DE3904595C1 - Device for determining the spatial coordinates of stereotactic target points by means of X-ray pictures - Google Patents

Device for determining the spatial coordinates of stereotactic target points by means of X-ray pictures

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Publication number
DE3904595C1
DE3904595C1 DE3904595A DE3904595A DE3904595C1 DE 3904595 C1 DE3904595 C1 DE 3904595C1 DE 3904595 A DE3904595 A DE 3904595A DE 3904595 A DE3904595 A DE 3904595A DE 3904595 C1 DE3904595 C1 DE 3904595C1
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Prior art keywords
plate
wires
plates
ray
stereotactic
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DE3904595A
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German (de)
Inventor
Otto 6906 Leimen De Pastyr
Wolfgang Dr. 6900 Heidelberg De Schlegel
Wolfgang Dr. 6915 Dossenheim De Maier-Borst
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Deutsches Krebsforschungszentrum DKFZ
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Deutsches Krebsforschungszentrum DKFZ
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/12—Arrangements for detecting or locating foreign bodies
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/08—Auxiliary means for directing the radiation beam to a particular spot, e.g. using light beams
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00902—Material properties transparent or translucent
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Engineering & Computer Science (AREA)
  • Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Health & Medical Sciences (AREA)
  • Pathology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • High Energy & Nuclear Physics (AREA)
  • Radiology & Medical Imaging (AREA)
  • Optics & Photonics (AREA)
  • Physics & Mathematics (AREA)
  • Biophysics (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Apparatus For Radiation Diagnosis (AREA)

Abstract

The invention relates to a device for the distortion-free spatial determination of stereotactic target points with a headring or other fixation elements to which at least four radioparent plates are connected; in each case two parallel plates are located opposite each other in pairs so as to receive the head or the relevant body part of the patient between them; each plate pair is provided with corresponding marks which are imaged - so as to overlap each other - together with the target point to be determined on the X-ray picture of the head or the relevant body part, so that the spatial position of the target point can be determined from two orthogonal X-ray pictures. The invention is based on the object of designing the marks in a device of the generic type in such a way that evaluation of the X-ray pictures is simplified and, above all, evaluation errors are avoided. Moreover, unambiguous, visual control of the adjustment of the stereotactic X-ray unit is to be ensured in order to increase the precision of stereotactic treatments. The solution is characterised in that the marks comprise several wires arranged concentrically relative to one another in the form of semi-circles or polygons which greatly absorb the X-rays and are arranged on or in the plates.

Description

Die Erfindung geht aus von einer Vorrichtung zum Ermitteln der räumlichen Koordinaten stereotaktischer Zielpunkte gemäß dem Oberbegriff von Patentanspruch 1.The invention is based on a device for determining the spatial coordinates according to stereotactic target points the preamble of claim 1.

Eine Vorrichtung dieser Art ist aus der Zeitschrift Int. J. Radiation Oncology, Biology, Physics, Vol. 13, Number 8, Au­ gust 1987, Seiten 1241-1246, bekannt. Sie besteht im wesent­ lichen aus einem quaderförmigen Behältnis, an dessen eine Seite ein Kopfring anschließt, durch den der Kopf des Patien­ ten in das Behältnis hineinragt. Die hieran angrenzenden vier Seiten des Behältnisses tragen je vier Markierungen, die je­ weils die Eckpunkte eines Rechtecks bilden. Die Koordinaten dieser sechzehn Markierungen sind genau bekannt in bezug auf ein stereotaktisches Koordinatensystem. Diese Markierungen werden auf den orthogonalen Röntgenaufnahmen mitabgebildet und ermöglichen, die räumliche Lage des Zielpunktes rechnerisch zu ermitteln.A device of this type is from the magazine Int. J. Radiation Oncology, Biology, Physics, Vol. 13, Number 8, Au gust 1987, pages 1241-1246. It essentially consists Lichen from a cuboid container, on one A head ring connects through which the patient's head protrudes into the container. The four adjacent to it Sides of the container each have four marks, each because form the corner points of a rectangle. The coordinates of these sixteen marks are well known in relation to a stereotactic coordinate system. These markings are also shown on the orthogonal X-rays and enable the spatial position of the target point to be calculated determine.

