Robot guided oblique spinal stabilization

摘要

A robotic system for performing minimally invasive spinal stabilization, using two screws inserted in oblique trajectories from an inferior vertebra pedicle into the adjacent superior vertebra body. The procedure is less traumatic than such procedures performed using open back surgery, by virtue of the robot used to guide the surgeon along a safe trajectory, avoiding damage to nerves surrounding the vertebrae. The robot arm is advantageous since no access is provided in a minimally invasive procedure for direct viewing of the operation site, and the accuracy required for oblique entry can readily be achieved only using robotic control. This robotic system also obviates the need for a large number of fluoroscope images to check drill insertion position relative to the surrounding nerves. Disc cleaning tools with flexible wire heads are also described. The drilling trajectory is determined by comparing fluoroscope images to preoperative images showing the planned path.

主权项

1. A system for performing a minimally invasive spinal stabilization procedure between two adjacent vertebrae of a subject, the system comprising:
a surgical robot mounted such that it defines at least one path for oblique screw insertion from the pedicle region in an inferior one of said two adjacent vertebrae into the body of the adjacent superior vertebra, towards its anterior cortical rim; a control system receiving three-dimensional preoperative data, including information regarding the spatial location of the bone structures and the nerve positions of said two adjacent vertebrae; and a registration system to relate the coordinate system of said surgical robot with said three-dimensional preoperative data,wherein said control system is adapted to use said information to determine a safe path for said oblique screw insertion, such that said spinal stabilization procedure can be performed by minimally invasive techniques without direct viewing of anatomical details of said vertebrae.