Robotic assisted spinal surgery–from concept to clinical practice

Figures & data

Figure 1. Miniature robot for positioning of surgical tools.

Figure 2. Planning a screw insertion in three orthogonal projections. [Color version available online.]

Figure 3. Attachment to bony anatomy. (a) Clamp and bridge. (b) Minimally invasive Hover-T.

Figure 4. Clamp and targeting device mounted on the spinous process. [Color version available online.]

Figure 5. Drilling into the pedicle through the SpineAssist's cannulated guide.

Figure 6. Three arms with cannulated guides of different sizes and angulations.

Figure 7. Dry bone jig for verification of system accuracy.

Figure 8. Actual versus planned drill positions for pedicle screw (a) and translaminar screw (b). [Color version available online.]

Table I.  Accuracy analysis.

					Deviation from preoperative plan^2
Screw serial #	Cadaver #	Level & side	Insertion type^1	Surgery type	LT	AP	Axial	Comments
1	003	L1-R	P	Open	1 S	1 S	1.5 M	Good accuracy
2	003	L1-L	P	Open	1.5 i	1.5 i	1.5 M	Good accuracy
3	003	L2-L	P	Open	0.2 S	1.5 S	0	Good accuracy
4	003	L3-R	P	Open	1.3 S	1.2 S	1.1 M	Good accuracy
5	003	L3-L	P	Open	1.5 i	1.5 i	1.5 M	Good accuracy
6	263	L4-R	T	MIS	0	1.5 i	0	Good accuracy
7	263	L5-R	T	MIS	0	1.5 i	1.5 M	Good accuracy
8	263	L5-L	T	MIS	1.5 i	1.5 i	0.8 L	Good accuracy

¹Insertion type: P = Pedicle K-wire; T = Translaminar threaded K-wire.

²Direction of deviation from plan: S = superiorly; i = inferiorly; M = medially; L = laterally.

Figure 9. Procedure completion rate and placement accuracy.

Figure 10. Anterior-posterior (a) and lateral (b) fluoroscopic views of SpineAssist-guided pedicle screw insertion (using the Hover-T clamping device).