used in conjunction with a scanner.

A ninth object of the invention is to provide a device of the above type that can be easily removed from the table of a CT scanner.

These and other objects will become apparent to those skilled in the art from the following description.

[Summary of the invention]

The apparatus of the present invention allows a computerized tomography scanner to be used to perform a surgical procedure on a target site within a patient's skull.

This device has a base that can be removably attached to the top of a scanner table.

The base has opposing sides and first and second ends, and the opposing sides are provided with a scale. A central marker is provided at the end of each piece of the base.

Vertically disposed support members are respectively mounted for selective movement in the longitudinal direction on opposite sides of the base and are provided with positioning graduations.

The bow support is vertically movably mounted on the support and the lower end of the bow carrier is rotatably mounted.

The bow is mounted for lateral movement on the upper end of the bow carrier, and the probe holder is movably mounted.

〔Example〕

Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the accompanying drawings.

The device according to the invention, designated 10, comprises:
It is provided with a bottom stand 12 that can be attached to an attachment 14 that can be detachably attached to the top surface of the table of the CT scanner. Reference numeral 16 indicates the patient's head.

Base 12 has opposing ends 18, 20 and opposing sides 22, 24. Each side 2
2 and 24 are each provided with a positioning scale 26. Each side 22, 24 has a groove 28,
30 are formed into which grooves are slidably fitted projections 32 extending inwardly from the lower ends of the support members 34, 34'.

Pinion 38 is rotatably mounted in bore 40 of support member 34 and has a knob 42 mounted on the outer end of the support member. The inner end of pinion 38 is adapted to engage rack 44.

A screw 46 is threaded into the lower end of the support member 34 and engages the side of the base, if desired, to hold the support member in place relative to the side of the base.

As is clear from the drawing, one side of the support member 34 has a rack 4 located between the grooves 50 and 52.
8 is provided. As is clear from FIG. 1, a positioning scale is provided on the lateral side surface of the support member 34.

The support member 34' is also provided with a hole 40' in which a pinion 38' can be rotatably mounted, the inner end of the pinion 38' engaging a rack 44'.

A knob 42' is attached to the outer end of the pinion 38', by means of which the pinion can be rotated.

As is clear from the drawings, the support member 34' includes:
Rack 48' located between grooves 50', 50'
is provided. On the side surface of the support member 34',
A scale corresponding to the scale 54 is provided.

Support members 34, 34' each have an arcuate member support 56, 56' mounted for selective vertical movement.

Since the support parts 56 and 56' of the arcuate member are exactly the same, a detailed explanation will be given only for those without a dash.
Explanations for those marked with "datsushiyu" will be omitted.

The arcuate member support 56 includes a lower portion, or circular attachment 58, which is attached to the support member 34 for vertical movement, as shown in the figures.

The pinion 60 is rotatably attached to the hole 62, and by moving a knob 64 fixed to the pinion 60, the pinion 60 is rotated.
It is adapted to engage the rack 48 so that it can be rotated and the lower portion 58 can be moved in a direction perpendicular to the support member 34.

Lower portion 58 includes a semicircular recess 66 terminating in shoulders 68,70.

A positioning scale 72 is stamped on the lateral side of the lower part 58 together with a vertical scale 74, which vertical scale 74 corresponds to the center of rotation of the upper part of the arcuate member support which is pivoted in the semicircular recess 66. The center of the recess 66, which coincides with the axis, is supported.

The upper portion 76 of the arcuate member carrier 56 includes a cylindrical portion 78 extending inwardly therefrom, and the cylindrical portion 78 is fitted into the recess 66 where it is retained by the cap member 80. .

Cap member 80 has a lip 82 that is removably attached to groove 84 and an opening 86 for attaching cap screws 88.

The threaded lower end of the cap screw 88 is threaded into a threaded opening 90 in the lower portion 58.

A screw 92 is inserted into the lower portion 5 for engagement with the support 34 to securely hold the arcuate support in place relative to the support 34, if desired.
It is screwed into the opening 94 provided in 8.

The arcuate carrier 96 consists of a top 98 and legs 100, 102 extending downwardly from opposite ends thereof. Groove 10 formed in top portion 98
6,108, the rack segment 104
can be installed.

One side of the top portion 98 is provided with a positioning scale 110 as shown in FIG.

The lower ends of the legs 100, 102 are secured to the upper parts 76, 76' by screws 111, respectively.

As is clear from the drawings, the legs 100, 102
are respectively fixed to the upper parts 76, 76' between the rotation axis between the upper part and the lower part of the arcuate member support and the support members 34, 34'.

The arcuate member 112 is movably connected to the arcuate member carrier 96 as shown in the drawings.
can be attached to.

