A new approach for safe planning transfer using semi-automatically adjustable instrument guides

Accurate planning transfer is a prerequisite for successful operative care. For different applications, diverse computer-assisted systems have been developed and clinically evaluated. This paper presents the implementation and evaluation of a new modular concept. The approach is based on passive application specific kinematics that are semi-automatically adjusted using a universal hand-held computer controlled Smart Screw Driver. The system was realized for pedicle screw instrumentation and evaluated according to IEC 60601-1-6 (usability engineering). The accuracies of the drill holes achieved were comparable with robotic approaches, while operation time and radiation were reduced compared with conventional operation techniques. The adjustment procedure has proven high learnability and user satisfaction. The next step will be optimization of the kinematic structure and fixation to the patient in order to increase accuracies of planning transfer as well as evaluation of the overall system by medical staff in preclinical and clinical studies.