Abstract: An exemplary method of determining a surgical spinal correction for a subject using analysis of motion capture images of the subject, which uses the steps of obtaining pre-operative three-dimensional images of a spinal region, obtaining a pre-operative time sequenced set of images of the subject during a movement progression of said subject, calculating in a plurality of the motion capture images, alignment parameters relating to upper and lower body regions of the subject, and determining if any of the calculated alignment parameters are outside their predetermined acceptable ranges in one or more of the images, iteratively adjusting anatomical elements in three-dimensional images until all of the calculated alignment parameters are within their predetermined acceptable ranges; and adjusting spinal anatomy in the three-dimensional images according to the degree of adjustment of spinal parameters in the motion capture images to determine a surgical spinal correction.

Abstract: A system for cutting bone is provided and may comprise a cutting tool configured to rotate and a shield. The system may also comprise a first robotic arm configured to hold the cutting tool and a second robotic arm configured to hold the shield. A processor and a memory storing instructions for execution by the processor that, when executed, may cause the processor to cause the second robotic arm to orient the shield proximate an anatomical element along a cutting path of the cutting tool.

Abstract: A surgical robot system whose robotic arm is divided into two parts, and is connected to the patient at the junction of the two parts, by means of a bone connector. The section between the bone connector and the robotic base has a predetermined level of flexibility, enabling the bone connector limited movement. Consequently, the patient's body can also move without the bone connector exerting excess forces on the patient, and without detachment from the patient. The arm section between the bone connection link and the end actuator has high rigidity, such that the pose of the end actuator relative to the patient is accurately maintained. As the patient undergoes small movements, such as in breathing or coughing, the bone connector and base connection arm section, move together with motion of the patient's bone, while the pose of the end actuator relative to the patient is accurately maintained.

Abstract: A system and method for verifying the accurate insertion positioning of a robotically guided surgical tool or probe, at its cranial target region, such as for Deep Brain Stimulation. A head mounted robot aligns a probe or tool guiding sleeve, together with an aiming rod attached at a predefined position and angle to the guiding sleeve. The aiming rod incorporates apertures through which an X-ray system can view the patient's skull. The aiming rod is attached to the tool guiding sleeve at an angle and position calculated such that the line of sight through the apertures falls exactly on the target region when the tool or probe is inserted to its predetermined depth. If the tip of the tool or probe is seen located at the center of the apertures in the X-ray image, verification is obtained that the insertion procedure has been performed accurately.

Abstract: A system and method for the minimally invasive insertion of an intervertebral rod into the vertebrae of a subject, according to a preoperative surgical plan also defining positions for the insertion of rod clamping screws into the vertebrae. The rod shape for connecting the heads of the screws is calculated, and a path planning algorithm used to determine whether the distal end of the rod can be threaded through the screw heads by longitudinal and rotational manipulation of the proximal end of the rod. If so, instructions are provided for forming that rod shape and for the robotic insertion of the screw holes and the rod. If not, either or both of the screw positions and the rod shape are adjusted, to moderate the bends in the rods, until insertion becomes possible. The insertion can be performed robotically, or, if a navigation tracking system is added, manually.

Abstract: A hand held robotic system that remains stiff so long as it is operating within allowed limits, but which become actively controlled once the operator exceeds those limits. The system thus corrects deviations by more than a predetermined amount of the operator's hand motions, so that the tool remains in the allowed region even when the operator's hand deviates from the planned trajectory. The pose and path of the robotic operating head is ascertained by means of a navigation or tracking system, or by means of a proximity device to measure the closeness of the operating head to a damage sensitive feature. As the tool deviates from its predetermined path or pose, or comes too close to the hazardous area, the robot control acts to move the tool back to its predetermined pose or path, or away from the hazardous region, independently of user's hand movement.

