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Background <p>Surgical errors of orthopedics robotic are influenced by a multitude of factors. This study aims to investigate the impact of non-navigational errors on the accuracy of pedicle screw placement in orthopedic surgery.</p> Methods <p>Initially, a robot-assisted Kirschner wire (K-wire) placement simulation system was constructed, comprising a universal arm, wide-angle cameras, microscope cameras, and a vertebral base. Utilizing this system, we conducted a systematic analysis of the effects of four factors on non-navigational errors: operator habits, guide-to-bone surface distance, robotic arm stiffness, and vertebral fixation stiffness.We investigated two distinct operator habits: Habit 1 involves first positioning the K-wire against the bone surface through the guide and then inserting it using a bone drill; Habit 2 involves clamping the K-wire onto the bone drill and then inserting it together. Based on the control variable method, we designed precision measurement experiments for K-wire placement under different factors, forming 26 variable combinations to investigate the K-wire placement errors under each factor and their proportions in the overall error.</p> Results <p>A total of 933&#xa0;K-wire placements were performed in this study. The average deviation under Habit 2 conditions was 0.51&#xa0;mm, compared to 0.13&#xa0;mm under Habit 1 conditions; the average deviation was 0.36&#xa0;mm when the guide-to-bone surface distance was 5&#xa0;cm, and 0.28&#xa0;mm when the distance was 1&#xa0;cm; the average deviation was 0.36&#xa0;mm under the 600&#xa0;mm robotic arm condition, and 0.24&#xa0;mm under the 500&#xa0;mm robotic arm condition; the average deviation was 0.37&#xa0;mm in the Plaster-Fixed Vertebra Group, and 0.85&#xa0;mm in the Silicone-Fixed Vertebra Group.</p> Conclusions <p>Operator habits and vertebral fixation stiffness are the primary factors influencing non-navigational errors, while guide-to-bone surface distance and robotic arm stiffness are secondary factors. This study recommends adopting Habit 1 in clinical surgeries, minimizing the guide-to-bone surface distance, and enhancing the stiffness of the robotic arm and vertebral fixation to reduce non-navigational errors and improve the accuracy of robot-assisted pedicle screw placement.</p>

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Simulation and analysis of non-navigational errors in robot-assisted pedicle Kirschner wire placement surgery

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月2日

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  • Yongkang Yang,
  • Yishi Jia,
  • Chang Liu,
  • Liang Li,
  • Boyao Wang

摘要

Background

Surgical errors of orthopedics robotic are influenced by a multitude of factors. This study aims to investigate the impact of non-navigational errors on the accuracy of pedicle screw placement in orthopedic surgery.

Methods

Initially, a robot-assisted Kirschner wire (K-wire) placement simulation system was constructed, comprising a universal arm, wide-angle cameras, microscope cameras, and a vertebral base. Utilizing this system, we conducted a systematic analysis of the effects of four factors on non-navigational errors: operator habits, guide-to-bone surface distance, robotic arm stiffness, and vertebral fixation stiffness.We investigated two distinct operator habits: Habit 1 involves first positioning the K-wire against the bone surface through the guide and then inserting it using a bone drill; Habit 2 involves clamping the K-wire onto the bone drill and then inserting it together. Based on the control variable method, we designed precision measurement experiments for K-wire placement under different factors, forming 26 variable combinations to investigate the K-wire placement errors under each factor and their proportions in the overall error.

Results

A total of 933 K-wire placements were performed in this study. The average deviation under Habit 2 conditions was 0.51 mm, compared to 0.13 mm under Habit 1 conditions; the average deviation was 0.36 mm when the guide-to-bone surface distance was 5 cm, and 0.28 mm when the distance was 1 cm; the average deviation was 0.36 mm under the 600 mm robotic arm condition, and 0.24 mm under the 500 mm robotic arm condition; the average deviation was 0.37 mm in the Plaster-Fixed Vertebra Group, and 0.85 mm in the Silicone-Fixed Vertebra Group.

Conclusions

Operator habits and vertebral fixation stiffness are the primary factors influencing non-navigational errors, while guide-to-bone surface distance and robotic arm stiffness are secondary factors. This study recommends adopting Habit 1 in clinical surgeries, minimizing the guide-to-bone surface distance, and enhancing the stiffness of the robotic arm and vertebral fixation to reduce non-navigational errors and improve the accuracy of robot-assisted pedicle screw placement.