Robot can perform spinal surgery more accurately than humans

Scientists develop a ground-breaking robot ‘which could revolutionise spinal surgery’ because it can drill holes with 0.1mm accuracy – better than EVER recorded for humans

  • Patients with scoliosis need spine-straightening surgery involving drilling
  • The robotic arm can drill within 0.1mm of accuracy better than ever recorded
  • It senses the patients movements to adjust it’s actions for better precision 
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A robot that can perform spinal surgery with more accuracy than deemed humanly possible has been developed by scientists.

The ground-breaking research could revolutionise surgery for conditions including scoliosis or kyphosis – when a patient has a curved back.

The device is able to drill holes – part of the operation to straighten spines – within 0.1mm of accuracy, better than ever recorded for humans. 

Researchers hope to develop the technology further using augmented reality, to allow surgeons to watch what the robot is doing live on a screen. 

A team at Nottingham Trent University, led by Professor Phillip Breedon, have developed a robot which can perform spinal surgery with greater precision than surgeons

The robot, called Scoliobot, has two robotic arms, known as the datum (right) and tooling (left) robots which work in unison to drill holes into the vertebrae in spine straightening surgery

Scoliosis affects one in around 250 children, according to statistics.

The team at Nottingham Trent University, led by Professor Philip Breedon, of the Medical Design Research Group, designed two robotic ‘arms’ that do the work normally required by surgeons.

In spine-straightening operations, holes are drilled into the each vertebrae. Screws are then attached and a flexible rod passes through. 

The rod is secured by a screw at the top and bottom of the spine. When the rod is pulled tight, it straightens the spine.

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The robot, called Scoliobot, has two robotic arms, known as the datum and tooling robots which work in unison. 

What is scoliosis?

Scoliosis is the abnormal curvature of the spine in an S-shape.

Signs include a visible curve in the spine, one shoulder or hip being more prominent than the other, clothes not hanging properly and back pain.

Pain usually only affects adults with the condition.

In most cases, the cause of the scoliosis is not known but it can be caused by cerebral palsy and muscular dystrophy.

In the UK, scoliosis affects three to four children could of every 1,000.

It is also thought that as many as 70 per cent of over 65s have some degree of scoliosis.

It is more common in women than in men.

Most children with the condition do not require treatment as it is mild and corrects itself as the child grows.

However, in severe cases the child may need to wear a back brace until they stop growing.

Occasionally, a child needs surgery to straighten their spine.

In adults, it is usually too late to treat the condition with a back brace or surgery so treatment revolves around reducing pain.

Source: NHS Choices

While on the operating table, the datum robot is secured to the individual vertebrae being operated on with a plate that slips over like a glove. 

Using a CT scan of the patient’s spine, a 3D scan is printed, so that plates can be made for each individual vertebrae. 

The datum tool is designed to sense the minor natural movement of the patient, for example if the patient needs to be moved slightly or was moved by accident.

The goal is to be able to read the patients’ breathing movements.  

It relays this data to the tooling robot, so it can adjust its drilling path accordingly.

With better insight into the patients’ movements, the tooling robot can ensure it drills in the most accurate spot.

Once this process is done, the tooling arm would then use a screwdriver to insert the screws.  

Professor Breedon told MailOnline: ‘All operations rely on the knowledge and skill of the surgeon. But robots are very accurate.

‘As long as all the safety protocols are in place, there will be accuracy. We hope to incorporate surgeons into the experience using artificial intelligence.’

The team are exploring the use of augmented reality to provide surgeons with live visual feedback to illustrate the depth of each hole as it is drilled.   

‘It is paramount that spinal procedures are carried out with total accuracy in order to minimise what can be substantial risks to a patient,’ said Professor Bronek Boszczyk, head of spinal surgery at Benedictus Krankenhaus Tutzing, Germany, who worked with Professor Breedon.

The datum tool collects data from the vertebrae through a plate. It can sense the patients’ movements, which leads to a more accurate drilling

The team are in the process of testing the robot on spine models 

‘This technology has the potential to minimise those risks by performing a key part of the operation with accuracy which cannot be achieved by a human hand.

‘It’s a brilliant example of how robotics can enhance and improve the way in which intrusive operations are carried out, improving patient safety and ensuring efficiency of process.’   

Some risks that spinal surgery carries are bleeding, wound infection, damage to the nerves or spine and the rods or metalwork failing to attach properly.   

Scoliosis causes the spine to curve in an ‘S’ shape, from side to side, and kyphosis causes abnormal rounding of the upper back.   

Professor Breedon said they are still in their early signs of testing but hopes to see the robot in use within the next five years. 

He said: ‘We’ve done the original development and programming and created a realistic bone like model to test it on. 

‘So our next step is to do some testing to show some proof of principle, and that it would work on humans.

‘I’d love to say in a couple of years but there is a lot of testing to be done. Hopefully within the next five to ten years, depending on health and safety measures.’   

How do you perform Anterior scoliosis correction to straighten the back?

Scoliosis causes the spine to curve to the side instead of running straight down the back.

The curve can affect any part of the spine and there can be more than one curve.

Anterior scoliosis correction (ASC) aims to reduce the degree of the curve and untwist it using screws and a flexible cord.

Doctors access the front of the spine via a 3-4in incision made in the side of the patient’s body.

A titanium screw is inserted via this incision into each vertebra affected by the curve.

In very large rigid curves, the discs between vertebrae and the ligament running down the spine are abnormally stiff, restricting flexibility, and may require cutting. This allows the spine to untwist and straighten better.

A flexible cord is then inserted vertically down the spine and held in place by the screws.

This is pulled tighter from the top vertebra to the bottom vertebra of the curve, pulling the spine straight. 

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