Related Experiment Video
Updated: Jun 16, 2026
A Teleoperated Robotic System-Assisted Percutaneous Transiliac-Transsacral Screw Fixation Technique
Published on: January 6, 2023
Global Workflow of a Comanipulation-Based Robotic System for Cervical Spine Surgery
A Koszulinski1,2, J Sandoval2, C-T Wu3
1Department of GMSC, Pprime Institute CNRS, ENSMA, University of Poitiers, UPR 3346, Poitiers, France.
Background:
Cervical arthrodesis requires precise pedicle screw placement to ensure safety and effectiveness. Traditional planning and execution are time-consuming and prone to variability.
Methods:
We developed a robot-assisted system integrating three components: an AI-based preoperative planning module, adapted from previous work, to generate patient-specific screw trajectory from 3D CT point-clouds; an intraoperative registration and motion compensation system with optical tracking to align the trajectory with patient anatomy in real time; and a comanipulation control strategy enforcing virtual fixtures and depth limits to guide the robotic arm safely. The system was tested on 3D-printed models and cadaveric specimens.
Results:
Robotic assistance significantly improved the geometric accuracy of drilling, reducing transverse positional deviations by a factor of two and orientation deviations by a factor of eight compared with freehand procedures. In addition, the average drilling depth overshoot was reduced by 50%. Perforation rates were found to be of the same order as those observed with freehand techniques.
Conclusion:
The proposed workflow improves trajectory-following accuracy and depth control while preserving intuitive surgeon interaction. These results demonstrate the feasibility of integrating AI-based planning, intraoperative tracking, and collaborative robotics for cervical spine surgery.
