Robot guided oblique spinal stabilization
First Claim
1. A system for performing a minimally invasive spinal stabilization procedure between two adjacent vertebrae of a subject, the system comprising:
- a surgical robot mounted such that it defines at least one path for oblique screw insertion from the pedicle region in an inferior one of said two adjacent vertebrae into the body of the adjacent superior vertebra, towards its anterior cortical rim;
a control system receiving three-dimensional preoperative data, including information regarding the spatial location of the bone structures and the nerve positions of said two adjacent vertebrae; and
a registration system to relate the coordinate system of said surgical robot with said three-dimensional preoperative data,wherein said control system is adapted to use said information to determine a safe path for said oblique screw insertion, such that said spinal stabilization procedure can be performed by minimally invasive techniques without direct viewing of anatomical details of said vertebrae.
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Accused Products
Abstract
A robotic system for performing minimally invasive spinal stabilization, using two screws inserted in oblique trajectories from an inferior vertebra pedicle into the adjacent superior vertebra body. The procedure is less traumatic than such procedures performed using open back surgery, by virtue of the robot used to guide the surgeon along a safe trajectory, avoiding damage to nerves surrounding the vertebrae. The robot arm is advantageous since no access is provided in a minimally invasive procedure for direct viewing of the operation site, and the accuracy required for oblique entry can readily be achieved only using robotic control. This robotic system also obviates the need for a large number of fluoroscope images to check drill insertion position relative to the surrounding nerves. Disc cleaning tools with flexible wire heads are also described. The drilling trajectory is determined by comparing fluoroscope images to preoperative images showing the planned path.
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Citations
21 Claims
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1. A system for performing a minimally invasive spinal stabilization procedure between two adjacent vertebrae of a subject, the system comprising:
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a surgical robot mounted such that it defines at least one path for oblique screw insertion from the pedicle region in an inferior one of said two adjacent vertebrae into the body of the adjacent superior vertebra, towards its anterior cortical rim; a control system receiving three-dimensional preoperative data, including information regarding the spatial location of the bone structures and the nerve positions of said two adjacent vertebrae; and a registration system to relate the coordinate system of said surgical robot with said three-dimensional preoperative data, wherein said control system is adapted to use said information to determine a safe path for said oblique screw insertion, such that said spinal stabilization procedure can be performed by minimally invasive techniques without direct viewing of anatomical details of said vertebrae. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 15)
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9. A method for performing a minimally invasive procedure for spinal stabilization between two adjacent vertebrae of a subject, the method comprising:
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generating three-dimensional preoperative data including information regarding the spatial location of the bone structures and nerve positions associated with said two adjacent vertebrae; using said three-dimensional preoperative data to plan at least one safe path for oblique screw insertion, from the pedicle region in an inferior one of said two adjacent vertebrae into the body of the adjacent superior vertebra towards its anterior cortical rim; mounting a surgical robot such that it can delineate said at least one safe path; registering the coordinate system of said robot to said three-dimensional preoperative data; utilizing said surgical robot to generate a drilled hole along one of said at least one planned paths; and inserting a screw obliquely between said inferior and superior vertebrae through said drilled hole. wherein said method enables said spinal stabilization procedure to be performed by minimally invasive techniques without direct viewing of anatomical details of said vertebrae. - View Dependent Claims (10, 11, 12, 13, 14, 16)
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17. A method for performing spinal stabilization between two adjacent vertebrae of a subject, the method comprising:
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drilling two oblique posterior entry passages, one from each pedicle region in an inferior one of said two adjacent vertebrae into the body of the adjacent superior vertebra towards its anterior cortical rim; cleaning the disc space between said two adjacent vertebrae; accessing said disc space between said two adjacent vertebrae through a first one of said oblique posterior entry passages, and distracting said two adjacent vertebrae; inserting a screw obliquely into said inferior and superior vertebrae along the other one of said oblique posterior entry passages, such that said vertebrae are mutually fixed in position; and inserting a second screw obliquely between said inferior and superior vertebrae along the first one of said oblique posterior entry passages, such that said vertebrae are firmly fixed in position. - View Dependent Claims (18, 19, 20, 21)
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Specification