Design and control of an image‐guided robot for spine surgery in a hybrid OR. Issue 4 (7th May 2020)

• Record Type: Journal Article
• Authors: Balicki, Marcin; Kyne, Sean; Toporek, Grzegorz; Holthuizen, Ronald; Homan, Robert; Popovic, Aleksandra; Burström, Gustav; Persson, Oscar; Edström, Erik; Elmi‐Terander, Adrian; Patriciu, Alexandru
• Is Part Of: International journal of medical robotics and computer assisted surgery. Volume 16:Issue 4(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-05-07
• Subjects: hybrid OR -- image guidance -- medical robotics -- pedicle fixation -- robot‐assisted surgery -- spine fusion -- surgical navigation; Robotics in medicine -- Periodicals; Surgery -- Technological innovations -- Periodicals; Imaging systems in medicine -- Periodicals; 617.90285
• DOI: 10.1002/rcs.2108
• Languages: English
• ISSNs: 1478-5951

Abstract

Abstract: Background: Minimally invasive spine (MIS) fusion surgery requires image guidance and expert manual dexterity for a successful, efficient, and accurate pedicle screw placement. Operating room (OR)‐integrated robotic solution can provide precise assistance to potentially minimize complication rates and facilitate difficult MIS procedures. Methods: A 5‐degrees of freedom robot was designed specifically for a hybrid OR with integrated surgical navigation for guiding pedicle screw pilot holes. The system automatically aligns an instrument following the surgical plan using only instrument tracking feedback. Contrary to commercially available robotic systems, no tracking markers on the robotic arm are required. The system was evaluated in a cadaver study. Results: The mean targeting error (N = 34) was 1.27±0.57 mm and 1.62±0.85°, with 100% of insertions graded as clinically acceptable. Conclusions: A fully integrated robotic guidance system, including intra‐op imaging, planning, and physical guidance with optimized robot design and control, can improve workflow and provide pedicle screw guidance with less than 2 mm targeting error.