Die Erkennung der Markierungspunkte im stereotaktischen Rönt­ genbild kann jedoch insbesondere bei angiographischer Röntgen­ technik Schwierigkeiten bereiten. So kann es vorkommen, daß diese Markierungspunkte von kontrastmitteltragenden Gefäßen verdeckt werden und dadurch die Auswertung des Röntgenbildes erschwert wird.The detection of the marking points in the stereotactic X-ray However, genotyping can be particularly important for angiographic x-rays cause technical difficulties. So it can happen that these marking points of contrast medium-carrying vessels are covered and thereby the evaluation of the x-ray image is difficult.

Der Erfindung liegt die Aufgabe zugrunde, bei einer Vorrich­ tung der gattungsgemäßen Art die Markierungen so zu gestalten, daß die Auswertung der Röntgenbilder vereinfacht und vor allem Auswertefehler vermieden werden und daß eine eindeutige, visuelle Kontrolle über die Einjustierung der stereotaktischen Röntgeneinrichtung zur Erhöhung der Präzision stereotaktischer Behandlungen gegeben ist. The invention has for its object in a Vorrich the generic type to design the markings so that the evaluation of x-rays is simplified and above all Evaluation errors are avoided and that a clear, visual control over the adjustment of the stereotactic X-ray device to increase precision stereotactic treatments.  

Diese Aufgabe wird mit dem Gegenstand des Patentanspruchs 1 gelöst. Die Unteransprüche geben vorteilhafte Aus­ gestaltungen und Weiterbildungen dieses Gegenstandes an.This object is the subject of claim 1 solved. The Sub-claims give advantageous designs and further developments of this subject.

Durch die kreisringförmigen, konzentrischen Drähte entstehen auf den Röntgenbildern einfache und eindeutige, geometrische Konfigurationen, aus denen der Verzeichnungsmaßstab auch bei teilweiser Verdeckung einzelner Drähte leicht ermittelt werden kann. Dabei ist die Kenntnis des genauen Abstandes zwischen Röntgenfilm und Röntgenfokus bzw. zwischen dem stereotakti­ schen Koordinatensystem und dem Röntgenfokus nicht notwendig. Der Abstand zwischen Röntgenfilm und Röntgenfokus kann relativ gering sein, ohne daß hierdurch die erforderliche Genauigkeit der Zielpunktbestimmung beeinträchtigt wird; dadurch kommt man mit kleinen räumlichen Abmessungen bei der Einrichtung des stereotaktischen Operationssaales aus.Due to the circular, concentric wires simple and unambiguous, geometric on the X-ray images Configurations that make up the distortion scale at partial covering of individual wires can be easily determined can. The knowledge of the exact distance between X-ray film and X-ray focus or between the stereotacti coordinate system and the X-ray focus are not necessary. The distance between the X-ray film and the X-ray focus can be relative be low without the required accuracy the target point determination is impaired; that's how you come with small spatial dimensions when setting up the stereotactic operating room.

Ein Ausführungsbeispiel wird im folgenden anhand der Zeichnung erläutert.An embodiment is shown below with reference to the drawing explained.

Auf einer Fixiereinrichtung, einem stereotaktischen Grund- oder Kopfring 1 eines soge­ nannten "Riechert-Mundinger-Fixierungssystems", sind vier Plat­ ten 2, 3, 4, 5 aus formbeständigem, transparentem Kunststoff, z. B. aus "Plexiglas", aufgebracht. Einander benachbarte Plat­ ten sind senkrecht zueinander angeordnet, so daß sich jeweils zwei Platten 2, 4 bzw. 3, 5 paarweise in genau vorgegebenem Abstand gegenüberstehen.On a fixing device, a stereotactic base or head ring 1 of a so-called "Riechert-Mundinger fixation system", four plates are 2, 3, 4, 5 made of dimensionally stable, transparent plastic, eg. B. from "plexiglass" applied. Adjacent plat ten are arranged perpendicular to each other, so that two plates 2, 4 and 3, 5 face each other in pairs at a precisely specified distance.

