CN107205783B - 髋臼边缘数字化装置和方法 - Google Patents
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Abstract
一种用于跟踪骨盆的取向的计算机辅助手术(CAS)***,包括:至少一个器械,该器械具有适于被接纳在髋臼中的髋臼邻接端、适于抵靠髋臼的边缘的边缘邻接部、以及表示器械的物理取向的指示器。至少一个惯性传感器单元连接至至少一个器械,惯性传感器单元产生表示其取向的读数。运行手术辅助程序的计算机辅助手术处理器单元,包括:坐标系模块,坐标系模块用于在至少一个器械的髋臼邻接端被接纳在髋臼中时根据至少一个惯性传感器单元的读数设定骨盆坐标系,坐标系模块在边缘邻接部抵靠边缘的位置时通过从至少一个惯性传感器单元获取多个取向值来设定骨盆坐标系,取向值中的一个使指示器与参考界标对准,坐标系模块根据多个取向值限定表示骨盆坐标系的髋臼平面;和跟踪模块,跟踪模块用于使用来自惯性传感器单元的读数在其运动期间跟踪至少一个惯性传感器单元相对于骨盆坐标系的取向。界面输出作骨盆坐标系的函数的取向数据。
Description
技术领域
本申请涉及使用惯性传感器的计算机辅助手术,并且更具体地,涉及用于在髋部手术中确定骨盆倾斜以便随后的髋臼杯定位流程的工具。
背景技术
在髋关节置换术中,髋臼被铰孔以随后在其中接纳髋臼杯。髋臼杯是被接纳在经铰孔的髋臼中的植入物并且充当针对股骨头或股骨头植入物的受器。因此,在流程中使用诸如铰孔器和杯冲击器的工具。在这样的流程中的挑战之一是向髋臼杯提供正确的取向。实际上,不准确的取向可能导致移动的损耗、不合适的步态和/或植入物部件的过早磨损。例如,髋臼杯通常通过冲击器被定位在经铰孔的髋臼中。冲击器具有杆,在该杆的端部处是髋臼杯。杆由手术者把持,其影响自由端以便将髋臼杯驱动到髋臼中。然而,重要的是,手术者将冲击器的阀杆保持在相对于骨盆的精确的三维取向上,以便确保在倾斜和前倾方面的髋臼杯的足够的取向。
出于该目的,计算机辅助手术已经被开发,以便帮助手术者将冲击器定位和定向到期望的取向,这尤其是通过确定骨盆的骨盆倾斜、髋臼平面等取向数据。在被用在计算机辅助手术中的各种跟踪技术中间,已经使用光学导航、C形臂验证和手动参考引导。光学导航要求使用导航***,其增加手术时间。其还要求将参考器钉在患者上,其增加到流程的侵入性。其还限于阻碍正常手术流的视线约束。C形臂验证要求使用庞大的设备并且验证不具有成本效益。此外,其不提供在一旦被完成时对杯定位的定量评估,并且通常与在手术中相反,在手术后被使用。最后,诸如A型的手动夹具没有考虑患者在手术桌台上的位置。因此,惯性传感器由于其成本效益和其提供的有价值信息而被使用。
发明内容
因此,本发明的目的在于提供一种解决与现有技术相关的问题的髋臼边缘数字化器。
因此,根据本公开的第一实施例,提供了一种用于跟踪骨盆的取向的计算机辅助手术(CAS)***,包括:至少一个器械,器械具有适于被接纳在髋臼中的髋臼邻接端、适于抵靠髋臼的边缘的边缘邻接部、以及表示器械的物理取向的指示器;连接至至少一个器械的至少一个惯性传感器单元,惯性传感器单元产生表示其取向的读数;运行手术辅助程序的计算机辅助手术处理器单元,其包括坐标系模块和跟踪模块,坐标系模块用于在至少一个器械的髋臼邻接端被接纳在髋臼中时根据至少一个惯性传感器单元的读数设定骨盆坐标系,坐标系模块在边缘邻接部抵靠边缘的位置时通过从至少一个惯性传感器单元获取多个取向值来设定骨盆坐标系,取向值中的一个使指示器与参考界标对准,坐标系模块根据多个取向值限定表示骨盆坐标系的髋臼平面,跟踪模块用于使用来自惯性传感器单元的读数在其期间跟踪至少一个惯性传感器单元相对于骨盆坐标系的取向;以及用于输出作为骨盆坐标系的函数的取向数据的界面。
进一步根据第一实施例,至少一个器械在其上具有适于相对于骨盆坐标系将销定位在髋臼中的期望的位置的销导向器。