The pinion 114 is screwed to the back side of the arcuate member 112 so that it can rotate and is easily attached.
Rotation of pinion 114 is adapted to engage segment 104 so that the arc can be moved laterally relative to the arc carrier.

The top surface of the arcuate member 112 is marked with a scale indicating angular displacement to either side of the center "O".

The support portion 118 is configured to allow selective movement.
It has a probe holder 122 which is attached to a groove 120 in the arcuate member 112 and which is attached to the arcuate member for selective movement as shown in FIG.

The screws 124 and 126 can be attached to the support part 1 as necessary.
The support part 11 is designed to firmly hold the probe holder 122 in a predetermined position relative to the support part 18.
8 is screwed into the support portion 128 of the probe holder 122.

The probe holder 122 has a cylindrical hole 130 drilled therethrough into which is inserted a collar 132 having vertically spaced notches 134 formed on its side.

pinion 13 for engagement with notch 134;
6 is attached to the opening 138 of the probe holder 122. By turning knob 140, color 1
32 can be raised and lowered relative to the probe holder.

The probe holder cylinder 142 has a collar 13.
2, and an elongated hole 144 that can receive a probe 146 is formed inside the cylinder.

The bore 144 is arranged so that when the bow holder is in a fully vertical orientation, the axis of the bore 144, ie, the probe 146, intersects the axis of rotation between the upper and lower parts of the bow support. is offset laterally with respect to the arcuate member so as to

Therefore, no matter how the angle of the bow support changes, the axis of the hole 144 will be in the same plane as the axis of rotation between the upper and lower portions of the bow support.

As shown in FIG. 1, a head holder 148 is attached to the base 12 and is selectively movable in the longitudinal direction. The head holder 148 has threads 150 extending inwardly from the holder for engagement with the patient's head.

Screws 152 are threaded into the lower end of the head holder 148 to engage the base 12 to securely hold the head holder 148 in place relative to the base 12, if desired.

As is clear from Fig. 1, the bottom stand 12 has CT
When a scan is performed, a central marker 154 is provided to visually confirm that the desired measurement is being made, as will be explained in detail later.

In use, base 12 is secured to attachment 14 by screws 156. This attachment 14 is placed on top of the CT scan table.

Typically, the first step in removing the arcuate carrier from the device is to remove the screws 88, 88' which allow the cap members 80, 80' to be removed from the lower circular attachments 58, 58'.

Next, the arc carrier 96 and the upper part 7
6, 76' are removed from the arc member supports 56, 56'.

Place the patient's head in the head holder 14 so that the base is completely parallel to the longitudinal direction of the CT table.
If 8 can be seen, the patient is placed on the head holder 148 and CT imaging of the target area is performed.

If the CT image is focused on a target region, the head holder 148 can be moved to another location to avoid artifacts.

The pin 150 is fixed to the patient's head and the target area is
Another image in the CT plane is taken.

Next, the positioning laser light of the CT scanner is irradiated, and the lower circular attachments 58, 58' of the arcuate member support are aligned with the positioning laser and the vertical scale 7.
The support members 34, 34' are moved in the longitudinal direction of the base until the support members 34, 34' are in a position where they coincide with each other.

From a single CT image with a narrowed target area,
Measure the values of the X and Y coordinates.

Using the scanner cursor, center marker 1
Measure the vertical distance from 54 to the target site and use this as the X coordinate value, and measure the distance from the top of the base to the target site and use this as the Y coordinate value.

Y-axis adjustment is accomplished by moving the arcuate supports 56, 56' to the desired height.

Adjustment in the Y axis is accomplished by moving the middle section of the arc to a distance equal to the value of the X coordinate.

After making these adjustments, the bow carrier 96 is returned to the bow supports 56, 56'.

The bow carrier 96 can then be moved to any desired angle and the probe holder 12 provided on the bow carrier 96 can be moved to any desired angle.
2 can be moved at any desired angle to reach target areas anywhere on the head.

Before the patient is taken to the CT scan room,
The burr hole is placed in any convenient location deemed safe and as close as possible to the target area. Also, twist, drill,
A twist drill hole is placed in the CT room or after measurements are taken.

The patient is then transported with the device to the operating room, and within the operating room a burr hole is placed and the target area is approximated.

When performing a biopsy, the probe is moved through varying depths to obtain tumor samples at varying depths.

As is clear from the above description, according to the present invention, surgical procedures can be performed without the need for various calculations or special computer programs, so that all of the above objectives can be achieved.

The device according to the invention also allows easy access to laterally placed target areas.

According to the present invention, there is no need to calculate or measure the Z coordinate, and there is no need for an intermediate frame or simulator for calculating the coordinates.

The device according to the present invention can be used before taking CT images,
It can be used during or after the process, and
Can be used in conjunction with NMR equipment and various body scanners.

Thus, with the device of the invention at least all of the objectives mentioned above are achieved.