Die unteren Plattenkanten 2 a, 3 a, 4 a, 5 a sind auf dem Kopfring 1, die oberen Plattenkanten 2 e, 3 e, 4 e, 5 e an einem weiteren, parallel zu dem Kopfring 1 verlaufenden Haltering 6 fixiert und ragen etwas über die Ringe 1, 6 hinaus. Jede Platte trägt in gleicher Weise Markierungen in Gestalt von mehreren halb­ kreisförmigen oder mehreckigen und konzentrisch zueinander angeordneten Stahldrähten 2 c, 3 c, 4 c, 5 c, die die Röntgenstrahlung stark absorbieren und auf dem Röntgenbild (Fig. 2) als Kontrastlinien abgebildet werden. Der geometrische Mittelpunkt 2 b, 3 b, 4 b, 5 b befindet sich beim Riechert-Mundinger-Fixierungssystem 7,5 mm unterhalb der Plattenkanten 2 a, 3 a, 4 a, 5 a. Die Drähte können auch in die Platten eingebettet sein.The lower plate edges 2 a , 3 a , 4 a , 5 a are fixed on the head ring 1 , the upper plate edges 2 e , 3 e , 4 e , 5 e on a further holding ring 6 running parallel to the head ring 1 and protrude somewhat beyond rings 1, 6 . In the same way, each plate bears markings in the form of several semicircular or polygonal and concentrically arranged steel wires 2 c , 3 c , 4 c , 5 c , which strongly absorb the x-rays and are shown on the x-ray image ( FIG. 2) as contrast lines . The geometric center 2 b , 3 b , 4 b , 5 b is in the Riechert-Mundinger fixation system 7.5 mm below the plate edges 2 a , 3 a , 4 a , 5 a . The wires can also be embedded in the plates.

Die halbkreisförmigen Drähte 2 c, 3 c, 4 c, 5 c enden an den unte­ ren Plattenkanten 2 a, 3 a, 4 a, 5 a. Je eine Platte 2 bzw. 3 je­ des Plattenpaares 2, 4 bzw. 3, 5 ist mit einem zusätzlichen geraden Draht 2 d bzw. 3 d versehen, der senkrecht auf dem Kopf­ ring 1 steht und den Mittelpunkt 2 d, 3 d und die Scheitelpunkte der Halbkreise 2 c, 3 c schneidet. Die jeweils gegenüberliegen­ den Platten 4 und 5 haben je zwei gerade und senkrecht auf dem Kopfring 1 stehende Drähte 4 d, 5 d, die von den Mittellinien gleiche Abstände aufweisen. In der Projektion gesehen schließen daher die Drähtepaare 4 d, 5 d der Platten 4 und 5 die Drähte 2 d und 3 d mittig zwischen sich ein. Zusätzlich sind schräge Drähte 2 f, 3 f, 4 f, 5 f aufgebracht, die vom Mittelpunkt 2 b, 3 b, 4 b, 5 b ausgehen und die Drähte 2 c, 3 c, 4 c, 5 c schnei­ den.The semicircular wires 2 c , 3 c , 4 c , 5 c end at the lower plate edges 2 a , 3 a , 4 a , 5 a . One plate 2 or 3 each of the pair of plates 2, 4 or 3, 5 is provided with an additional straight wire 2 d or 3 d , which is perpendicular to the head ring 1 and the center 2 d , 3 d and the Vertices of the semicircles 2 c , 3 c intersect. The opposite plates 4 and 5 each have two straight and vertical wires 4 d , 5 d on the head ring 1 , which have the same distances from the center lines. Seen in the projection, therefore, the wire pairs 4 d , 5 d of the plates 4 and 5 enclose the wires 2 d and 3 d in the middle between them. In addition, oblique wires 2 f , 3 f , 4 f , 5 f are applied, which start from the center 2 b , 3 b , 4 b , 5 b and cut the wires 2 c , 3 c , 4 c , 5 c .

