ADVANCED INTRAOPERATIVE IMAGE REGISTRATION FOR PLANNING AND GUIDANCE OF ROBOT-ASSISTED SURGERY

Robot-assisted surgery offers improved accuracy, precision, safety, and workflow for a variety of surgical procedures spanning different surgical contexts (e.g., neurosurgery, pulmonary interventions, orthopaedics). These systems can assist with implant placement, drilling, bone resection, and biopsy while reducing human errors (e.g., hand tremors and limited dexterity) and easing the workflow of such tasks. Furthermore, such systems can reduce radiation dose to the clinician in fluoroscopically-guided procedures since many robots can perform their task in the imaging field-of-view (FOV) without the surgeon. Robot-assisted surgery requires (1) a preoperative plan defined relative to the patient that instructs the robot to perform a task, (2) intraoperative registration of the patient to transform the planning data into the intraoperative space, and (3) intraoperative registration of the robot to the patient to guide the robot to execute the plan. However, despite the operational improvements achieved using robot-assisted surgery, there are geometric inaccuracies and significant challenges to workflow associated with (1-3) that impact widespread adoption. This thesis aims to address these challenges by using image registration to plan and guide robot- assisted surgical (RAS) systems to encourage greater adoption of robotic-assistance across surgical contexts (in this work, spinal neurosurgery, pulmonary interventions, and orthopaedic trauma). The proposed methods will also be compatible with diverse imaging and robotic platforms (including low-cost systems) to improve the accessibility of RAS systems for a wide range of hospital and use settings. This dissertation advances important components of image-guided, robot-assisted surgery, including: (1) automatic target planning using statistical models and surgeon-specific atlases for application in spinal neurosurgery; (2) intraoperative registration and guidance of a robot to the planning data using 3D-2D image registration (i.e., an “image-guided robot”) for assisting pelvic orthopaedic trauma; (3) advanced methods for intraoperative registration of planning data in deformable anatomy for guiding pulmonary interventions; and (4) extension of image-guided robotics in a piecewise rigid, multi-body context in which the robot directly manipulates anatomy for assisting ankle orthopaedic trauma

Life Sciences Program Tasks and Bibliography for FY 1996

This document includes information on all peer reviewed projects funded by the Office of Life and Microgravity Sciences and Applications, Life Sciences Division during fiscal year 1996. This document will be published annually and made available to scientists in the space life sciences field both as a hard copy and as an interactive Internet web page

Life Sciences Program Tasks and Bibliography for FY 1997

This document includes information on all peer reviewed projects funded by the Office of Life and Microgravity Sciences and Applications, Life Sciences Division during fiscal year 1997. This document will be published annually and made available to scientists in the space life sciences field both as a hard copy and as an interactive internet web page

The Development of an in Vivo Spinal Fusion Monitor Using Microelectromechanical (Mems) Technology to Create Implantable Microsensors

Surgical fusion of the spine is a conventional approach, and often last alternative, to the correction of a degenerative painful spinal segment. The procedure involves the surgical removal of the intervertebral disc at the problematic site, and the placement of a bone graft that is commonly harvested from the patients iliac crest and placed within the discectomized space. The surrounding bone is expected to incorporate and remodel into the bone graft to eventually provide an immobilized site. Spinal instrumentation often accompanies the bone graft to provide further immobility to the targeted site, thus augmenting the fusion process. However, the status of a fusion and the incorporation of bone across a destabilized spinal segment are often difficult for the surgeon to assess. Radiographic methods provide static views of the fusion site that possess excessive limitations. The radiographic image cannot provide the surgeon with information regarding fusion integrity when the patient is mobile and the spine is exposed to multiple motions. Fortunately, technological advances utilizing microelectromechanical system technology (MEMS) have provided insight into the development of miniature devices that exhibit high resolution, electronic accuracy, miniature sizing, and have the capacity to monitor long-term, real-time in vivo pressures and forces for a variety of situations. However, numerous challenges exist with the utilization of MEMS devices for in vivo applications.This work investigated the feasibility of utilizing implantable microsensors to monitor the pressure and force patterns of bone incorporation and healing of a spine fusion in vivo. The knowledge obtained from this series of feasibility tests using commercially available transducers to monitor pressures and forces, will be applied towards the development of miniature sensors that utilize MEMS technology to monitor real-time, long-term spine fusion in living subjects. The packaging, radiographic, and sterilization characteristics of MEMS sensors were eva