Visuohaptic Feedback in Robotic-Assisted Spine Surgery for Pedicle Screw Placement

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Medical Robotics

Background:

• Robotic-assisted (RA) spine surgery improves pedicle screw accuracy via navigation.
• Minimally invasive (MIS) procedures limit tactile and visual feedback.
• Registration errors and motion can affect RA navigation accuracy.

Purpose of the Study:

• To describe a novel visuohaptic phenomenon during RA spine surgery.
• To explain the mechanical principles of the observed phenomenon.
• To explore its potential utility in enhancing intraoperative feedback.

Main Methods:

• Observation of a rhythmic resistance variation during automated pedicle screw drilling in RA spine surgery.
• Analysis of the phenomenon across multiple cases.
• Hypothesis of localized stick-slip dynamics as the underlying mechanism.

Main Results:

• A cyclical insertional torque (CIT) pattern was observed visually and haptically.
• The CIT pattern is most pronounced at low insertion speeds.
• The phenomenon provides cues for bone engagement during screw advancement.

Conclusions:

• Cyclical insertional torque (CIT) is a newly described visuohaptic feedback during RA pedicle screw insertion.
• CIT may enhance surgeon awareness and confidence in MIS spine surgery.
• Further validation is needed for clinical relevance, reproducibility, and impact on accuracy.