[Brief explanation of drawings]

FIG. 1 is a perspective view of a device according to the invention.
FIG. 2 is an exploded perspective view of the various parts of the apparatus according to the present invention, showing their mutual relationships. FIG. 3 is an exploded perspective view showing each part of the probe holder and the arcuate member. FIG. 4 is an end view from one side of the device according to the invention. The patient's head is indicated by a dashed line. 10... device, 12... bottom stand, 14... attachment, 16... head, 18, 20... end,
22, 24...Side part, 26...Positioning scale, 2
8, 30...Groove, 32...Protrusion, 34, 34'
... Support member, 38 ... Pinion, 40, 40'
... Hole, 42, 42' ... Knob, 44 ... Rack, 46 ... Screw, 48, 48' ... Rack, 5
0, 52...groove, 50', 52'...groove, 54...
Scale, 56, 56'... Support part, 58... Circular attachment, 60... Pinion, 62... Hole,
64...Knob, 66...Semicircular recess, 68,
70...Shoulder, 72...Scale, 74...Scale, 7
6, 76'... upper part, 78... cylindrical part, 80,
80'... Cap member, 82... Lip, 84
... Groove, 86 ... Opening, 88, 88' ... Cap screw, 90 ... Opening, 92 ... Screw, 94 ...
...Aperture, 96... Arc-shaped member carrier, 98...
Top, 100, 102... Leg, 104... Rack segment, 106, 108... Groove, 110
... Scale, 111 ... Screw, 112 ... Arcuate member, 114 ... Pinion, 116 ... Scale, 11
8... Support part, 120... Groove, 122... Probe holder, 124, 126... Screw, 128... Support part, 130... Cylindrical hole, 132... Collar,
134...notsuchi, 136...pinion, 138
...Opening, 140...Knob, 142...Cylinder, 144...Hole, 146...Tip, 148...
Head holder, 150...screw, 152...screw, 154...center marker, 156...screw.

Claims (1)

Claims: 1. A base having opposing sides and first and second ends; means for installing the base on a table of a scanner; a laterally disposed support member, each vertically disposed for selective movement in the longitudinal direction; and an arcuate member attached to each support member for selective movement in the vertical direction. a support; a bow carrier selectively rotatably attached to and extending upwardly from the bow support; and a bow carrier selectively movable. an arcuate member attached to the top of the probe; and a probe holder attached to the arcuate member for selective movement and having a cylindrical hole capable of receiving an elongated probe or the like; a scale is provided on the side of the base to indicate the longitudinal position of the support member with respect to the base; and a top extending between the upper ends of the legs, the lower ends of the legs being rotatably attached to the arcuate support; a pivot connection between a leg and the arcuate member support is adapted to be longitudinally offset from the support member towards one end of the base; vertically offsetable from the pivot link, at least one of said arcuate supports having a vertical scale for indicating axial rotation of said pivot link, and said tip holder The cylindrical hole bored in the cylindrical hole is in a positional relationship such that its longitudinal axis intersects the central axis of the rotational connection between the leg and the arcuate member support, and the base pedestal is provided with a central marker at one end thereof and a head holder attached to the base pedestal. A device that performs surgical procedures on an area. 2. By using the computerized tomography scanner according to claim 1, wherein the head holder is attached to the base so as to be selectively movable in the vertical direction, A device that performs surgical procedures on target areas inside the skull. 3. With the use of a computerized tomography scanner according to claim 1, characterized in that a scale is provided on the side of the leg to assist in positioning the arcuate support, the patient A device that performs surgical procedures on target areas inside the skull. 4. By using a computerized tomography scanner as claimed in claim 1, wherein the arch carrier is removably attached to the arch support, A device used to perform surgical procedures. 5. A computer tomography scanner according to claim 1, characterized in that the top of the arcuate carrier is provided with graduations to assist in positioning the arcuate member relative to said arcuate carrier. A device that performs surgical procedures on target areas inside a patient's skull by using 6. Use of the computerized tomography scanner according to claim 5, characterized in that the arcuate member is provided with a scale, which serves to position the probe holder with respect to the arcuate member. A device that performs surgical procedures on target areas inside a patient's skull. 7. By using the computerized tomography scanner according to claim 1, wherein the arcuate member support is movably attached to the support member by means of a rack and pinion, objects inside the skull of a patient can be detected. A device that performs surgical procedures on an area. 8. The support member is connected by a rack and a pinion.
An apparatus for performing a surgical procedure on a target site within a patient's skull by utilizing a computerized tomography scanner as claimed in claim 1, wherein the scanner is movably mounted on a base. 9 The arcuate member is connected by the rack and pinion,
Apparatus for performing surgical procedures on a target site within a patient's skull by means of a computerized tomography scanner as claimed in claim 1, which is movably mounted on top.