Abstract: Surgical systems and methods involve manipulation of a bone. A robotic manipulator supports and moves a surgical tool that has a cutting bur rotatable about a cutting axis. Controller(s) control the manipulator to align the cutting axis to a target axis associated with the bone and advance the cutting bur along the target axis towards a cortical region of the bone. The controller(s) control the surgical tool to rotate the cutting bur about the cutting axis and contact the cortical region. The controller(s) detect, from sensor(s), forces applied to the cutting bur by the cortical region and compare the sensed forces to a threshold indicative of skiving of the cutting bur relative the cortical region. In response to the sensed forces exceeding the threshold, the controller(s) adjust control of the manipulator and/or surgical tool to reduce forces applied to the cutting bur by the cortical region.

Abstract: Systems, devices, and methods to accurately and precisely align a visualized axis with one or more objects in an image field during a procedure using an imager based positioner system attached to an electronic positioning device are described. Specific methods of implanting guide pins into a first pedicle and a second pedicle of a vertebrae of a patient through a lumen of a trocar to a target of interest are also described.

Abstract: A method of diagnosing, minimizing symptoms and/or treating the pathology of intervertebral disc degeneration includes introducing a first cannula through a vertebra along an axis of at least one pedicle of the vertebra from a generally posterior to a generally anterior direction and inserting a second cannula within a lumen of the first cannula, the second cannula constrained to a relatively straight configuration within at least a portion of the first cannula and assumes a nonlinear or curvilinear geometry external to the first cannula within at least a portion of a vertebral body of the vertebra and away from a longitudinal axis of the first cannula. The method includes forming a channel with the second cannula, the channel extending to or adjacent to a vertebral endplate of the vertebral body in order to create a defect through the vertebral endplate of the vertebra. Related systems, devices, and methods are described.

Abstract: Surgical systems and methods for utilizing virtual boundaries having different constraint parameters. A robotic manipulator supports and moves a surgical tool for treating a bone structure. A navigation system tracks the surgical tool and the bone structure. Controller(s) obtain a virtual model of the bone structure and define first and second virtual boundaries relative to the virtual model. The first virtual boundary has a first constraint parameter and the second virtual boundary has a second constraint parameter that is different than the first constraint parameter. The virtual model and virtual boundaries are registered to the bone structure. The manipulator moves the surgical tool relative to the bone structure and the first and second virtual boundaries. The surgical tool is constrained relative to the first virtual boundary in accordance with the first constraint parameter and constrained relative to the second virtual boundary in accordance with the second constraint parameter.

Abstract: A system for surgical registration. The system may include at least one computing device in communication with a surgical navigation system and the surgical device. The at least one computing device: a) receiving external bone registration data corresponding to locations on the exterior surface of the femur; b) calculating a first registration transform based on the external bone registration data; c) transforming a first bone removal plan of a surgical plan to the operative coordinate system based on the first registration transform; d) receiving internal bone canal registration data corresponding to at least one of location or orientation data from the inner canal of the femur; e) calculating a second registration transform based on both of the external and internal bone canal bone registration data; and f) transforming a second bone removal plan of the surgical plan to the operative coordinate system based on the second registration transform.

Abstract: A system for surgical registration. The system may include at least one computing device in communication with a surgical navigation system and the surgical device. The at least one computing device: a) receiving external bone registration data corresponding to locations on the exterior surface of the femur; b) calculating a first registration transform based on the external bone registration data; c) transforming a first bone removal plan of a surgical plan to the operative coordinate system based on the first registration transform; d) receiving internal bone canal registration data corresponding to at least one of location or orientation data from the inner canal of the femur; e) calculating a second registration transform based on both of the external and internal bone canal bone registration data; and f) transforming a second bone removal plan of the surgical plan to the operative coordinate system based on the second registration transform.

