用可导航钻孔机器人+柔性螺钉，增强脊柱固定抗拉拔力
Augmented Bridge Spinal Fixation: A New Concept for Addressing Pedicle Screw Pullout via a Steerable Drilling Robot and Flexible Pedicle Screws
- 用同心管机器人钻出J型隧道，形成连接双椎弓根的桥接通道
- 通过柔性螺钉注入骨水泥，在椎弓根间构建增强桥接结构
- 适用于需高抗拉拔力的脊柱固定，尤其适合骨质疏松患者
为解决传统刚性椎弓根螺钉在脊柱固定中易松动、拔出的问题，结合我们近期研发的同心管可导航钻孔机器人（CT-SDR）和柔性椎弓根螺钉（FPS），本文提出一种新型增强桥式脊柱固定技术（AB-SF）。该技术首先利用CT-SDR在椎弓根内钻出两条连接用的J型隧道；随后将两枚FPS沿隧道置入，并通过其空心结构注入骨水泥，形成跨椎弓根的增强桥接结构，以提升固定强度。为验证可行性，我们使用集成机械臂的机器人系统，在椎体假体上钻出不同深度的双J型隧道，成功植入柔性螺钉并模拟了骨水泥灌注过程。
原文摘要 · Abstract (English)
To address the screw loosening and pullout limitations of rigid pedicle screws in spinal fixation procedures, and to leverage our recently developed Concentric Tube Steerable Drilling Robot (CT-SDR) and Flexible Pedicle Screw (FPS), in this paper, we introduce the concept of Augmented Bridge Spinal Fixation (AB-SF). In this concept, two connecting J-shape tunnels are first drilled through pedicles of vertebra using the CT-SDR. Next, two FPSs are passed through this tunnel and bone cement is then injected through the cannulated region of the FPS to form an augmented bridge between two pedicles and reinforce strength of the fixated spine. To experimentally analyze and study the feasibility of AB-SF technique, we first used our robotic system (i.e., a CT-SDR integrated with a robotic arm) to create two different fixation scenarios in which two J-shape tunnels, forming a bridge, were drilled at different depth of a vertebral phantom. Next, we implanted two FPSs within the drilled tunnels and then successfully simulated the bone cement augmentation process.
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