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Abstract

A method and apparatus for positioning a surgical instrument during stereotactic surgery on a body, for example, during spinal surgery or general surgery. A mounting device is attached to a bone structure of the body, for example, by attaching a rail to the spine for spinal surgery, or a mounting plate and a rod attached to the mounting plate. In spinal surgery, the rail is attached to the spine by clamping the rail to two spinous processes and adjusting the separation of the two spinous processes to match the separation of the two processes in three-dimensional scanned image, thereby matching a curvature of the spine with a corresponding curvature of the spine in the image. Multiple of fiducial points are located on the body in relation to the mounting device. An adjustable guidance fixture that includes an instrument guide for guiding the surgical instrument along a constrained trajectory relative to the instrument guide is attached to the mounting device. A location and orientation of the instrument guide is tracked and a position of the constrained trajectory in the three-dimensional image is computed. The guidance fixture is adjusted relative to the mounting device using a first constrained motion followed by a second constrained motion, so that the constrained trajectory of the instrument guide passes through the target.

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First Claim