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A New Template and Teleoperation System for Human‐Guided Spine Surgery

机译：用于人为脊柱手术的新模板和漫步系统

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Abstract Fluoroscopy‐guided placement of pedicle screws is usually used to position pedicle screws, although it is highly risky due to lack of accuracy during operation and surgeon’s intensive labor requirement during surgery. In this study, a new method was introduced to consider the issues and we tried to reduce the risk of pedicle screw placement and drilling process. To put pedicle screws in the correct position and orientation, a specific drill guide is designed and fabricated by additive manufacturing technology. In addition, since the drilling process is remarkably important and it is usually dependent on surgeon skill, therefore a teleoperation system is proposed to perform this task. In order to let the surgeon to have better control on the patient, a control scheme including position and velocity signals along with surgeon force and reaction force of vertebra was proposed. This helped the surgeon for proper control on the patient during surgery. A force estimation algorithm was presented to eliminate measuring external force signal. Consequently, 10 vertebras were used to evaluate specific drill guide and teleoperation system simultaneously. Then, the computed tomography evaluation demonstrated that Kirschner wire trajectories followed the planned axes with an error between 1 and 2?mm in 20% of cases and less than 1 mm in 80% of cases. The results obtained by the teleoperation system showed that the surgeon, in the master side, has proper control over the patient body in the slave side because the slave robot followed the master position. Furthermore, the surgeon in the master side sensed the reaction force of vertebra in the slave side appropriately.
机译：摘要椎弓根螺钉的透视引导放置通常用于定位椎弓根螺钉，尽管由于在手术期间缺乏准确性而缺乏准确性，它是非常危险的。在这项研究中，引入了一种新方法来考虑这些问题，我们试图降低椎弓根螺钉放置和钻井过程的风险。为了将椎弓根螺钉放在正确的位置和方向上，通过添加制造技术设计和制造了特定的钻头引导件。此外，由于钻井过程非常重要，并且通常取决于外科医生技能，因此提出了一种漫步系统来执行这项任务。为了让外科医生能够更好地控制患者，提出了一种控制方案，包括位置和速度信号以及椎骨的外科力力和反作用力。这有助于外科医生在手术期间对患者进行适当的控制。提出了一种力估计算法以消除测量外力信号。因此，使用10个椎骨同时评估特定的钻头引导件和远程化系统。然后，计算的断层扫描评估证明了Kirschner线轨迹遵循计划的轴，误差在20％的病例中以1到2毫米的误差，80％的病例中少于1毫米。由智托化系统获得的结果表明，外科医生在主侧，在奴隶侧的患者体上有适当的控制，因为从机器人遵循主位置。此外，主侧的外科医生适当地感测了从侧椎骨中的反作用力。

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