Application of semi-automatic spinal surgery robot system in spinal surgery / 中国组织工程研究

ABSTRACT

BACKGROUND: Spinal surgical robots are mainly imported from countries outside China. The overall level of automation is still low. Domestic robot’s core technology still has some difficulties to conquer. Domestic robots are in the ascendant. The cost of spinal surgical robots is too expensive to apply in clinic practice. Our research group has developed Orthobot spinal surgical robot system for spine surgery with Shenzhen Xinjunte Company, which may be of great significance to the development of domestic surgical robots. OBJECTIVE: To explore the safety and effectiveness of the application of Orthobot semi-automatic spine surgery robot system in spine surgery in swine lumbar experimental model by analyzing its feasibility so as to optimize surgical procedures. METHODS: Totally 12 swine lumbar samples (L1-L6) were randomly divided into 2 groups. In the experimental group (6 cases), pedicle screw path was planned under the three-dimensional CT data after matching the pre-operative CT images and intra-operative C-arm film. Orthobot spinal surgical robot system was used to locate the pedicle start point automatically and to drill a hole with Kirschner wire into the pedicle. Pedicle screw path was prepared through the Kirschner wire. In the control group (6 cases), X-ray perspective data of C-arm machine during operation were directly used, and the screw path was planned under the two-dimensional X-ray data. The surgical planning time, Kirschner wire implantation time, X-ray exposure time, and total operation time were recorded for further analysis. The accuracy and the excellent and good rate of pedicle screw implantation were evaluated by CT scan according to Abul-Kasimhierarchy grading system. RESULTS AND CONCLUSION: (1) The planning time and the total operation time of single pedicle screw path preparation were lower in the experimental group than in the control group (P 0.05). (2) Post-operation CT evaluation showed that the excellent and good rate of pedicle screw path preparation was significantly better in the experimental group 96.7% (58/60) than in the control group 85.0% (51/60) (P < 0.05). (3) Results suggested that compared with intraoperative C-arm, the application of Orthobot semi-automatic spine surgery robot system combined with preoperative CT and intraoperative C-arm has high accuracy, safeness and effectiveness. However, the registration and matching time of the system is increased and the total operation time is long.