Global Workflow of a Comanipulation-Based Robotic System for Cervical Spine Surgery

Area of Science:

• Robotics in Spine Surgery
• Artificial Intelligence in Medicine
• Surgical Navigation Systems

Background:

• Cervical arthrodesis demands precise pedicle screw placement for optimal outcomes.
• Current freehand techniques for screw insertion are limited by time constraints and variability.
• Ensuring surgical accuracy is critical for patient safety in cervical spine procedures.

Purpose of the Study:

• To develop and evaluate a robot-assisted system for precise pedicle screw placement in cervical spine surgery.
• To integrate AI-based planning, real-time tracking, and robotic control for improved surgical accuracy.
• To reduce variability and enhance safety in cervical arthrodesis procedures.

Main Methods:

• A robot-assisted system was developed, incorporating an AI-based preoperative planning module for patient-specific screw trajectories.
• An intraoperative registration and motion compensation system with optical tracking was utilized for real-time anatomical alignment.
• A comanipulation control strategy with virtual fixtures and depth limits guided the robotic arm during simulated procedures on 3D-printed models and cadaveric specimens.

Main Results:

• Robotic assistance reduced transverse positional deviations by 50% and orientation deviations by an eight-fold factor compared to freehand methods.
• The system decreased average drilling depth overshoot by 50%.
• Perforation rates with the robotic system were comparable to freehand techniques.

Conclusions:

• The developed robot-assisted workflow significantly enhances trajectory-following accuracy and depth control in cervical spine surgery.
• The integration of AI planning, intraoperative tracking, and collaborative robotics is feasible for improving cervical arthrodesis.
• This technology offers a safer and more effective approach to pedicle screw placement in complex spinal procedures.