Abstract: A bone connection system for attaching a surgical robot having its base mounted in the vicinity of a patient, to a bone of the patient. The system incorporates a switchable bone connection unit attached between the bone and a support element of the robot. This unit has a locked state in which the bone is attached essentially rigidly to the support element, and a released state in which the bone can move relative to the support element. The unit comprises a force sensor for determining the force exerted between the bone and the support element of the robot, and a position sensor for measuring the position of the bone relative to the support element of said robot. The unit switches from its locked state to its released state when the force exceeds a predetermined level, selected to ensure that the bone can move without detaching any bone connection elements.

Abstract: A method of planning the correction of spinal deformations of a subject, by performing segmentation on a three dimensional image of the subject's spine in its erect neutral position, such that the positions and orientations of the vertebrae in a region of interest are characterized. Parameters relating to the alignment and position of the vertebrae are derived from the segmentation, followed by determining whether the parameters fall within an acceptable range desired for the spine of the subject. If not within the acceptable range, an alignment optimization is performed on the vertebrae to bring the parameters within the acceptable range, to reduce the spinal deformations of the subject's spine. The alignment optimization is performed by taking into consideration limitations arising from the dynamic range of motion of the vertebrae as determined by analyzing images of the subject's spine, while the subject is in positions of maximum bending.

Abstract: A system for insertion of a surgical tool along a trajectory to a target region in a patient's tissues, under the guidance of ultrasound imaging. The system includes a hand-held robot to whose base the probe of an ultrasound system is rigidly connected. The activated platform of the hand held robot carries a surgical tool guide. The alignment of the tool guide defines the trajectory which the tool takes within the subject's body. The position of the target region seen on the ultrasound display, can be recorded, and the robot coordinate frame of reference registered thereto. The system aligns the pose of the robot such that the surgical tool is aimed directly at the target region, independently of motion of the ultrasound probe and its associated robot. An inertial measurement unit can be incorporated to provide back-up positional information if the image of the lesion is lost.

Abstract: A system for rod bending for use in robotic spinal surgery, enabling the correct bending of a fusion rod to match the shape required to accurately pass through the heads of the pedicle screws. The system uses data generated by information provided to the robot by the surgeon's preoperative plan, optionally augmented by feedback from the robot control system of deviations encountered intraoperatively. Such deviations could occur, for example, when the surgeon decides intraoperatively on a different trajectory or even to skip screws on one vertebra, in which case, the robot will be commanded to perform the alternative procedure, with commensurate instructions relayed to the control system of the rod-bending machine. The system is also able to thin down the rod at predetermined locations along its length, adapted to be at selected intervertebral locations, for maintaining limited flexibility between vertebrae, instead of fixating them.

Abstract: Automatic dilator devices for generating minimally invasive access apertures for surgical procedures or endoscopic surveillance. The automatic dilators comprise a number of spreader tubes nested one inside the other. The devices deploy automatically by means of coupled mechanical mechanisms which insert one spreader after the other distally into the patient's tissue. Each spreader moves distally into the tissue by means of a screwing action, by which rotation is converted into linear motion of the neighboring spreader, immediately external to it, by means of interaction between a helical thread form on a surface of a spreader being engaged by a section of thread, or by one or more protrusions on the opposing face of the next spreader external to the rotating spreader. Such a combination of helical thread and follower enables a rotatory mechanism to be used to deploy one nested spreader tube after the other, by continuous rotary motion.

Abstract: Methods and apparatus for detecting or predicting surgical tool-bone skiving are disclosed. In some embodiments, the surgical tool is movably and/or snugly disposed within a guide-sleeve. In some embodiments, a magnitude of a lateral force between the surgical tool and the guide-sleeve is measured (e.g. by a force sensor or strain sensor). The present or future skiving may be detected or predicted according to the magnitude of the lateral force. In some embodiments, an alert signal is generated in response to the detecting or predicting of the skiving.

Abstract: Disclosed are methods for performing a surgical procedure at a surgical site utilizing a surgical robot. Other embodiments are also disclosed.