仍进一步根据第一实施例,指示器是将光束发射在参考界标上的光源。
仍进一步根据第一实施例,获取的取向值中的第一个使指示器与参考界标对准。
仍进一步根据第一实施例,取向值中的第一个根据术前成像编程为表示患者取向。
仍进一步根据第一实施例,跟踪模块相对于骨盆坐标系跟踪支撑惯性传感器单元中的一个的至少一个工具。
仍进一步根据第一实施例,跟踪模块计算至少一个工具相对于骨盆的前倾和倾斜中的至少一个。
根据本公开的第二实施例,提供了一种用于跟踪骨盆的取向的计算机辅助手术(CAS)***,包括:至少一个器械,器械具有适于以计划互补邻接抵靠髋臼的边缘的髋臼邻接端;连接至至少一个器械的至少一个惯性传感器单元,惯性传感器单元产生表示其取向的读数;一种运行手术辅助程序的计算机辅助手术处理器单元,其包括包括坐标系模块和跟踪模块,坐标系模块用于在至少一个器械的髋臼邻接端以计划互补邻接抵靠髋臼的边缘时根据至少一个惯性传感器单元的读数设定骨盆坐标系,坐标系模块基于计划互补邻接通过限定表示骨盆坐标系的髋臼平面来设定骨盆坐标系,跟踪模块用于使用来自惯性传感器单元的读数在其运动期间跟踪至少一个惯性传感器单元相对于骨盆坐标系的取向;以及用于输出作为骨盆坐标系的函数的取向数据的界面。
进一步根据第二实施例,至少一个器械在其上具有适于相对于骨盆坐标系将销定位在髋臼中的期望的位置的销导向器。
仍进一步根据第二实施例,跟踪模块相对于骨盆坐标系跟踪支撑惯性传感器单元中的一个的至少一个工具。
仍进一步根据第二实施例,跟踪模块计算至少一个工具相对于骨盆的前倾和倾斜中的至少一个。
仍进一步根据第二实施例,髋臼邻接端是具有适于在计划互补邻接中被邻接的三个邻接凸出部的三脚架。
仍进一步根据第二实施例,髋臼邻接端是基于患者的术前成像为患者特异性地制造的。
仍进一步根据第二实施例,髋臼邻接端具有通过可锁定接头连接至器械的其余部分的可调节支脚,以使得髋臼邻接端布置成用于基于患者的术前成像的计划互补邻接。
仍进一步根据第二实施例,每个支脚具有平移自由度接头和旋转自由度接头。
根据本公开的第三实施例,提供了一种用于在计算机辅助的髋部手术中跟踪骨盆的取向的方法,包括:获取具有惯性传感器单元、适于接触髋臼的边缘的髋臼邻接端、和旋转指示器的器械;使髋臼邻接端抵靠髋臼的边缘并且使旋转指示器与骨盆界标对准来初始化器械的取向;对至少初始取向记录取向;根据取向限定表示骨盆坐标系的髋臼平面;以及使用惯性传感器单元产生相对于骨盆坐标系的取向数据。
进一步根据第三实施例,使用惯性传感器单元产生相对于骨盆坐标系的取向数据包括产生具有惯性传感器单元的工具相对于骨盆的前倾和/或倾斜角度。
进一步根据第三实施例,记录取向包括记录每个与边缘和髋臼邻接端之间的不同接触位置相关联的多个取向值。
进一步根据第三实施例,引导在骨盆坐标系中的取向已被获知的销的安装。
进一步根据第三实施例,使髋臼邻接端抵靠髋臼的边缘并且使旋转指示器与骨盆界标对准来初始化器械的取向基于表示患者取向的术前成像。
附图说明
图1是根据本发明的髋臼边缘数字化装置相对于骨盆的透视图;
图2是图1的髋臼边缘数字化装置的工具作业端的放大透视图;
图3是根据本发明的另一实施例的具有平坦表面的髋臼边缘数字化装置的工具作业端的放大正视图;
图4是图3的髋臼边缘数字化装置的透视图;和
图5是根据本发明的另一实施例的具有支脚的髋臼边缘数字化装置的透视图。
具体实施方式
参考附图,并且更具体地参考图1和图2,髋臼边缘数字化装置或器械通常相对于具有髋臼A的骨盆P以10表示,该髋臼具有边缘R。装置10和与装置10有关的方法可用于确定各种形式的骨盆取向数据(例如,骨盆倾斜、髋臼的前倾/倾斜等)。装置10也可以用于使用惯性传感器对用在髋关节置换术或包括骨塑造和尸体检验的类似流程中的诸如髋臼铰孔器、杯冲击器、冲击器导向销的器械精确地导航。
