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Design Innovation

Design of a Novel Device to Provide Assured Seating of Bone Implanted Fiducial Markers

[+] Author and Article Information
Jason Mitchell

Department of Mechanical Engineering, Vanderbilt University, Nashville, TN 37235

Robert F. Labadie

Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University, Nashville, TN 37232

J. Michael Fitzpatrick

Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN 37235

J. Med. Devices 4(2), 025002 (Aug 04, 2010) (4 pages) doi:10.1115/1.4001585 History: Received January 11, 2010; Revised April 01, 2010; Published August 04, 2010; Online August 04, 2010

Microstereotactic frames are a subset of stereotactic frames. They are smaller than traditional frames, and they employ small discrete anchors that are screwed into a patient’s bony anatomy, typically the skull. These anchors provide points of attachment for the frame and also serve as markers that provide a bridge between image space and physical space. Both these markers and the anatomy of interest are imaged in a CT or MRI scanner, and their positions are established relative to one another. The microstereotactic frame is then custom made so that, when it is attached to the anchors, it will guide a surgical instrument to an anatomical target. These frames offer advantages over stereotactic frames, including increased targeting accuracy and patient comfort. Firm placement of these anchors is critical as any movement will cause errors in the imaging localization, frame design, or frame attachment. Anchor placement is complicated by the variation in bone density and by the obscuring tissue and bleeding that make visual confirmation of seating very difficult. A novel device called the PosiSeat™ is presented that provides assured seating for bone-implanted anchors.

FIGURES IN THIS ARTICLE
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Copyright © 2010 by American Society of Mechanical Engineers
Topics: Bone , Design , Surgery
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References

Figures

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Figure 1

StarFix platform mounted to DBS patient (courtesy of FHC Inc.; Bowdoin, ME)

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Figure 2

(a) StarFix platform, (b) leg attached to WayPoint anchor, and (c) closeup of WayPoint anchor

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Figure 3

MicroTable during in vivo targeting validation

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Figure 4

(a) MicroTable (b) leg attached to spherical extender and WayPoint anchor, and (c) close up of WayPoint anchor

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Figure 5

Three bone anchor tightening outcomes: under tightened, fully seated, and over tightened and stripping out the bone

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Figure 6

Exploded and unexploded views of the PosiSeat™

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Figure 7

(a) Starting position, (b) intermediate, and (c) seated

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Figure 8

Cutaway detail view of hexagonal mating surfaces

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Figure 9

Exploded and unexploded views of the PosiSeat™

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Figure 10

PosiSeat™ inserting screw into temporal bone of patient using Stryker driver

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Figure 11

Anchor in temporal bone showing positive seating

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Figure 12

CT images of anchor in bone: (a) showing positive seating achieved with the PosiSeat™, and (b) showing a typically poor result achieved without the assistance of the PosiSeat

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