Visuohaptic Feedback in Robotic-Assisted Spine Surgery for Pedicle Screw Placement

Area of Science:

• Neurosurgery
• Robotics in Medicine
• Orthopedic Surgery

Background:

• Robotic-assisted (RA) spine surgery improves pedicle screw accuracy but lacks traditional haptic feedback.
• Minimally invasive (MIS) procedures further limit direct visual confirmation.
• Navigation systems in RA surgery can be affected by registration errors and motion.

Purpose of the Study:

• To describe a novel visuohaptic phenomenon during RA spine surgery.
• To explain the mechanical principles behind this observation.
• To explore its potential utility in enhancing intraoperative feedback.

Main Methods:

• Observation of a rhythmic variation in drill resistance during pedicle screw insertion.
• Utilizing slow-speed automated drilling in RA spine procedures.
• Correlating visual data from navigation systems with haptic feedback from the drill.

Main Results:

• A cyclical insertional torque (CIT) pattern was consistently observed during slow-speed automated drilling.
• This pattern is hypothesized to arise from stick-slip dynamics at the bone-screw interface.
• The CIT pattern is more pronounced at lower insertion speeds.

Conclusions:

• Cyclical insertional torque (CIT) is a newly identified intraoperative phenomenon in RA spine surgery.
• CIT may offer valuable visuohaptic feedback, indicating bone engagement during screw insertion.
• Further validation is needed to confirm CIT's clinical relevance, reproducibility, and impact on accuracy.