Fluoroscopy-Guided Robotic System for Transforaminal Lumbar Epidural Injections

Area of Science:

• Robotics
• Medical Imaging
• Orthopedic Surgery

Background:

• Spine needle injections are crucial for orthopedic treatments.
• Current free-hand injection techniques can be limited by clinician experience and precision.
• Image-guided navigation offers potential for improved accuracy in spinal procedures.

Purpose of the Study:

• To develop and evaluate an autonomous robotic system for spine needle injection.
• To assess the system's accuracy using fluoroscopic image-based navigation.
• To compare the robotic system's performance against experienced clinicians.

Main Methods:

• Developed a robotic system with patient-specific planning and 2D/3D registration.
• Utilized intra-operative fluoroscopic imaging for navigation and automatic needle injection.
• Validated accuracy through simulation studies and cadaveric trials comparing robotic vs. free-hand injections.

Main Results:

• Simulation studies showed high registration accuracy for vertebrae and injection devices.
• Cadaveric studies demonstrated lower mean needle tip translational error (5.1 ± 2.4 mm) and orientation error (3.6 ± 1.9 degrees) for robotic injections compared to clinicians (7.6 ± 2.8 mm and 9.9 ± 4.7 degrees).
• All robotic injections placed needle tips within defined safety zones.

Conclusions:

• The autonomous robotic spine needle injection system is feasible for orthopedic applications.
• Image-guided robotic navigation enhances precision and accuracy in spinal injections.
• This technology has the potential to improve patient outcomes in spine treatments.