Abstract: A method of diagnosing, minimizing symptoms and/or treating the pathology of intervertebral disc degeneration includes introducing a first cannula through a vertebra along an axis of at least one pedicle of the vertebra from a generally posterior to a generally anterior direction and inserting a second cannula within a lumen of the first cannula, the second cannula constrained to a relatively straight configuration within at least a portion of the first cannula and assumes a nonlinear or curvilinear geometry external to the first cannula within at least a portion of a vertebral body of the vertebra and away from a longitudinal axis of the first cannula. The method includes forming a channel with the second cannula, the channel extending to or adjacent to a vertebral endplate of the vertebral body in order to create a defect through the vertebral endplate of the vertebra. Related systems, devices, and methods are described.

Abstract: Surgical systems and methods for utilizing virtual boundaries having different constraint parameters. A robotic manipulator supports and moves a surgical tool for treating a bone structure. A navigation system tracks the surgical tool and the bone structure. Controller(s) obtain a virtual model of the bone structure and define first and second virtual boundaries relative to the virtual model. The first virtual boundary has a first constraint parameter and the second virtual boundary has a second constraint parameter that is different than the first constraint parameter. The virtual model and virtual boundaries are registered to the bone structure. The manipulator moves the surgical tool relative to the bone structure and the first and second virtual boundaries. The surgical tool is constrained relative to the first virtual boundary in accordance with the first constraint parameter and constrained relative to the second virtual boundary in accordance with the second constraint parameter.

Abstract: A method of diagnosing, minimizing symptoms and/or treating the pathology of intervertebral disc degeneration includes introducing a first cannula through a vertebra along an axis of at least one pedicle of the vertebra from a generally posterior to a generally anterior direction and inserting a second cannula within a lumen of the first cannula, the second cannula constrained to a relatively straight configuration within at least a portion of the first cannula and assumes a nonlinear or curvilinear geometry external to the first cannula within at least a portion of a vertebral body of the vertebra and away from a longitudinal axis of the first cannula. The method includes forming a channel with the second cannula, the channel extending to or adjacent to a vertebral endplate of the vertebral body in order to create a defect through the vertebral endplate of the vertebra. Related systems, devices, and methods are described.

Abstract: Disclosed herein are techniques for preparation of a bone structure wherein a robotically controlled cutting bur is utilized for both milling the entry point at the outer cortical region and cannulation of the cancellous bone region for receipt of an implant. A robotic manipulator supports and moves the cutting bur and one or more controllers analyze measurements from sensors and, in response, control the robotic manipulator and/or the cutting bur for purposes such as landmark detection to determine entry point, avoiding tool skiving at entry point, and avoidance of cortical wall breach during cannulation. Also described are techniques for managing feed rate, rotational cutting speed, or mode of operation depending on operational conditions surrounding various stages of cannulation. A control interface is also provided to enable the user to manage or adjust cutting bur operation and feed rate.

Abstract: A method of diagnosing, minimizing symptoms and/or treating the pathology of intervertebral disc degeneration includes introducing a first cannula through a vertebra along an axis of at least one pedicle of the vertebra from a generally posterior to a generally anterior direction and inserting a second cannula within a lumen of the first cannula, the second cannula constrained to a relatively straight configuration within at least a portion of the first cannula and assumes a nonlinear or curvilinear geometry external to the first cannula within at least a portion of a vertebral body of the vertebra and away from a longitudinal axis of the first cannula. The method includes forming a channel with the second cannula, the channel extending to or adjacent to a vertebral endplate of the vertebral body in order to create a defect through the vertebral endplate of the vertebra. Related systems, devices, and methods are described.

Abstract: Disclosed herein are techniques for preparation of a bone structure wherein a robotically controlled cutting bur is utilized for both milling the entry point at the outer cortical region and cannulation of the cancellous bone region for receipt of an implant. A robotic manipulator supports and moves the cutting bur and one or more controllers analyze measurements from sensors and, in response, control the robotic manipulator and/or the cutting bur for purposes such as landmark detection to determine entry point, avoiding tool skiving at entry point, and avoidance of cortical wall breach during cannulation. Also described are techniques for managing feed rate, rotational cutting speed, or mode of operation depending on operational conditions surrounding various stages of cannulation. A control interface is also provided to enable the user to manage or adjust cutting bur operation and feed rate.

