Experiments on robot-assisted navigated drilling and milling of bones for pedicle screw placement

Ortmaier, Tobias; Weiß, Holger; Döbele, Stefan; Schreiber, Ulrich

doi:10.1002/rcs.114

Cited by 53 publications

(37 citation statements)

References 17 publications

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“…The Miro system was developed at the German Aerospace Centre DLR, and a possible setup for pedicle screw placement was investigated. 22 The system consists of a lightweight robotic arm, an optical tracking system, and software. In the operating room, several robot control modes adapted to surgical requirements are available.…”

Section: Discussionmentioning

confidence: 99%

Spinal Robotics

2013

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Even though robotic technology holds great potential for performing spinal surgery and advancing neurosurgical techniques, it is of utmost importance to establish its practicality and to demonstrate better clinical outcomes compared with traditional techniques, especially in the current cost-effective era. Several systems have proved to be safe and reliable in the execution of tasks on a routine basis, are commercially available, and are used for specific indications in spine surgery. However, workflow, usability, interdisciplinary setups, efficacy, and cost-effectiveness have to be proven prospectively. This article includes a short description of robotic structures and workflow, followed by preliminary results of a randomized prospective study comparing conventional free-hand techniques with routine spine navigation and robotic-assisted procedures. Additionally, we present cases performed with a spinal robotic device, assessing not only the accuracy of the robotic-assisted procedure but also other factors (eg, minimal invasiveness, radiation dosage, and learning curves). Currently, the use of robotics in spinal surgery greatly enhances the application of minimally invasive procedures by increasing accuracy and reducing radiation exposure for patients and surgeons compared with standard procedures. Second-generation hardware and software upgrades of existing devices will enhance workflow and intraoperative setup. As more studies are published in this field, robot-assisted therapies will gain wider acceptance in the near future.

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Section: Discussionmentioning

confidence: 99%

Spinal Robotics

2013

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“…Therefore, measurement and compensation for deviation between the intraoperative and preoperative planned position can be performed. 27 Use of the SpineAssist miniature robotic guidance system for pedicle screw placement has been reported by a number of authors. [20][21][22][23][24][25][26] Although use of this robotic approach seems to be effective, Barzilay et al 20 have outlined a number of The Spine Bull's-Eye Robot uses a unique guiding technique.…”

Section: Discussionmentioning

confidence: 97%

“…Since 1995, a number of reports have described the use of SpineAssist, a miniature robotic guidance system for pedicle screw placement, in conjunction with CAS. [20][21][22][23][24][25][26] Ortmaier et al 27 have also described robot-assisted navigated drilling and milling for the placement of pedicle screws. Findings from the aforementioned studies are encouraging, and suggest that robot-assisted surgery can be used to increase the accuracy of pedicle screw placement in spinal surgery.…”

mentioning

confidence: 99%

Spine Bull’s-Eye Robot Guidewire Placement With Pedicle Standard Axis View for Thoracic and Lumbar Pedicle Screw Fixation

Zhang¹,

Wang²,

Fu-an³

et al. 2012

Journal of Spinal Disorders &Amp; Techniques

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“…Future directions will involve further evaluation via both retro-and prospective studies, as well as the integration of virtual planning platform with existing computer-assisted navigation platforms (Ortmaier et al 2006). In addition, we plan to compare the screw fastening strength outcome yielded by our surrogate formulation to that predicted by classical finite element models under different loading conditions, and demonstrate the feasibility of employing the proposed fastening strength formulation as a validated predictor of the holding power of the implanted pedicle screws.…”

Section: Summary and Future Directionsmentioning

confidence: 99%

Estimating pedicle screw fastening strength via a virtual templating platform for spine surgery planning: a retrospective preliminary clinical demonstration

Linte

Camp

Augustine

et al. 2014

Computer Methods in Biomechanics and Biomedical Engineering: Im

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III (2014): Estimating pedicle screw fastening strength via a virtual templating platform for spine surgery planning: a retrospective preliminary clinical demonstration, Traditional 2D images provide limited use for accurate planning of spine interventions, due to their inability to display the complex 3D spine anatomy and proximity of nerve bundles and vascular structures that must be avoided during the procedure. We have developed a platform for spine surgery planning that employs standard of care 3D preoperative images and enables oblique reformatting and 3D rendering of individual or multiple vertebrae, interactive templating and placement of virtual pedicle implants into the patient-specific computed tomography data. Here we propose a combined surrogate metric -the fastening strength -to provide estimates of the optimal implant selection and trajectory based on implant dimension and bone mineral density (BMD) of the displaced bone substrate. We conducted a retrospective clinical study based on pre-and post-operative data from four patients who underwent procedures involving pedicle screw implantation. We assessed the retrospective plans against the post-operative imaging data according to implant dimension, mean voxel intensity of implant trajectory, and fastening strength and showed consistency between the proposed plans and the postoperative procedure outcome. Our preliminary studies have demonstrated the feasibility of the platform in assisting the surgeon with the selection of appropriate size implant and trajectory that optimises fastening strength, given the intrinsic vertebral geometry and BMD.

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Experiments on robot-assisted navigated drilling and milling of bones for pedicle screw placement

Abstract: It is expected that robot assisted navigated surgery helps to improve the reliability of surgical procedures. Further experiments are necessary to take the whole workflow into account.

Cited by 53 publications

References 17 publications

Spinal Robotics

Spinal Robotics

Spine Bull’s-Eye Robot Guidewire Placement With Pedicle Standard Axis View for Thoracic and Lumbar Pedicle Screw Fixation

Estimating pedicle screw fastening strength via a virtual templating platform for spine surgery planning: a retrospective preliminary clinical demonstration

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