Zum Ermitteln eines Zielpunktes wird zunächst eine visuelle Einjustierung vorgenommen, worauf zwei orthogonale Röntgenbil­ der des durch den Ring 1 in die Vorrichtung hineinragenden Kopfes des zu behandelnden Patienten aufgenommen werden.To determine a target point, a visual adjustment is first carried out, whereupon two orthogonal x-ray images of the head of the patient to be treated protruding through the ring 1 are recorded.

Fokus und Röntgenfilm werden visuell so einjustiert, daß die Halbkreise 2 c der Platte 2 und die Halbkreise 4 c der Platte 4 sich konzentrisch auf dem Bild überlagern und auch die Abbil­ dung des Drahtes 2 d mittig zwischen die beiden Drähte 4 d zu liegen kommt. Entsprechendes gilt für die hierzu orthogonale Einjustierung in bezug auf das Plattenpaar 3, 5.Focus and X-ray film are visually adjusted so that the semicircles 2 c of the plate 2 and the semicircles 4 c of the plate 4 overlap concentrically on the image and also the image of the wire 2 d comes to lie centrally between the two wires 4 d . The same applies to the orthogonal adjustment in relation to the plate pair 3, 5 .

Nach diesem Justieren werden die entsprechenden Röntgenauf­ nahmen durchgeführt. Anhand der Lage des Zielpunktes auf den beiden Röntgenaufnahmen in bezug auf die mitabgebildeten Mu­ ster der Drähte können die genauen Raumkoordinaten des Ziel­ punktes in dem stereotaktischen Koordinatensystem rechnerisch ermittelt werden. Da es sich hierbei um sehr einfache geome­ trische Konfigurationen handelt, ist eine leichte Nachprüfbar­ keit der z. B. von einem Rechner ausgegebenen Koordinatenwerte möglich, was etwaige Fehler eingrenzt und damit die Sicherheit erhöht.After this adjustment, the corresponding X-rays are taken took place. Based on the location of the target point on the two x-rays with reference to the mapped mu ster of the wires can be the exact spatial coordinates of the target point in the stereotactic coordinate system be determined. Because this is very simple geome trical configurations is easy to verify speed of the z. B. coordinate values output by a computer possible, which limits possible errors and thus safety elevated.

Sollten sich bei der Auswertung der orthogonalen Röntgenaufnahmen Fehljustierungen der Röntgenröhre ergeben, dann können anhand der Schnittpunkte der schrägen Drähte mit den halbkreis- oder mehreckförmigen Drähten auch eine schräge Einstrahlungsrichtung berücksichtigt und die Ziel­ punktskoordinaten entsprechend korrigiert werden.Should be considered when evaluating the orthogonal X-rays show misalignments of the X-ray tube then you can with the intersection of the oblique wires the semicircular or polygonal wires also an oblique Irradiation direction taken into account and the target point coordinates are corrected accordingly.

Claims (7)

