Simulation and analysis of non-navigational errors in robot-assisted pedicle Kirschner wire placement surgery

Area of Science:

• Orthopedic Surgery
• Robotic Surgery
• Surgical Error Analysis

Background:

• Surgical errors in orthopedic robotic procedures are influenced by numerous factors.
• Non-navigational errors can significantly affect the precision of pedicle screw placement.
• Understanding these errors is crucial for improving patient outcomes in robotic-assisted surgery.

Purpose of the Study:

• To investigate the impact of non-navigational errors on pedicle screw placement accuracy in orthopedic surgery.
• To identify key factors contributing to these errors.
• To provide recommendations for improving accuracy in robot-assisted procedures.

Main Methods:

• A robot-assisted Kirschner wire (K-wire) placement simulation system was developed.
• The study systematically analyzed four factors: operator habits, guide-to-bone surface distance, robotic arm stiffness, and vertebral fixation stiffness.
• Precision measurement experiments with 26 variable combinations were conducted to quantify K-wire placement errors.

Main Results:

• Operator Habit 1 resulted in significantly lower average deviation (0.13 mm) compared to Habit 2 (0.51 mm).
• A shorter guide-to-bone surface distance (1 cm vs. 5 cm) and greater robotic arm stiffness (500 mm vs. 600 mm) reduced deviation.
• Vertebral fixation stiffness also impacted accuracy, with plaster fixation showing less deviation (0.37 mm) than silicone fixation (0.85 mm).

Conclusions:

• Operator habits and vertebral fixation stiffness are primary determinants of non-navigational errors.
• Guide-to-bone surface distance and robotic arm stiffness are secondary influencing factors.
• Recommendations include adopting specific operator habits, minimizing distances, and enhancing fixation and arm stiffness for improved accuracy.