Abstract: A system for surgical registration. The system may include at least one computing device in communication with a surgical navigation system and the surgical device. The at least one computing device: a) receiving external bone registration data corresponding to locations on the exterior surface of the femur; b) calculating a first registration transform based on the external bone registration data; c) transforming a first bone removal plan of a surgical plan to the operative coordinate system based on the first registration transform; d) receiving internal bone canal registration data corresponding to at least one of location or orientation data from the inner canal of the femur; e) calculating a second registration transform based on both of the external and internal bone canal bone registration data; and f) transforming a second bone removal plan of the surgical plan to the operative coordinate system based on the second registration transform.

Abstract: Systems, devices, and methods to accurately and precisely align a visualized axis with one or more objects in an image field during a procedure using an imager based positioner system attached to an electronic positioning device are described. Specific methods of implanting guide pins into a first pedicle and a second pedicle of a vertebrae of a patient through a lumen of a trocar to a target of interest are also described.

Abstract: The present invention involves systems and related methods for performing percutaneous pedicle integrity assessments involving the use of neurophysiology.

Abstract: A method of diagnosing, minimizing symptoms and/or treating the pathology of intervertebral disc degeneration includes introducing a first cannula through a vertebra along an axis of at least one pedicle of the vertebra from a generally posterior to a generally anterior direction and inserting a second cannula within a lumen of the first cannula, the second cannula constrained to a relatively straight configuration within at least a portion of the first cannula and assumes a nonlinear or curvilinear geometry external to the first cannula within at least a portion of a vertebral body of the vertebra and away from a longitudinal axis of the first cannula. The method includes forming a channel with the second cannula, the channel extending to or adjacent to a vertebral endplate of the vertebral body in order to create a defect through the vertebral endplate of the vertebra. Related systems, devices, and methods are described.

Abstract: The present invention involves systems and related methods for performing percutaneous pedicle integrity assessments involving the use of neurophysiology.

Abstract: Disclosed are embodiments of a removable tip device, which include a bone penetration feature at a distal end and a securing feature that allows the removable tip device to be removably secured to a distal end of various embodiments of a bone coring device. Some embodiments of the removable tip device include features that assist in transmitting torsional loads from the bone coring device to the bone removal feature. In addition, some embodiments of the removable tip device include a protective element that is configured to provide a protective surface for a distal feature of the bone coring device.

Abstract: An anchor device for attaching materials within bone including a body having a distal end region, a proximal end region, and a plurality of struts extending between the distal end region to the proximal end region and at least partially surrounding an interior volume of the body. The anchor device includes an attachment feature positioned within the interior volume of the body and coupled near the distal end region. The attachment feature is configured to secure material to the body. Upon removal of a constraint and after delivery of the anchor device into bone, the body passively transitions from a constrained, delivery configuration that is radially contracted and axially elongated to a relaxed, deployment configuration that is radially expanded and axially shortened.

Abstract: A method of diagnosing, minimizing symptoms and/or treating the pathology of intervertebral disc degeneration includes introducing a first cannula through a vertebra along an axis of at least one pedicle of the vertebra from a generally posterior to a generally anterior direction and inserting a second cannula within a lumen of the first cannula, the second cannula constrained to a relatively straight configuration within at least a portion of the first cannula and assumes a nonlinear or curvilinear geometry external to the first cannula within at least a portion of a vertebral body of the vertebra and away from a longitudinal axis of the first cannula. The method includes forming a channel with the second cannula, the channel extending to or adjacent to a vertebral endplate of the vertebral body in order to create a defect through the vertebral endplate of the vertebra. Related systems, devices, and methods are described.