Philips Research North America, Cambridge, Massachusetts, USA.
Philips Healthcare, Best, The Netherlands.
Int J Med Robot. 2020 Aug;16(4):e2108. doi: 10.1002/rcs.2108. Epub 2020 May 7.
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.
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.
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.
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.
微创脊柱 (MIS) 融合手术需要图像引导和熟练的手动操作，以实现成功、高效和准确的椎弓根螺钉放置。手术室 (OR) 集成的机器人解决方案可以提供精确的辅助，有可能最大限度地降低并发症发生率并促进困难的 MIS 手术。
专门为混合 OR 设计了一个具有集成手术导航功能的五自由度机器人，用于引导椎弓根螺钉导孔。该系统仅使用器械跟踪反馈自动按照手术计划对齐器械。与市售的机器人系统不同，机器人臂上不需要跟踪标记。该系统在尸体研究中进行了评估。
平均目标误差（N=34）为 1.27±0.57mm 和 1.62±0.85°，100%的插入被评为临床可接受。
完全集成的机器人引导系统，包括术中成像、规划和物理引导，以及优化的机器人设计和控制，可以改善工作流程，并提供小于 2mm 的目标误差的椎弓根螺钉引导。
