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Robotic System for Spinal Decompression and Interbody Fusion

脊柱减压和椎间融合机器人系统

基本信息

批准号：
10355589
负责人：
MEHRAN ARMAND
金额：
$ 58.38万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-04-18 至 2026-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10355589
关键词：
Address Affect Age Aging Anatomy Animals Aorta Arthritis Back Biomechanics Blood Vessels Bone Growth Cadaver Calibration Complex Complication Data Debridement Deformity Development Devices Excision Facet joint structure Functional disorder Goals Growth Hybrids Image Imagery Implant Individual Injury Intervertebral disc structure Intraoperative Monitoring Laminectomy Lead Lower Extremity Magnetic Resonance Imaging Manuals Modeling Modernization Modification Motion Motor Nerve Nerve Tissue Nerve compression syndrome Neurologic Deficit Neurosurgeon Operative Surgical Procedures Orthopedics Pain in lower limb Pathology Patients Performance Persons Plant Roots Population Positioning Attribute Procedures Process Reporting Resected Robot Robotics Rod Roentgen Rays Sensory Series Shapes Site Spinal Spinal Cord Spinal Fusion Spinal Stenosis Spinal nerve structure Spine surgery Spondylarthritis Spondylolisthesis Spondylosis Stenosis Structure Surgeon Surgical Error System Techniques Technology Time Tissues Training Tube United States Update Variant Vertebral Bone Vertebral column Visualization base chronic back pain data fusion design dexterity flexibility image guided image visualization instrument intervertebral disk degeneration mechanical device minimally invasive novel novel therapeutic intervention operation pain sensation pressure procedure safety prototype reconstruction reduce symptoms relating to nervous system robotic system scoliosis sensory input soft tissue tool vertebra body

项目摘要

Summary The goal of this application is to develop a robotic workstation with integrated, novel imaging and visualization capabilities to perform complex tasks in minimally-invasive spine (MIS) surgery that cannot be currently performed with conventional surgical tools and approaches. The specific focus of this application will be two complex surgeries: laminectomy decompression and Transforaminal Lumbar Interbody Fusion (TLIF) Surgery. We propose the development of an image-guided prototype robotic system for planning, real-time intraoperative monitoring, navigation, and updating of the plans. There are over 5 million spinal operations performed worldwide annually, with 1.3 million surgeries in the United States alone. In the low back (lumbar spine), decompression and fusion are commonly performed to treat a variety of pathologies that result in spinal stenosis (compression of nerves), including: degenerative disc disease, spondylosis (spinal arthritis), spondylolisthesis (translational instability) and spinal deformities such as scoliosis. As the population of the United States continues to age, spinal fusion surgery has become increasingly more common over the last decade. Spinal fusion is a surgical technique that creates an osseous (bony) union between two or more vertebral bones to eliminate any intersegmental motion. In the modern era, this is accomplished by placement of pedicle screws (anchors in individual vertebral bodies) connected with rods that span across multiple vertebral bones. Additionally, placement of a mechanical device in the disc space is frequently performed to facilitate direct bone growth between the vertebral bodies. A popular approach to performing this procedure is known as a transforaminal lumbar interbody fusion or “TLIF.” Placement of screws and interbody devices are technically challenging due to their close proximity to vital neural and vascular structures. The current commercial robotic systems focus on guiding pedicle screws only. These systems generally rely on preoperative imaging that is merged with intraoperative positioning data for calibration and trajectory planning. The planned screw trajectory is executed by the surgeon manually. In complex tasks in spinal surgery such as TLIF (where the intervertebral disc is removed, bony end plates are prepared, and biomechanical implants are placed through interference fit to facilitate fusion), surgeons are limited in their visualization and approach by the constraints of the anatomy. In order to accomplish their goals, surgeons frequently create collateral damage on normal anatomical structures. We propose that an active surgical robotic system integrated with continuum dexterous manipulators (CDM) may provide the ability to accomplish complex spinal surgical tasks such as spinal decompression and TLIF with less disruption to surrounding tissues, and thus, result in reduction of collateral damage compared to traditional, open surgery and traditional MIS spinal surgery.

总结