3D Image-Guided Robotic System for Bone Fracture Reduction
3D Image-Guided Robotic System for Bone Fracture Reduction
复制标题
用于减少骨折的 3D 图像引导机器人系统
DOI：
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发表时间：
2022
影响因子：
5.2
通讯作者：
Jaesung Hong
中科院分区：
文献类型：
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作者：
Seongpung Lee;S. Joung;Hogun Ha;Jin;K. Park;S. Kim;Kwonsun Nam;Jongsuk Lee;Hyun;Chang;Ilhyung Park;Jaesung Hong
为了克服骨折复位的可能缺点，例如旋转不良、辐射暴露以及费力的牵引的风险，已经提出了图像引导的机器人手术系统。然而，光学跟踪系统（OTS）的使用会产生固有的视线问题，导致手术期间频繁中断。我们提出了一种无OTS图像引导骨折复位系统，利用Stewart机器人平台，以解决传统的OTS为基础的机器人系统的问题。该系统应用逆运动学来计算断骨碎片之间的相对位置。每个片段术前登记在机器人系统中的半自动图像为基础的注册方法，使用一个可连接的夹具设计的建议的平台。当在荧光透视图像中没有清楚地检测到图像特征时，该方法特别有效。通过术前和术后股骨体模的计算机断层扫描（CT）来评价所提出的系统的准确性。还在山羊腿上进行了离体实验以评估临床可行性。在体模和离体实验中，复位的平均旋转误差分别为1.79°和1.76°。减少的平均时间约为3分钟。这封信提出了一种新的方法来计算骨碎片之间的相对位置，使用逆运动学和半自动机器人患者注册，而不需要一个C形臂和OTS。无OTS的机器人手术系统具有提高骨折复位准确性、减少手术时间和辐射暴露的潜在优势。
To overcome possible drawbacks of bone fracture reduction such as risks of malrotation, radiation exposure, as well as laborious traction, image-guided robotic surgery systems have been proposed. However, the use of optical tracking systems (OTS) creates inherent line-of-sight problems that cause frequent interruptions during surgery. We propose an OTS-free image-guided bone fracture reduction system utilizing a Stewart robot platform to solve the problem of conventional OTS-based robotic systems. The system applies inverse kinematics to compute the relative positions between the broken bone fragments. Each fragment is pre-operatively registered in the robotic system with a semi-automatic image-based registration method using an attachable jig designed for the proposed platform. This approach is particularly effective when the image features are not clearly detected in the fluoroscopic images. The accuracy of the proposed system was evaluated via pre- and post-operative computed tomography (CT) scans of femoral phantoms. Ex-vivo experiments were also performed on caprine legs to assess the clinical feasibility. In the phantom and ex-vivo experiments, the mean rotational errors of the reduction were 1.79° and 1.76°, respectively. The mean time for the reduction was approximately 3 min. This letter proposes a new method to compute the relative positions between the bone fragments using inverse kinematics and semi-automatic robot-patient registration without requiring a C-arm and an OTS. The OTS-free robotic surgery system has the potential advantages to enhance the accuracy of fracture reduction and reduce the surgery time and radiation exposure.