Human–Robot Shared Control for Osteotomy Procedure

Abstract

Spinal intervention can benefit from advancements in robotic systems, particularly in the field of Human-Robot Interaction (HRI). Despite their potential, robotic technologies remain limited to selected spine procedures. Meanwhile, complex and time-consuming procedures, such as osteotomy, are still performed manually, impacting surgeon workload and stress. This paper introduces a robotic system to assist surgeons during the drilling of the vertebral body, enhancing precision and improving patient outcomes. The system integrates a pre-planning tool for establishing the desired correction angle, a virtual fixture-based impedance control algorithm to assist the user in following cutting trajectories while safeguarding surrounding structures, and a navigation tool for enhanced procedural guidance. The system consists of a 7 Degree-of-Freedom robotic manipulator equipped with a drilling system attached to its end-effector. System accuracy was validated on 5 vertebral phantoms, achieving tracking errors of 0.39 $\pm $ 0.033 mm and 0.74 $\pm $ 0.07 mm, margin errors of 0.84 $\pm $ 0.17 mm and 0.19 $\pm $ 0.5 mm, and angular alignment errors of 0.34 $\pm $ 0.16 and 0.13 $\pm $ 0.27$^{\circ } $ for the sagittal and coronal planes, respectively. Additionally, the system's performance was evaluated with real porcine bone, with results demonstrating similar precision and robustness under realistic mechanical properties. A user Study was conducted to evaluate whether the proposed system effectively enhanced user performance compared to a manual control strategy. The results demonstrated reduced deviation from the desired path and fewer instances of the system exceeding predetermined restricted areas when using the proposed system. Additionally, participants rated the proposed system as less mentally and physically demanding in comparison to the traditional control strategy.