Workflow and Efficiency of Robotic-Assisted Navigation in Spine Surgery

Avrumova, Fedan; Sivaganesan, Ahilan; Alluri, Ram K.; Vaishnav, Avani S.; Qureshi, Sheeraz A.; Lebl, Darren R.

doi:10.1177/15563316211026658

Cited by 17 publications

(14 citation statements)

References 15 publications

(27 reference statements)

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“…Few navigation systems for spine surgery using an integrated 3D2D registration algorithm are commercially available, for example, the ExcelsiusGPS by GlobusMedical and the Mazor X Stealth Edition by Medtronic [13]. The registra- In total, 19 outliers occurred, which were in the registrations performed with rotation angle differences of 40°(n 9), 56°(n 4), 60°(n 2), 64°(n 2), and 90°(n 2), thoracic vertebrae (n 1), subject A (n 15), subject B (n 2) and subject C (n 2).…”

Section: Discussionmentioning

confidence: 99%

“…Few navigation systems for spine surgery using an integrated 3D2D registration algorithm are commercially available, for example, the ExcelsiusGPS by GlobusMedical and the Mazor X Stealth Edition by Medtronic [ 13 ]. The registration setup of the algorithm under study may be more simple and intuitive than the existing algorithms because no bone-mounted or table-mounted instruments are needed, nor is any equipment required for calibrating and tracking the C-arm.…”

Section: Discussionmentioning

confidence: 99%

“…Although future studies should explore the exact boundaries of the algorithm, a RAD of 40° may be too small for safe application of 3D2D navigation. Commercially available systems often require a specific RAD of 90° for 3D2D registration [ 8 , 13 ]. The practical impact may be small, but if the current algorithm remains accurate with RADs between 56° and 90°, it may provide a more flexible and safer future workflow.…”

Section: Discussionmentioning

confidence: 99%

“…Compared to existing 3D2D registration algorithms for navigated spine surgery, the algorithm does not need any bone-mounted or table-mounted instruments for registration. Neither does the algorithm require additional equipment attached to the intraoperative fluoroscopic imaging device to calibrate or track the imaging device [ 8 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Assessing the accuracy of a new 3D2D registration algorithm based on a non-invasive skin marker model for navigated spine surgery

et al. 2022

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Purpose We assessed the accuracy of a new 3D2D registration algorithm to be used for navigated spine surgery and explored anatomical and radiologic parameters affecting the registration accuracy. Compared to existing 3D2D registration algorithms, the algorithm does not need bone-mounted or table-mounted instruments for registration. Neither does the intraoperative imaging device have to be tracked or calibrated. Methods The rigid registration algorithm required imaging data (a pre-existing CT scan (3D) and two angulated fluoroscopic images (2D)) to register positions of vertebrae in 3D and is based on non-invasive skin markers. The algorithm registered five adjacent vertebrae and was tested in the thoracic and lumbar spine from three human cadaveric specimens. The registration accuracy was calculated for each registered vertebra and measured with the target registration error (TRE) in millimeters. We used multivariable analysis to identify parameters independently affecting the algorithm’s accuracy such as the angulation between the two fluoroscopic images (between 40° and 90°), the detector-skin distance, the number of skin markers applied, and waist circumference. Results The algorithm registered 780 vertebrae with a median TRE of 0.51 mm [interquartile range 0.32–0.73 mm] and a maximum TRE of 2.06 mm. The TRE was most affected by the angulation between the two fluoroscopic images obtained (p < 0.001): larger angulations resulted in higher accuracy. The algorithm was more accurate in thoracic vertebrae (p = 0.004) and in the specimen with the smallest waist circumference (p = 0.003). The algorithm registered all five adjacent vertebrae with similar accuracy. Conclusion We studied the accuracy of a new 3D2D registration algorithm based on non-invasive skin markers. The algorithm registered five adjacent vertebrae with similar accuracy in the thoracic and lumbar spine and showed a maximum target registration error of approximately 2 mm. To further evaluate its potential for navigated spine surgery, the algorithm may now be integrated into a complete navigation system.

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Section: Discussionmentioning

confidence: 99%

“…Few navigation systems for spine surgery using an integrated 3D2D registration algorithm are commercially available, for example, the ExcelsiusGPS by GlobusMedical and the Mazor X Stealth Edition by Medtronic [ 13 ]. The registration setup of the algorithm under study may be more simple and intuitive than the existing algorithms because no bone-mounted or table-mounted instruments are needed, nor is any equipment required for calibrating and tracking the C-arm.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessing the accuracy of a new 3D2D registration algorithm based on a non-invasive skin marker model for navigated spine surgery

et al. 2022

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“…Comanipulation robots are currently the most widespread robotic devices in the field of orthopedic surgery [12]: two strategies of use can be identified. The first one is to use the robot's end effector as a guide, like ROSA Spine [13] developed by Medtech, Mazor X Stealth [14] from Medtronic or the ExcelsiusGPS [15] produced by Globus Medical.…”

Section: Existing Robotic Devices For Orthopedic Surgerymentioning

confidence: 99%

Comanipulation Robotic Platform for Spine Surgery With Exteroceptive Visual Coupling: Development and Experimentation

Koszulinski

Sandoval

Vendeuvre

et al. 2022

Journal of Medical Devices

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In this paper, a novel surgical robotic platform intended to assist surgeons in cervical spine surgery is presented. The purpose of this surgery is to treat cervical spine instabilities. The surgical procedure requires drilling into specific region of the vertebrae in order to attach spinal implants and ensure a normal spacing between each vertebra. In this context, the proposed robotic platform allows to control and restrict surgeon's movements to a specific drilling direction set by the surgeon. The current platform is composed of a collaborative robot with 7 DoF equipped with a drilling tool and directly comanipulated by the surgeon. A motion capture system, as an exteroceptive sensor device, provides the robot controller with the movement data of the vertebra to be drilled. Robot Operating System (ROS) framework is used to enable real-time communication between the collaborative robot and the visual exteroceptive device. In addition, an implemented compliance control program allows to enhance the safety aspect of the robotic platform. Indeed, the collaborative robot follow the patient's movements while constraining the tool movements to an optimal trajectory as well as a limited drilling depth selected by the surgeon. The robot's elbow movements are also restricted by exploiting the null-space in order to avoid collisions with other equipment or medical team members. Experimental drilling trials have been performed by an orthopedic surgeon to validate the usefulness and different functionalities of the developed robotic platform, and provide that a collaborative robot can comply with spine surgery procedure.

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Design and Modelisation of a 6 Degree of Freedom Interface with Repositionable Centre of Rotation

Koszulinski

Sandoval

Laribi

2023

Mechanisms and Machine Science

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Workflow and Efficiency of Robotic-Assisted Navigation in Spine Surgery

Cited by 17 publications

References 15 publications

Assessing the accuracy of a new 3D2D registration algorithm based on a non-invasive skin marker model for navigated spine surgery

Assessing the accuracy of a new 3D2D registration algorithm based on a non-invasive skin marker model for navigated spine surgery

Comanipulation Robotic Platform for Spine Surgery With Exteroceptive Visual Coupling: Development and Experimentation

Design and Modelisation of a 6 Degree of Freedom Interface with Repositionable Centre of Rotation

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