Trajectory guide, access port, and fiducial marker alignment

摘要

A trajectory guide for introducing an instrument into a human or animal subject is described. A guide stem can be removed in sections without disturbing the aligned instrument. An access port portion of the trajectory guide can be left in place, without disturbing trajectory alignment, and can allow overlying skin to be sutured closed. The access port can provide infusate delivery, such as using an injection port, catheter or the like. A fiducial marker arrangement can provide easy and accurate trajectory alignment, for use with the present trajectory guide, another trajectory guide, or without any trajectory guide.

主权项

1. A trajectory guide apparatus, comprising:
a base, configured to be able to be capable of being affixed substantially in a burr hole in a skull in a human or animal subject, the base including a socket configured to be located in the burr hole when the base is affixed to the skull of the subject; a spherical or other ball, configured to be located in and pivotable with respect to the socket and to be located substantially in the burr hole when the base is affixed to the subject, such that a central pivot point of the ball is located below a surface of the skull when the base is affixed to the skull of the subject, the ball including therethrough a pivotably adjustable instrument guide ball passage providing an adjustable instrument trajectory defined longitudinally by the ball passage; an engageable ball retainer, configured to be located in and engageable into the socket, and to be contained substantially within the burr hole when the base is affixed to the subject and when the retainer is engaged into the socket of the base that is located substantially within the burr hole, the retainer engaged into the socket to secure the ball to inhibit pivoting of the ball to hold the instrument trajectory substantially constant, the retainer including a plurality of upward-facing user-engageable receptacle features to engage the retainer from above the burr hole to permit threading the retainer into the socket of the base such that the plurality of user-engageable receptacle features is contained within the socket of the base; and an elongate guide stem, including a proximal end and a distal end and a bore therebetween, wherein the distal end of the guide stem is configured to engageably concentrically align the bore with the ball passage, such that the guide stem extends longitudinally outward from and supported by the ball.