Chinese Journal of Tissue Engineering Research ›› 2020, Vol. 24 ›› Issue (24): 3792-3796.doi: 10.3969/j.issn.2095-4344.2745

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Application of semi-automatic spinal surgery robot system in spinal surgery

Lin Yunzhi, Fang Guofang, Li Xiuwang, Wu Jiachang, Wu Mingjie, Tan Liang, Lai Guohua, Ye Zhuofeng, Sang Hongxun   

  1. Department of Orthopedics, Shenzhen Hospital, Southern Medical University, Shenzhen 518100, Guangdong Province, China
  • Received:2019-11-13 Revised:2019-11-16 Accepted:2020-01-17 Online:2020-08-28 Published:2020-08-12
  • Contact: Sang Hongxun, PhD, Chief physician, Professor, Department of Orthopedics, Shenzhen Hospital, Southern Medical University, Shenzhen 518100, Guangdong Province, China
  • About author:Lin Yunzhi, Master, Department of Orthopedics, Shenzhen Hospital, Southern Medical University, Shenzhen 518100, Guangdong Province, China
  • Supported by:
    the Shenzhen Health and Family Planning System Research Project, No. SZXJ2017053; the Shenzhen Medical and Health “Three-Ming Engineering” Project, No. SZSM201612019; the Key Laboratory of Shenzhen Digital Surgery 3D Printing, No. ZDSYS201707311542415

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 < 0.001). X-ray exposure time and Kirschner wire implantation time were not significantly different between the two groups (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.

Key words: orthopedics, spine; semi-automation, robot, surgical robot, pedicle screw, minimally invasive surgery, animal experiment

CLC Number: