| dc.description.abstract | The spine is the most important tissue for human body support. Excessive use will cause varying degrees of damage. The lumbar spine is the most stressed section of the entire spine, so surgical treatment of lumbar spine lesions is a common spine surgery. The trend of minimally invasive lumbar spine surgery is to use a robotic surgical navigation system to assist in positioning and stabilizing the direction of the surgical path, and the most fundamental screw implant path planning is determined by the experience of the surgeon. However, the screw needs to be fixed and matched with the fixation rod, and the currently known surgical navigation systems do not provide the path planning function that can plan the optimum fixation relationship between the fixation rod and the screws from the mechanics point of view. In addition, a metal wire (K-wire) is usually used as a guide for tapping and screw implantation in the current operation, but it is easy to cause the wire to pierce the body due to the low bone density of the patient, and damage the central nerve or arterial vessels. Moreover, the spinal cage for spinal fusion plays an important role on the restoration or correction of the patient′s lumbar anterior curvature structure. Therefore, this study proposes the integrated path planning of both screw and fixed rod implantation during path planning, the design of drilling and guiding equipment for use together with the robot path guidance sleeve, and the design of the new vertebral cage. The path planning in this study is to construct a 3D spine model with CT images and to segment each single vertebra. Then, based on the ideal lumbar elliptic curve shape and considering the external force direction of the screw, the pedicle path is planned by a semi-automatic method and determined. The fixed rod and screw should be placed in the appropriate space above the vertebral body, hoping to reduce the problem of screw loosening or fixation rod breakage that may occur after operation. A set of drilling equipment that cooperates with the positioning guide groove of the robot to replace the metal wire (K-wire) and the reference coordinate holder attached to the spinous process. The purpose of the latter is to avoid the problem of additional wounds. Finally, according to the functional requirements of intervertebral cages commonly used in posterior fusion surgery, a new mechanical design of intervertebral cages is proposed. The purpose of this research is to improve the surgeon′s operation quality and reduce the risk of surgicl revision, and to enhance the functionality and application value of the robotic spine surgery navigation system. | en_US |