装置10具有细长本体11,细长本体11具有工具作业端12和手柄端14。虽然装置10的本体被示出为具有轴向偏移部分,但是其也可以是完全直的或者具有任何其它合适的形状。
装置10具有用于以已知方式在其中可释放地接纳惯性传感器单元18的受器16。可替代地,惯性传感器单元18可以集成或嵌入到细长本体11中。惯性传感器单元18可以具有陀螺仪装置,以通过对由传感器通过注册处理记录的角速度数据进行积分来跟踪装置10的取向。惯性传感器单元18也可以包括加速度计装置,其用于校准装置10的初始位置并且在记录稳定位置时补偿陀螺仪漂移。在惯性传感器单元18中可以设置有诸如测斜计、磁力计等其它可能的惯性传感器的其它类型的惯性传感器,以补充数据或作为加速度计和/或陀螺仪的替代物。
惯性传感器单元18使用其惯性传感器读数来连续计算本体的取向和速度,而不需要外部参考,即,不需要从传感器组件外部的信号传输,惯性传感器单元18是自成独立的。这个过程通常被称为航位推算并且有资料佐证,其构成公知常识的一部分。初始的取向和速度必须被提供给惯性传感器单元18,即图1的X-Y-Z坐标系,其后通过对每个时间步(timestep)的陀螺仪读数的角速率进行积分来跟踪取向。通过精确估计惯性传感器单元18相对于全局参照系的取向,可以移除重力作用并且可以对作用在加速度计上的惯性力进行积分,以跟踪速度和位置的变化。由于惯性传感器单元18不需要外部参考,因此它可以免受诸如磁场的环境因素的影响,并且可以在宽范围的条件下运行。
如将在下面详细描述的,惯性传感器单元18是用于对器械进行导航以实现方法10的计算机辅助髋关节手术***的一部分。该***包括计算机辅助手术(CAS)处理单元19,其可以是例如通过无线通信连接至惯性传感器单元18的独立计算机。然而,应指出的是,CAS处理单元可以部分或完全地集成到也被称为容器(pod)的惯性传感器单元18中。惯性传感器单元18在结合CAS处理单元时,可以因此配备有用户界面,以提供导航数据,而无论用户界面以LED显示器、屏幕还是数字显示器等的形式。计算机辅助手术(CAS)处理单元19可以具有以下将进一步详细描述的坐标系模块19A和跟踪模块19B、以及编程到CAS处理单元19中的手术辅助程序的一部分。
半球形基座20紧固至工具作业端12。基座20能够可释放地连接(例如,通过螺纹接合)至本体11,以使得能够基于被手术的髋臼来选取合适的尺寸的基座20。基座20的几何形状可以被认为是准半球形、截头圆球形等。实际上,当基座20在注册期间被置于髋臼中时,可预期的是基座20被很好地置于髋臼中,并且在注册处理期间不会移动位置。为了此目的,可以在基座20的表面上或其附近设置压力传感器(或多个压力传感器)。压力传感器(或多个压力传感器)提供可被监测的信号,以确定基座20是否被合适地抵靠髋臼的表面施加。
此外,装置10可以包括凸出部22,如图1和图2所示,凸出部22与基座20间隔开并且被设计成置于髋臼边缘上,以用于每个获取的点。装置10可以进一步具有旋转指示器24,以用于限定不平行于边缘平面法线的固定旋转轴线,从而构建用于髋臼的全坐标系。在示出的实施例中,旋转指示器24是发射可见光束的光源,尽管也可以使用诸如机械臂、激光、位于器械上的标记、或任何其它视觉指示器的其它旋转指示器。也可以将销导向器26设置成从细长本体11侧向伸出,其具有用于在注册后引导销28***骨盆中的狭槽的特征。旋转指示器24在惯性传感器单元18的坐标系中处于已知的物理取向。
CAS处理单元被编程有使本体11(例如,其轴线)与位于其上的诸如基座20、凸出部22和旋转指示器24的部件的取向相联系的几何数据。术前获取的这种几何数据被CAS处理单元(以18示出)使用,以执行下述的方法和序列。
仍参考图1,髋臼边缘数字化装置10可以在手术时与下面的术中方法一起使用:
1.在对髋臼A铰孔前或铰孔后,将装置10的基座20置于髋臼A中。已经选取基座20并将其安装成具有与髋臼A的直径互补的直径。