1. Vorrichtung zum Ermitteln der räumlichen Koordinaten stereotaktischer Zielpunkte mittels Röntgenaufnahmen, umfassend eine Fixierungseinrichtung (1), mit der wenigstens vier für Röntgenstrahlung durchlässige Platten (2, 3, 4, 5) verbunden sind, von denen je zwei Platten, die den zu untersuchenden Körperteil des Patienten zwischen sich aufnehmen, einander parallel gegenüberstehen und mit zueinander korrespondierenden Markierungen versehen sind, die die Röntgenstrahlung stark absorbieren und auf oder in den Platten (2, 3, 4, 5) derart ange­ ordnet sind, daß sie - sich überlagernd - zusammen mit dem zu bestimmenden Zielpunkt auf der Röntgenaufnahme abgebildet werden, dadurch ge­ kennzeichnet, daß die Markierungen aus mehreren, konzentrisch zuein­ ander angeordneten Drähten (2 c, 3 c, 4 c, 5 c) in Form von Halbkreisen oder Vielecken bestehen.1. Device for determining the spatial coordinates of stereotactic target points by means of X-ray recordings, comprising a fixing device ( 1 ), with which at least four plates ( 2, 3, 4, 5 ) that are transparent to X-radiation are connected, two of which each plate that is to be examined Include the body part of the patient between them, face each other in parallel and are provided with mutually corresponding markings that strongly absorb the X-rays and are arranged on or in the plates ( 2, 3, 4, 5 ) in such a way that they - overlapping - together with the target to be determined on the X-ray image, characterized in that the markings consist of several concentrically arranged wires ( 2 c , 3 c , 4 c , 5 c) in the form of semicircles or polygons. 2. Vorrichtung nach Anspruch 1, dadurch gekennzeichnet, daß die Enden der Drähte (2 c, 3 c, 4 c, 5 c) in eine Plattenkante (2 a, 3 a, 4 a, 5 a) ausmünden, an der die Platte an der Fixiereinrichtung befestigt ist.2. Device according to claim 1, characterized in that the ends of the wires ( 2 c , 3 c , 4 c , 5 c) open into a plate edge ( 2 a , 3 a , 4 a , 5 a) on which the plate is attached to the fixing device. 3. Vorrichtung nach Anspruch 2, dadurch gekennzeichnet, daß die eine Platte (2, 3) jedes Plattenpaares einen zusätzli­ chen geraden Draht (2 d, 3 d) aufweist, der senkrecht auf der Fixiereinrichtung steht und den Mittelpunkt (2 b, 3 b) und die Scheitelpunkte der halbkreisförmigen Drähte schneidet, und daß die andere Platte (4, 5) jedes Plattenpaares je zwei gerade, zueinander parallele Drähte (4 d, 5 d) aufweist, die - in der Projektion gesehen - den ersten Draht (2 d, 3 d) mit­ tig zwischen sich aufnehmen.3. Apparatus according to claim 2, characterized in that the one plate ( 2, 3 ) of each plate pair has an additional chen straight wire ( 2 d , 3 d) which is perpendicular to the fixing device and the center ( 2 b , 3 b ) and the vertices of the semicircular wires intersect, and that the other plate ( 4, 5 ) of each plate pair has two straight, parallel wires ( 4 d , 5 d) , which - seen in the projection - the first wire ( 2 d , 3 d) with tig between them. 4. Vorrichtung nach Anspruch 2, dadurch gekennzeichnet, daß die Fixiereinrichtung ein Kopfring ist und daß ein weiterer, parallel zu diesem angeordneter Halte­ ring (6) vorhanden ist, an dem die Platten (2, 3, 4, 5) mit ihren gegenüberliegenden Plattenkanten (2 e, 3 e, 4 e, 5 e) fixiert sind.4. The device according to claim 2, characterized in that the fixing device is a head ring and that a further, arranged parallel to this holding ring ( 6 ) is present on which the plates ( 2, 3, 4, 5 ) with their opposite plate edges ( 2 e , 3 e , 4 e , 5 e) are fixed. 5. Vorrichtung nach Anspruch 1, dadurch gekennzeichnet, daß die Platten aus formbeständigem Kunststoff bestehen.5. The device according to claim 1, characterized in that the plates are made of dimensionally stable plastic. 6. Vorrichtung nach Anspruch 1, dadurch gekennzeichnet, daß jede Platte (2, 3, 4, 5) zusätzlich schräg verlaufende Drähte enthält (2 f, 3 f, 4 f, 5 f), die vom geometrischen Mittelpunkt (2 b, 3 b, 4 b, 5 b) der Drahtmarkierungen ausgehen und die halbkreis- oder mehreckför­ migen Drähte schneiden.6. The device according to claim 1, characterized in that each plate ( 2, 3, 4, 5 ) additionally contains obliquely running wires ( 2 f , 3 f , 4 f , 5 f) , the geometric center ( 2 b , 3rd b , 4 b , 5 b) go out of the wire markings and cut the semicircular or polygonal wires. 7. Vorrichtung nach Anspruch 1, dadurch gekennzeichnet, daß die geometrischen Mittelpunkte der Drahtmarkierungen (2 b, 3 b, 4 b, 5 b) außerhalb der Plattenkanten (2, 3, 4, 5) lie­ gen.7. The device according to claim 1, characterized in that the geometric centers of the wire markings ( 2 b , 3 b , 4 b , 5 b) outside the plate edges ( 2, 3, 4, 5 ) lie gene.
DE3904595A 1989-02-16 1989-02-16 Device for determining the spatial coordinates of stereotactic target points by means of X-ray pictures Expired - Fee Related DE3904595C1 (en)

