Patient-matched apparatus and methods for performing surgical procedures
A system and method for developing customized apparatus, such as guides, for use in one or more surgical procedures is disclosed. The system and method incorporates a patient's unique anatomical features or morphology, which may be derived from capturing MRI data or CT data, to fabricate at least one custom apparatus or guide. According to a preferred embodiment, the customized apparatus comprises at least one patient-specific surface and or contour, which may be derived from MRI or CT data. Apparatus may be matched in duplicate and oriented around the patient's own anatomy, and may further provide any desired axial alignments or surgical instrument insertional trajectories. In an alternate embodiment, the apparatus may further be aligned and/or matched and/or nested with at least one other apparatus during the surgical procedure.
1. A patient-specific cutting guide, comprising:
first side and a second side of the guide;
at least one patient-specific track formed in the guide and oriented in a path determined from the anatomical data of the patient, the at least one patient-specific track extending at least partially through the guide;
the second side of the guide comprising at least a first patient specific contour on one portion of the second side and a second patient-specific contour on another portion of the second side of the guide for mating with a patient's boney anatomy;
wherein the at least a first and second patient-specific contours are determined from the anatomical data of the patient and are shaped to substantially conform to a patient's boney anatomy.
2. The patient-specific cutting guide of claim 1 , wherein the at least one patient-specific track is configured to permit an instrument to pass from the first side through the second side of the guide for making cuts along a patient's boney anatomy.
3. The patient-specific cutting guide of claim 1 , wherein the path of the at least one patient-specific track comprises depth control for facilitating insertion and movement of an instrument along the path.
4. The patient-specific cutting guide of claim 1 , further comprising at least a second patient-specific track formed in the body of the guide.
5. The patient-specific cutting guide of claim 4 , wherein the at least a second patient-specific track defines a second path, which comprises depth control for facilitating movement of an instrument along the second path.
6. The patient-specific cutting guide of claim 4 , wherein the at least one patient-specific track has a predetermined trajectory determined from the anatomical features and the at least a second patient-specific track also has a predetermined trajectory determined from the anatomical features of a patient that is different from the trajectory of the at least one patient-specific track.
7. The patient-specific cutting guide of claim 6 , wherein the at least one track and the at least a second track are independently configured to permit an instrument to pass through the body of the guide and make multiple cuts along different depths and trajectories.
8. The patient-specific cutting guide of claim 1 , wherein the at least one patient-specific track is configured to guide an instrument through the path for removal of a specific portion of a patient's boney anatomy.
9. The patient-specific cutting guide of claim 1 , wherein the at least a first and second patient-specific contours are configured to contact one or more of a lamina, a pars interarticularis, a portion of a transverse process, a superior articular process, spinous process, and an inferior articular process.
10. The patient-specific cutting guide of claim 1 , wherein the at least a first and second patient-specific contours are configured to contact a portion of a patient's boney anatomy that has previously been modified by a surgeon.
11. The patient-specific cutting guide of claim 1 , wherein the at least one track is adapted to receive and guide an instrument for achieving a pedicle subtraction, an osteotomy, a laminectomy, a facetectomy, a Smith-Peterson osteotomy, a Ponte osteotomy, or a vertebral column resection.
12. The patient-specific cutting guide of claim 1 further comprising a frame configured to be placed at least partially on the boney anatomy of the patient.
13. The patient-specific cutting guide of claim 1 , wherein the guide is comprised of at least a first and a second section that are selectively interconnected to each other to form the patient-specific cutting guide.
14. The patient-specific cutting guide of claim 1 , wherein the guide is used to modify a patient's boney anatomy, and further comprising a second patient-specific cutting guide used to further modify a patient's boney anatomy.
15. The patient-specific cutting guide of claim 1 , wherein the path of the at least one patient-specific track comprises at least one predetermined angle for facilitating insertion and movement of an instrument along the path.
16. The patient-specific cutting guide of claim 1 , wherein the path of the at least one patient-specific track comprises at least one predetermined orientation for facilitating insertion and movement of an instrument along the path.
17. The patient-specific cutting guide of claim 4 , wherein the second path of the at least a second patient-specific track comprises at least one predetermined angle for facilitating insertion and movement of an instrument along the second path.
18. The patient-specific cutting guide of claim 4 , wherein the second path of the at least a second patient-specific track comprises at least one predetermined orientation for facilitating insertion and movement of an instrument along the second path.
19. The patient-specific cutting guide of claim 5 , wherein either of the at least one patient-specific track and the second patient specific tracks are configured to guide an instrument through their respective paths for removal of a specific portion of a patient's boney anatomy.
20. The patient-specific cutting guide of claim 12 , wherein the guide may be selectively interconnected to the frame.
21. The patient-specific cutting guide of claim 1 , wherein the guide further comprises at least one marker for facilitating registration or location of the guide.
22. The patient-specific cutting guide of claim 1 , wherein the guide is configured to permit one or more location of cuts to be marked on a patient's boney anatomy.
23. The patient-specific cutting guide of claim 1 further comprising a feature for protecting neural elements located adjacent the guide.
24. The patient-specific cutting guide of claim 10 , wherein the portion of a patient's boney anatomy previously modified is a cannulated pedicle.
25. The patient-specific cutting guide of claim 12 , wherein the frame is selectively interconnected to a pedicle screw.
26. The patient-specific cutting guide of claim 14 , wherein the second patient-specific cutting guide comprises at least one patient specific contour for mating with a portion of a patient's boney anatomy previously modified by the use of the first patient-specific cutting guide.