2.旋转指示器24用于使装置10具有预定的取向。取决于实施例,这种旋转指示器24可以定向成指向、标记、接触术前可识别的界标。例如,在骨盆的情况中,可识别的界标可以是侧向髂前上棘(ASIS)、髋臼边缘的12点钟特征、髋臼凹口等特征。
3.可以通过CAS处理单元的用户界面(例如,打开惯性传感器单元18上的按钮)来启动注册。
4.在例如从基座20中的压力传感器所确认的或者通过使手术者在装置10上施加合适的压力而不使基座20脱离的情况下,手动旋转装置10以将凸出部22定位在髋臼边缘R的不同段上(图2)。
5.通过用户要求或者通过稳定性标准,惯性传感器单元18记录数字化装置10的当前取向并向使用者提供反馈,以供确认。
6.重复步骤4至步骤5,直到惯性传感器单元18记录例如由惯性传感器单元18所指示的或基于预定数量的所需测量的足够数量的髋臼边缘位置。
7.CAS处理单元(例如,结合惯性传感器单元18)随后以任何合适的形式(即,骨盆坐标系)记录并提供与髋臼取向或骨盆倾斜相关的数据。
为了执行上述方法,CAS处理单元必须按以下序列编程:
1.当使用者启动初始记录时,CAS处理单元设定髋臼边缘数字化装置10的初始取向。通过假设任意偏转记录这个初始位置,以及由位于惯性传感器单元18中的加速度计装置提供滚动和俯仰。通过这个初始位置并且获知旋转指示器24相对于边缘数字化装置10的取向,可以将旋转轴线限定为:
rotationAxisInWorld
2.在初始化注册后,使用位于惯性传感器单元18中的陀螺仪装置来跟踪髋臼边缘数字化装置10的取向。记录装置10在凸出部22和髋臼边缘R之间的各个接触点处的取向。由位于惯性传感器单元18中的加速度计装置提供的倾斜数据(滚动和俯仰)可用于补偿(例如,使用卡尔曼或互补滤波器)陀螺仪数据的漂移。在各个点处的取向数据的集合提供了边缘数字化装置10在全局坐标系中的取向:
rimDigitizerInWorld
3.在具有稳定的取向的不同的接触点处,可以基于所获取的边缘数字化装置10的取向计算凸出部22的位置。这些位置中的每个被记录在由CAS处理单元保持的坐标系中,并且表示髋臼边缘R上的点。根据实施例,坐标系的原点位于半球形基座20的中心处。因此,边缘上每个点的位置可以识别如下:
rimPointInWorld=rimDigitizerInWorld*tabInRimDigitizerCenter
4.当已经记录了足够数量的点时,经注册的边缘点可用于限定髋臼边缘平面。根据实施例,使用诸如最小二乘拟合的合适方法来通过边缘点拟合平面。从而获知这个髋臼边缘平面:
rimPlaneNormalInWorld
5.髋臼边缘平面用于构建髋臼坐标系,如下:
rimXAxis=rimPlaneNormalInWorld
rimZAxis=rimXAxis*rotationAxisInWorld
rimYAxis=rimZAxis*rimXAxis
acetabulumInWorld=[rimXAxis rimYAxis rimZAxis]
6.使用术前计划数据(CT扫描、二维X射线、3-D建模等)创建骨盆坐标系。可以使用例如Lewinnek骨盆坐标系的任何标准限定。使用与在注册方法期间所使用的界标和旋转特征相同的界标和旋转特征,术前计划数据可以参考髋臼坐标系。通过从术前计划推断的数据,可以建立髋臼坐标系和骨盆坐标系之间的关系。通过将这种关系输入到导航***中,获取以下关系:
pelvisInWorld=acetabulumInWorld*pelvisInAcetabulum
7.全局坐标系的重力轴线也可用于从计算出的骨盆全局坐标系中确定骨盆倾斜。
在上述实施例中,用界标获取的髋臼边缘平面可以与在术前计划中限定的平面相匹配。可替代或附加地,CAS处理单元可以替代地将边缘界标与在术前计划中限定的表面相匹配。这个表面可以是表示髋臼边缘轮廓的3D表面。CAS处理单元可以使用最小二乘拟合来计算所获取的边缘点上的使这些点最接近髋臼边缘R的预先计划轮廓而定位的过渡。
