Design and control of an image-guided robot for spine surgery in a hybrid OR

Int J Med Robot. 2020 Aug;16(4):e2108. doi: 10.1002/rcs.2108. Epub 2020 May 7.


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.

Keywords: hybrid OR; image guidance; medical robotics; pedicle fixation; robot-assisted surgery; spine fusion; surgical navigation.

MeSH terms

  • Humans
  • Operating Rooms
  • Pedicle Screws*
  • Retrospective Studies
  • Robotic Surgical Procedures*
  • Robotics*
  • Spinal Fusion*
  • Spine / surgery
  • Surgery, Computer-Assisted*