Computer-aided design/computer-aided manufacturing skull base drill

Area of Science:

• Neurosurgery
• Medical Device Technology
• Surgical Robotics

Background:

• Computer-aided design/computer-aided manufacturing (CAD-CAM) systems are increasingly integrated into surgical planning and execution.
• Image guidance is crucial for precise localization and navigation during complex neurosurgical procedures.
• Accurate bone removal is essential in cranial and spine surgeries to access target pathologies while preserving critical structures.

Purpose of the Study:

• To develop and validate a novel CAD-CAM device for image-guided bone drilling in neurosurgery.
• To assess the device's potential to optimize cutting tool paths and improve surgical efficiency.
• To evaluate the accuracy and safety of the system in proximity to vital anatomical structures.

Main Methods:

• Utilizing 2D imaging data (CT/MRI) to generate a 3D model of the surgical site.
• Employing an image-guided system to define an optimized cutting tool path.
• Transmitting the generated tool path code to a surgical machining system for automated bone drilling.

Main Results:

• The device successfully generated precise cutting tool paths for bone removal.
• Demonstrated rapid bone removal (< 3 minutes) with accuracy within 1 mm of vital structures.
• Validated efficacy in transtemporal (translabyrinthine) approaches, highlighting potential for cranial and spine neurosurgery.

Conclusions:

• The developed CAD-CAM device offers a safe and efficient solution for image-guided bone drilling in neurosurgery.
• This technology has the potential to significantly reduce surgical duration and associated risks like infection and blood loss.
• The system's precision and speed indicate a promising advancement for neurosurgical bone removal techniques.