该表面也可以是使用X射线图像与相应的投影相机校准组合而获取的一组2D轮廓。在一个实施例中,相机校准可以根据F.CHERIET等人在Int.J.Patt.Recogn.Artif.Intell.13,761(1999).、DOI:10.1142/S0218001499000434的文献中的名称为“TOWARDS THESELF-CALIBRATION OF A MULTIVIEW RADIOGRAPHIC IMAGING SYSTEM FOR THE 3DRECONSTRUCTION OF THE HUMAN SPINE AND RIB CAGE”来执行。CAS处理单元可以通过最小二乘拟合来计算在获取的边缘点上的使如由投影相机模型限定的点到X射线上的反投影最接近所限定的2D轮廓的过渡。
在另一实施例中,超声装置可以被安装至装置10,以便在将装置10置于髋臼A中时获取超声读数。该超声读数可以用于创建边缘表面并且因此代替装置10的凸出部22,从而减轻了对与髋臼边缘R的物理接触的需要。当基座20被置于髋臼A中并且超声装置相对于髋臼保持静止时,在将超声数据与自惯性传感器单元18提供的取向数据组合时,可以在空间中精确地重建髋臼边缘表面。这种信息可用于使注册的边缘轮廓与术前计划轮廓相匹配。
可以通过装置10使用取向数据将销28定位至期望的取向。例如,可以将销28驱动进入骨盆中,以便用作冲击器引导件。因此,可以将销28的纵向轴线驱动至平行于髋臼边缘平面的法线的取向。在实施例中,对用于放置销的装置10的导航是通过向使用者提供前倾和倾斜来完成的。
参考图3和图4,在又一实施例中,平面30或多个共面特征(图4中的三个固定凸出部)可用作位于细长本体11的工具作业端12处的凸出部22的替代物。可以设有基座20,或者也可以不设基座20,尽管基座20可以提供一些操作稳定性以辅助将平面表面30施加至髋臼边缘R。图3和图4的装置10可以用于在单个步骤中获取平面表面和旋转界标。装置10具有例如基于术前成像而被计划成与髋臼的边缘呈唯一互补接合的构造,所述术前成像通过例如使患者特异性接触表面作为患者组织的底片来用于唯一互补接合。根据图3和图4的实施例,如果执行合适的预先计划,则上述方法的步骤4至步骤6将不是必需的。类似地,不再需要由CAS处理单元执行的序列的步骤2至步骤4。惯性传感器单元18可以不需要用于图3和图4的实施例的陀螺仪装置。
参考图5,在又一实施例中,三个可调节支脚50可用作平面表面30的替代物,从而有效地形成三脚架。在使用时,要求使用者将所有支脚定位到已知的界标(例如,基于术前成像的唯一互补接合)上。支脚50具有可轴向位移(例如,沿着本体11的纵向轴线)和旋转(例如,绕着平行于本体11的纵向轴线的轴线)的邻接端51。因此,支脚50每个设置有壳体52,确保可锁定的平移自由度和旋转自由度。
支脚50的端部51所抵靠的已知界标可以通过可识别的解剖学界标限定,或者通过例如在髋臼槽口中通过使用止动件约束器械的旋转而限定。
对于图5的实施例,术前计划用于限定对三脚架的唯一调节,以延伸至支脚50,并且用于在用支脚50和骨盆P之间预定的邻接部将装置10定位到髋臼A中时识别装置10的唯一位置。
由于图5的装置10的位置在骨盆解剖学上是唯一的,所以惯性传感器单元18中的测斜计的单次读数将足以记录当前骨盆倾斜。
与图5的装置10组合使用的方法如下:
1.在术前计划期间,识别要使用的三个界标。
2.从这三个界标创建坐标系,这个坐标系和骨盆坐标系之间的关系也可以从术前计划中获知。
3.根据从术前计划中计算出的数据,对三脚架执行所需的调节,以设定每个支脚50的位置和/或取向。
4.随后可以在视觉上或通过使用机械特征以图5所示的方式将装置10定位在预先识别的界标上,从而约束旋转。
