The Spinebot—A Robotic Device to Intraoperatively Quantify Spinal Stiffness

摘要

Abstract Degenerative spine problems and spinal deformities have high socio-economic impacts. Current surgical treatment is based on bony fusion that can reduce mobility and function. Precise descriptions of the biomechanics of normal, deformed, and degenerated spinal segments under in vivo conditions are needed to develop new approaches that preserve spine function. This study developed a system that intraoperatively measures the three-dimensional segmental stiffness of patient's spine. SpineBot, a parallel kinematic robot, was developed to transmit loads to adjacent vertebrae. A force/torque load cell mounted on the SpineBot measured the moment applied to the spinal segment and calculated segmental stiffnesses. The accuracy of SpineBot was characterized ex vivo by comparing its stiffness measurement of five ovine specimens to measurements obtained with a reference spinal testing system. The SpineBot can apply torques up to 10 N·m along all anatomical axes with a total range of motion of about 11.5 deg ± 0.5 deg in lateral bending, 4.5 deg ± 0.3 deg in flexion/extension, and 2.6 deg ± 0.5 deg in axial rotation. SpineBot's measurements are noisier than the reference system, but the correlation between SpineBot and reference measurements was high (R2 > 0.8). In conclusion, SpineBot's accuracy is comparable to that of current reference systems but can take intraoperative measurements. SpineBot can improve our understanding of spinal biomechanics in patients who have the pathology of interest, and take these measurements in the natural physiological environment, giving us information essential to developing new “nonfusion” products.