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WO1991007913A1 (en) * 1989-11-24 1991-06-13 Technomed International A method and apparatus for determining the position of a target relative to known co-ordinates
FR2665545A1 (en) * 1990-08-06 1992-02-07 Technomed Int Sa Method and apparatus for determining the position of a target with respect to a reference mark of known coordinates without knowing, a priori, the position of a source of radiation
DE4106554A1 (en) * 1991-03-01 1992-09-10 Siegfried Dr Med Dr Me Richter Appliance for marking patient before surgical operation - has plates with rows of holes to guide marking needles
DE4417414A1 (en) * 1993-06-15 1994-12-22 Siemens Ag Image processing method for medical engineering support of stereotactical operations
EP0699050A1 (en) * 1993-04-26 1996-03-06 St. Louis University Indicating the position of a surgical probe
DE29521895U1 (en) 1994-10-07 1998-09-10 St. Louis University, St. Louis, Mo. Surgical navigation system comprising reference and localization frames
US6146390A (en) 1992-04-21 2000-11-14 Sofamor Danek Holdings, Inc. Apparatus and method for photogrammetric surgical localization
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US7419714B1 (en) 1998-05-27 2008-09-02 Sepitec Foundation Composite of polymer or ceramic materials and component made of such a composite
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US8382765B2 (en) 2007-08-07 2013-02-26 Stryker Leibinger Gmbh & Co. Kg. Method of and system for planning a surgery
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Cited By (25)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1991007913A1 (en) * 1989-11-24 1991-06-13 Technomed International A method and apparatus for determining the position of a target relative to known co-ordinates
FR2665545A1 (en) * 1990-08-06 1992-02-07 Technomed Int Sa Method and apparatus for determining the position of a target with respect to a reference mark of known coordinates without knowing, a priori, the position of a source of radiation
US6490467B1 (en) 1990-10-19 2002-12-03 Surgical Navigation Technologies, Inc. Surgical navigation systems including reference and localization frames
US6374135B1 (en) 1990-10-19 2002-04-16 Saint Louis University System for indicating the position of a surgical probe within a head on an image of the head
DE4106554A1 (en) * 1991-03-01 1992-09-10 Siegfried Dr Med Dr Me Richter Appliance for marking patient before surgical operation - has plates with rows of holes to guide marking needles
US6146390A (en) 1992-04-21 2000-11-14 Sofamor Danek Holdings, Inc. Apparatus and method for photogrammetric surgical localization
US6491702B2 (en) 1992-04-21 2002-12-10 Sofamor Danek Holdings, Inc. Apparatus and method for photogrammetric surgical localization
US6165181A (en) 1992-04-21 2000-12-26 Sofamor Danek Holdings, Inc. Apparatus and method for photogrammetric surgical localization
EP0699050A1 (en) * 1993-04-26 1996-03-06 St. Louis University Indicating the position of a surgical probe
EP0997109A3 (en) * 1993-04-26 2000-06-14 ST. Louis University Indicating the position of a surgical probe
EP0699050A4 (en) * 1993-04-26 1998-09-16 Univ St Louis Indicating the position of a surgical probe
DE9422172U1 (en) 1993-04-26 1998-08-06 St. Louis University, St. Louis, Mo. Specify the location of a surgical probe
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