Robotic Assistance for Precise Spinal Injections: Development and Clinical Verification.

Robot-assisted surgical systems have shown promising results and better patient outcomes in pedicle screw instrumentation and percutaneous needle interventions. Many commercial robotic assistance systems are available for the aforementioned procedures. However, there is only limited literature on robotic spinal injection and needle delivery. Moreover, there is no robotic system that is commercially available for assisting surgeons in spinal injections and needle placement. To address this gap, we developed a robotic system that can provide stereotactic assistance to the surgeon for administering spinal injections and needles. The system utilizes a commercially available collaborative manipulator and a stereoscopic navigation system. A robot motion planner was developed to impart collision avoidance capabilities and make the manipulator adept for the surgical setting. A clinical phantom study was conducted to validate the overall system performance and accuracy. 60 different needle plans were targeted on the lumbar region by expert surgeons and executed through the proposed system. A mean target point error of 1.02 mm with a standard deviation of 0.5 mm was achieved. The observations and results obtained through the study show that the proposed robotic guidance system can be of potential aid in accomplishing accurate spinal needle and injection delivery.