Abstract: A robot-guided system to assist orthopedic surgeons in performing orthopedic surgical procedures on pre-positioned inserts, including for the fixation of bone fractures, and especially for use in long bone distal intramedullary locking procedures. The system provides a mechanical guide for drilling the holes for distal screws in intramedullary nailing surgery. The drill guide is automatically positioned by the robot relative to the distal locking nail holes, using data derived from only a small number of X-ray fluoroscopic images. The system allows the performance of the locking procedure without trial and error, thus enabling the procedure to be successfully performed by less experienced surgeons, reduces exposure of patient and operating room personnel to radiation, shortens the intra-operative time, and thus reduces post-operative complications.

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.

Abstract: A robotic surgical system incorporating a surgical robot attached to a patient's bone by an attachment member, such that motion of the bone induces corresponding motion of the robot, maintaining the robot/bone positional relationship. The robot is supported on a mechanical mounting member attached through a controlled joint to a bed-mounted base element. The controlled joint can alternatively enable the mechanical mounting member to move freely relative to the base element, or its position can be controlled by signal inputs adapted to prevent excessive force being applied in the system. Two modes of operation are available (i) free motion in which the control system is decoupled from the mounting member, which rides freely with patient bone motion, and (ii) servo-controlled motion, in which drive mechanisms control the joint motion to prevent application of excessive force on the patient bone or attachment member.

Abstract: A system and method for performing spinal fusion using vertebral connecting rods constructed of a shape memory material, such as shape memory alloy. The connecting rod is cooled below its phase transition temperature, which is chosen to be just below body temperature, and is inserted through a curved guide tube previously inserted into the back of the patient. The guide tube is located so as to deliver the connecting rod at its desired location between the preinserted pedicle screw heads. The rod, being in its flexible state below the transition temperature, negotiates the curve and exits the guide tube in a straight form and parallel to the patient's spine. As it heats up to body temperature, it regains its original straight shape and its original rigidity, and is ready for connecting its associated vertebrae to each other.

Abstract: A method verifying the position of a surgically inserted orthopedic insert. A preoperative three dimensional image data set of the surgical site is generated, showing the bone into which the insert is to be inserted. During the insertion procedure, a series of intraoperative two-dimensional fluoroscope images are generated, each at a known pose relative to the bone, showing the insert during or after insertion into the bone. The 3-D position of the insert is determined in an intraoperative three dimensional image data set reconstructed from the series of intraoperative 2-D fluoroscope images. The reconstructed intraoperative 3-D image data set is registered with the preoperative three dimensional image data set, such as by comparison of imaged anatomical features. Once this registration is achieved, the determined 3-D position of the insert is used to implant a virtual image of the insert into the preoperative three dimensional image data set.

Abstract: A novel image-guided system for precise automatic targeting in minimally invasive keyhole neurosurgery. The system consists of a miniature robot fitted with a mechanical guide for needle, probe, or catheter insertion. Intraoperative, the robot is directly affixed to a head clamp or to the patient skull. It automatically positions itself with respect to predefined entry points and targets in a preoperative CT/MRI image following an anatomical registration with an intraoperative 3D surface scan of the patient facial features and a registration jig. The registration procedure is a novel three-way scheme, in which the intraoperative surface scan including the registration jig is matched to a model generated from the preoperative CT/MRI image, the robot position is known in relation to the registration jig, and the entry and target points are known from the preoperative CT/MRI image, such that the robot position can be related to the entry and target points.

Abstract: Systems and methods for performing robotic endoscopic surgical procedures, according to a surgical plan prepared on a preoperative set of three dimensional images. The system comprises a surgical robot whose coordinate system is related to that of fluoroscope images generated intraoperatively, by using a three dimensional target having radio-opaque markers, attached in a predetermined manner to the robot or to another element to which the robot is attached, such as the spinal bridge or an attachment clamp. The robot is mounted directly or indirectly on a bone of the patient, thereby nullifying movement of the bone, or a bone tracking system may be utilized. The coordinate system of the intraoperative fluoroscope images may be related to the preoperative images, by comparing anatomical features between both image sets. This system and method enables the endoscope to be directed by the robot along the exact planned path, as determined by the surgeon.