Spinal orthopedic surgery is one of the typical high-risk surgeries. During the surgery, bone screws need to be inserted into the narrower vertebral pedicles and any failures in the screw-path-drilling process will directly hurt the important nerves and vessels of the patient. In this paper, a robotic spinal surgical system (RSSS) for assisting pedicle screw insertion surgery is proposed. The novel structural configuration of the RSSS can balance the gravity effects of the arms, and the workspace envelope of the RSSS can better fit the requirements of spinal surgery. The procedure of the screw insertion operation with the proposed RSSS is presented. To simulate the hand feel of the surgeon in surgical operations, a real-time force-sensing algorithm is developed for the screw-path-drilling process using a spherical or a twist drill. With the force sensing, five key states, including the initial state, the outer cortical state, the cancellous state, the transitional state, and the inner cortical state, are recognized. In particular, the clear recognition of the transitional zone between the cancellous bone and the inner cortical bone is very important as the drilled screw path ends in this zone. State recognition with force sensing can effectively improve the quality of the screw paths so as to enhance the quality of the spinal surgery. Experiments were carried out to verify the state recognition effects of the pedicle drilling process with force sensing.

State Recognition of Pedicle Drilling With Force Sensing in a Robotic Spinal Surgical System

A review of cutting mechanics and modeling techniques for biological materials

Virtual reality and haptics are novel human-machine interaction technologies which have shown a good application potential in many fields such as medical, entertainment, manufacturing, and education areas in the last 20 years. Especially for dental surgery simulation and training, they provide a new and low-cost approach whereby dentists can practice procedures as many times as they want at no incremental cost and training can take place anywhere. This paper provides a comprehensive survey of virtual reality and haptics for dental surgery simulation and training. Some new ideas and recent research progress are investigated, the major research efforts and their typical systems are introduced, and the involved major research issues are summarized, and finally future trends and conclusions are discussed.

Virtual reality and haptics for dental surgery: a personal review

In orthopedic surgery, the bone milling force has attracted attention owing to its significant influence on bone cracks and the breaking of tools. It is necessary to build a milling force model to improve the process of bone milling. This paper proposes a cortical bone milling force model based on the orthogonal cutting distribution method (OCDM), explaining the effect of anisotropic bone materials on milling force. According to the model, the bone milling force could be represented by the equivalent effect of a transient cutting force in a rotating period, and the transient milling force could be calculated by the transient milling force coefficients, cutting thickness, and cutting width. Based on the OCDM, the change in transient cutting force coefficients during slotting can be described by using a quadratic polynomial. Subsequently, the force model is updated for robotic bone milling, considering the low stiffness of the robot arm. Next, an experimental platform for robotic bone milling is built to simulate the milling process in clinical operation, and the machining signal is employed to calculate the milling force. Finally, according to the experimental result, the rationality of the force model is verified by the contrast between the measured and predicted forces. The milling force model can satisfy the accuracy requirement for predicting the milling force in the different processing directions, and it could promote the development of force control in orthopedic surgery.

A cortical bone milling force model based on orthogonal cutting distribution method

Bone-burring is a common procedure in orthopedic, dental, and otologic surgeries. Virtual reality (VR)-based surgical simulations with both visual and haptic feedbacks provide novice surgeons with a feasible and safe way to practice their burring skill. However, creating realistic haptic interactions between a high-speed rotary burr and stiff bone is a challenging task. In this paper, we propose a novel interactive haptic bone-burring model based on impulse-based dynamics to simulate the contact forces, including resistant and frictional forces. In order to mimic the lateral and axial burring vibration forces, a 3D vibration model has been developed. A prototype haptic simulation system for the bone-burring procedure has been implemented to evaluate the proposed haptic rendering methods. Several experiments of force evaluations and task-oriented tests were conducted on the prototype system. The results demonstrate the validity and feasibility of the proposed methods.

Impulse-Based Rendering Methods for Haptic Simulation of Bone-Burring

We present a physics-based training simulator for bone machining. Based on experimental studies, the energy required to remove a unit volume of bone is a constant for every particular bone material. We use this physical principle to obtain the forces required to remove bone material with a milling tool rotating at high speed. The rotating blades of the tool are modeled as a set of small cutting elements. The force of interaction between a cutting element and bone is calculated from the energy required to remove a bone chip with an estimated thickness and known material stiffness. The total force acting on the cutter at a particular instant is obtained by integrating the differential forces over all cutting elements engaged. A voxel representation is used to represent the virtual bone and removed chips for calculating forces of machining. We use voxels that carry bone material properties to represent the volumetric haptic body and to apply underlying physical changes during machining. Experimental results of machining samples of a real bone confirm the force model. A real-time haptic implementation of the method in a dental training simulator is described.

Physics-Based Haptic Simulation of Bone Machining

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Physics-Based Haptic Simulation of Bone Machining