5.当稳定时,使用惯性传感器单元18记录用于装置10的取向数据,并且这个数据用于通过使用装置10和骨盆P之间的已知关系计算骨盆倾斜。
pelvisInWorld=tripodInWorld*pelvisInTripod
因此,任何前述图中的装置10被用于提供用于在手术中评估骨盆倾斜的手段并获取髋臼取向数据,而无论手术是仰卧位还是侧卧位进行的。由CAS处理单元提供的数据可以用于例如将骨盆重新定位在手术台上,以引导使用者将非导航器械与期望的杯对准件对准,或者可以在全髋关节置换流程期间用作用于手术器械的导航的输入。尽管上面讨论了轴线的交叉乘积,但是表示轴线的方向的矢量也可以用于交叉乘积。
如图1所示,CAS处理器单元19可以具有坐标系模块19A和跟踪模块19B。基于CAS处理器单元19支持的实施例,模块19A和模块19B可以具有不同的功能。例如,对于图1和图2的实施例,当至少一个器械10的髋臼邻接端被接纳在髋臼中时,坐标系模块19A根据惯性传感器单元18的读数设定骨盆坐标系。当边缘邻接凸出部22抵靠边缘的位置时,坐标系模块19A通过从惯性传感器单元18获取多个取向值来设定骨盆坐标系。取向值中的一个使指示器24与参考界标对准。因此,坐标系模块19A根据多个取向值限定表示骨盆坐标系的髋臼平面。随后,跟踪模块19B使用来自惯性传感器单元的读数在其运动期间跟踪惯性传感器单元相对于骨盆坐标系的取向。
作为另一示例,对于图3至图5的实施例,当器械10的髋臼邻接端以计划的互补方式抵靠髋臼的边缘时,坐标系模块19A根据惯性传感器单元18的读数设定骨盆坐标系。坐标系模块19A基于计划互补邻接通过限定表示骨盆坐标系的髋臼平面来设定骨盆坐标系。随后,跟踪模块19B在惯性传感器单元运动期间使用来自惯性传感器单元的读数来跟踪惯性传感器单元相对于骨盆坐标系的取向。
Claims (7)
1.一种用于跟踪骨盆的取向的计算机辅助手术(CAS)***,包括:
至少一个器械,所述器械具有适于被接纳在髋臼中的髋臼邻接端、适于抵靠所述髋臼的边缘的边缘邻接部、以及表示所述器械的物理取向的指示器;
连接至所述至少一个器械的至少一个惯性传感器单元,所述惯性传感器单元产生表示其取向的读数;
运行手术辅助程序的计算机辅助手术处理器单元,包括:
坐标系模块,所述坐标系模块用于在所述至少一个器械的所述髋臼邻接端被接纳在所述髋臼中时根据所述至少一个惯性传感器单元的读数设定骨盆坐标系,所述坐标系模块在所述边缘邻接部抵靠所述边缘的位置时通过从所述至少一个惯性传感器单元获取多个取向值来设定所述骨盆坐标系,所述取向值中的一个使所述指示器与参考界标对准,所述坐标系模块根据所述多个取向值限定表示所述骨盆坐标系的髋臼平面;和
跟踪模块,所述跟踪模块用于使用来自所述惯性传感器单元的所述读数在其运动期间跟踪所述至少一个惯性传感器单元相对于所述骨盆坐标系的取向;以及
用于输出作为所述骨盆坐标系的函数的取向数据的界面。
2.根据权利要求1所述的CAS***,其特征在于,所述至少一个器械在其上具有适于相对于所述骨盆坐标系将销定位在所述髋臼中的期望的位置的销导向器。
3.根据权利要求1或2所述的CAS***,其特征在于,所述指示器是将光束发射在所述参考界标上的光源。
4.根据权利要求1或2所述的CAS***,其特征在于,获取的所述取向值中的第一个使所述指示器与参考界标对准。
5.根据权利要求4所述的CAS***,其特征在于,所述取向值中的所述第一个根据术前成像编程为表示患者取向。
6.根据权利要求1或2所述的CAS***,其特征在于,所述跟踪模块相对于所述骨盆坐标系跟踪支撑所述惯性传感器单元中的一个的至少一个工具。
7.根据权利要求6所述的CAS***,其特征在于,所述跟踪模块计算所述至少一个工具相对于所述骨盆的前倾和倾斜中的至少一个。
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