A New Template and Teleoperation System for Human-Guided Spine Surgery

Area of Science:

• Spine surgery
• Robotics in medicine
• Additive manufacturing

Background:

• Fluoroscopy-guided pedicle screw placement carries high risks due to operational inaccuracies and surgeon strain.
• Current methods necessitate significant surgeon skill and effort, increasing potential for complications.

Purpose of the Study:

• To develop and evaluate a novel system for accurate and safe pedicle screw placement.
• To reduce the risks associated with pedicle screw insertion and drilling procedures.
• To enhance surgeon control and provide realistic force feedback during spinal surgery.

Main Methods:

• Design and fabrication of a specialized drill guide using additive manufacturing technology.
• Implementation of a teleoperation system for precise control of the drilling process.
• Development of a control scheme incorporating position, velocity, and force feedback for the surgeon.

Main Results:

• Computed tomography evaluation showed Kirschner wire trajectories with <1 mm error in 80% of cases and 1-2 mm error in 20%.
• The teleoperation system demonstrated effective surgeon control, with the slave robot accurately following master commands.
• Surgeons experienced appropriate feedback of vertebral reaction forces, enhancing intraoperative control.

Conclusions:

• The combined use of an additive-manufactured drill guide and a teleoperation system significantly improves pedicle screw placement accuracy.
• This innovative approach enhances surgeon control and reduces risks in spinal instrumentation procedures.
• The system offers a promising solution for safer and more precise spinal surgery.