Due to highly rely on the C-arm X ray imaging during operation, the surgeon would need a lengthy time to implant the pedicle screw into right position and orientation in pedicle, and thus raise a risk for medical personnel and the patient to expose in a high-radiation-dose environment. Furthermore, the operation is highly relying on the doctor’s artifice and clinical experiences. So this research is to develop a C-arm image assisted robotic navigation system to assist surgeons to implant pedicle screws to the correct location. The surgeon can click the entry point and end point of drill bit on the computer-displayed C-arm X-ray images, and the bi-plane method will be applied to calculate the spatial position and orientation of the drill path, which are input to the robot controller so that the robot is able to automatically move the guide sleeve to align with the planned path. Then the surgeon can drill the pedicle by drilling along the guide sleeve.
This research uses a Siremobil Compact L C-arm equipment produced by SIEMENS Co. A probe tracked by optical tracker is placed at the drilling inlet of the pedicle, and the tip position and orientation of the probe are recorded as the control group (A). The path that calculated by the Bi-plane method was recorded as the first experimental group (A^′), and the path determined by the probe placed into the guide sleeve was recorded as the other experimental group (A^′′). By repeating the tests for several times, the experimental results indicate that the average distance error of tool tip between groups A and A^′ is 2.2mm±0.5mm and the average direction error between the paths 2.7 ±2.1 . Similarly, the average distance error of tool tip between A^′ and A^′′ is 1.2mm±0.3mm, the average direction error is 0.4 ±0.1 , the average distance error of tool tip between A and A^′′ is 2.9mm±0.5mm, and the average direction error is 2.8 ±2.3 . Moreover, the positioning experiment of the robotic navigation system with motion tracking function between A and A^′′ is 2.8mm±0.4mm and the average direction error is 0.5°±0.03 . The overall position errors are larger than the expected 2mm required for clinic applications and the direction errors are larger than the expected 2 degrees, either.
Keyword: C-arm Image, Surgical Navigation, Collaborative Robot, Respiratory Tracking, Spine Surgery.
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