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A Patient-Specific Framework for Autonomous Spinal Fixation via a Steerable Drilling Robot

Susheela Sharma, Sarah Go, Zeynep Yakay, Yash Kulkarni, Siddhartha Kapuria, Jordan P. Amadio, Mohsen Khadem, Nassir Navab, Farshid Alambeigi

TL;DR

This work presents the first image-guided, autonomous, patient-specific drilling framework for spinal fixation using a Concentric Tube Steerable Drilling Robot (CT-SDR). A J-shaped trajectory is planned from preoperative CT data, followed by hardware calibration (including pivot and hand-eye calibrations) and dual-stage ICP registration to align the patient anatomy with the planned path. The approach is validated on two patient-derived vertebral phantoms, achieving millimeter-scale registration accuracy, rapid drilling times (~35 s) for an 8 mm tunnel, and a safety margin well within clinical limits. The results demonstrate the potential for improved access, safety, and efficiency in osteoporotic PSF, with future work targeting cadaveric/animal validation and biomechanics-aware planning to enable end-to-end clinical deployment.

Abstract

In this paper, with the goal of enhancing the minimally invasive spinal fixation procedure in osteoporotic patients, we propose a first-of-its-kind image-guided robotic framework for performing an autonomous and patient-specific procedure using a unique concentric tube steerable drilling robot (CT-SDR). Particularly, leveraging a CT-SDR, we introduce the concept of J-shape drilling based on a pre-operative trajectory planned in CT scan of a patient followed by appropriate calibration, registration, and navigation steps to safely execute this trajectory in real-time using our unique robotic setup. To thoroughly evaluate the performance of our framework, we performed several experiments on two different vertebral phantoms designed based on CT scan of real patients.

A Patient-Specific Framework for Autonomous Spinal Fixation via a Steerable Drilling Robot

TL;DR

This work presents the first image-guided, autonomous, patient-specific drilling framework for spinal fixation using a Concentric Tube Steerable Drilling Robot (CT-SDR). A J-shaped trajectory is planned from preoperative CT data, followed by hardware calibration (including pivot and hand-eye calibrations) and dual-stage ICP registration to align the patient anatomy with the planned path. The approach is validated on two patient-derived vertebral phantoms, achieving millimeter-scale registration accuracy, rapid drilling times (~35 s) for an 8 mm tunnel, and a safety margin well within clinical limits. The results demonstrate the potential for improved access, safety, and efficiency in osteoporotic PSF, with future work targeting cadaveric/animal validation and biomechanics-aware planning to enable end-to-end clinical deployment.

Abstract

In this paper, with the goal of enhancing the minimally invasive spinal fixation procedure in osteoporotic patients, we propose a first-of-its-kind image-guided robotic framework for performing an autonomous and patient-specific procedure using a unique concentric tube steerable drilling robot (CT-SDR). Particularly, leveraging a CT-SDR, we introduce the concept of J-shape drilling based on a pre-operative trajectory planned in CT scan of a patient followed by appropriate calibration, registration, and navigation steps to safely execute this trajectory in real-time using our unique robotic setup. To thoroughly evaluate the performance of our framework, we performed several experiments on two different vertebral phantoms designed based on CT scan of real patients.
Paper Structure (12 sections, 2 equations, 3 figures, 1 table)

This paper contains 12 sections, 2 equations, 3 figures, 1 table.

Table of Contents

  1. Introduction
  2. Patient-Specific Autonomous Robotic Framework
  3. Integrated Robotic Framework Utilizing CT-SDR
  4. Hardware Calibration
  5. Patient-CT Registration Using a Dual-Stage ICP
  6. Evaluation Experiments
  7. Experimental Setup
  8. Experimental Procedure
  9. Calibration and Registration Verification:
  10. Autonomous Drilling Performance Evaluation:
  11. Results and Discussion
  12. Conclusion and Future Work

Figures (3)

  • Figure 1: The overall proposed framework including a patient planning module and calibration and registration methods.
  • Figure 2: The experimental setup used for performing the experiments: (A&B) Curved motion by the CT-SDR tip as it is actuated during drilling, with detailed view of the flexible cutting tool. (C) A view of the experimental set-up with the required known and calculated transformations. Known transformations are shown in green, blue transformations come from the performed pivot calibration, red from the performed hand-eye calibration, and white from the performed ICP registration.
  • Figure 3: The test specimen used during testing along with an ideal cross-section view, x-ray view of the drilled trajectory, and plotted trajectories from the magnetic tracker. The 5 hardware evaluation points are indicated by red $\star$.