CN102715947B - The self-align navigating surgery robot arm of follow-up spine - Google Patents
The self-align navigating surgery robot arm of follow-up spine Download PDFInfo
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- CN102715947B CN102715947B CN201210233830.XA CN201210233830A CN102715947B CN 102715947 B CN102715947 B CN 102715947B CN 201210233830 A CN201210233830 A CN 201210233830A CN 102715947 B CN102715947 B CN 102715947B
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Abstract
The invention discloses the self-align navigating surgery robot arm of a kind of follow-up spine, comprise common segment and private part; Common segment is made up of servo-actuated bindiny mechanism, attitude regulation mechanism and control software design and sensor, adjustable plate etc., and private part comprises Detection location unit and inserts performance element, is divided into the special two parts of Thoracolumbar disk, cervical vertebra; Keep and targeted vertebra geo-stationary by its follower, again by the preset on selected target vertebra as specified point, then left and right probe and locking pin is adopted to lock specified point, virtual rotation axle center is set up so that robot arm adjustment attitude in the coordinate system of robot, and then determine that pedicle of vertebral arch is inserted a little and inserts the localization method of angle, digitized guides pedicle accurately to insert.The accuracy that the surgical machine hands of said structure can improve the location in operation process and insert, ensures safety and the curative effect of spinal operation.The present invention also discloses the localization method of the self-align navigating surgery robot arm of a kind of follow-up spine.
Description
Technical field
The invention belongs to a kind of medical surgical instrument, particularly relate to the self-align navigating surgery robot arm of a kind of follow-up spine.
Background technology
As everyone knows, pedicle of vertebral arch is the little column structure connecting people vertebral body and vertebral arch, pedicle punctures or inserts internal fixtion has become one of main operation method of spinal surgery at present, its mode is varied, as vertebroplasty, spinal fracture internal fixtion, spondylolishesis internal fixtion, orthopedic surgery of scoliosis etc.Because vertebra is hidden in human body deep, and move up and down with breathing, pedicle puncture or insert just as " cover eyes beat running target ", accurately inserts not a duck soup.Four kinds: 1 can be summarized as pedicle method for posting at present and manually insert the method such as Electrophysiology and electrical impedance monitoring placing directions such as being aided with position, x-ray positive side perspective, somatosensory evoked potential and electromyogram.2 computer assisted navigations it guide based on global positioning system (GPS) principle, be stored in " virtual world coordinate system " by the data obtained after preoperative SCT, MRI 3-dimensional reconstruction, the locus of targeted vertebra and operating theater instruments is based upon " real-world coordinates system " by Intraoperative position device in real time again, then guides pedicle to insert by the coupling of these two coordinate systems.3 Digitalized guiding templates.4 operating robots are as Spineassiant (spinal column assistant), the operation guiding system based on C arm machine 2D image in art based on optically tracked operating robot-SPINEBOT, Germany of Korea S, the robotic surgical system etc. of O arm guiding of Israel.These methods have its respective advantage but also there is certain deficiency, if any complex operation time-consuming, image easily drifts about, tracing system is easily disturbed, can not real-time dynamic monitoring; What have needs range of exposure comparatively large, is difficult to apply under the Minimally Invasive Surgery conditions such as percutaneous; The restriction by existing air navigation aid had, though self precision is very high, inserts precision and is difficult to improve further.
In view of this, urgently for above-mentioned technical problem, look for another way the design self-align navigating surgery robot arm of a kind of new follow-up spine and localization method, realizes determining inserting a little and placing direction of pedicle nail accurately, improves safety and the curative effect of spinal operation.
Summary of the invention
The object of this invention is to provide a kind of self-align navigating surgery robot arm of follow-up spine based on specified point locking, this surgical machine hands can lock vertebra rear surface specified point and automatically adjust attitude, accurately control and insert a little and placing direction, thus realize digitized pedicle of vertebral arch and accurately insert, safe and efficient and easy and simple to handle.On this basis, another object of the present invention is to provide the localization method of the self-align navigating surgery robot arm of a kind of above-mentioned trailing type.
For solving the problems of the technologies described above, the invention provides the self-align navigating surgery robot arm of a kind of follow-up spine, it comprises common segment and private part; Common segment is made up of servo-actuated bindiny mechanism, attitude regulation mechanism and control software design and sensor, adjustable plate etc., and private part comprises Detection location unit and inserts performance element, is divided into the special two parts of Thoracolumbar disk, cervical vertebra; This surgical machine hands keeps and vertebra geo-stationary by its follower, and can be locked by these specified points from the different directions such as surrounding and top, then determines to insert a little and placing direction, and numerical control guides pedicle to insert.
Preferably, specified point is be positioned at the point that the non-same circular arc trailing edge line in vertebra rear surface can play position-limiting action, or described specified point is that on vertebra rear surface, the left and right sides is parallel to the line of long axis direction and left and right pedicle of vertebral arch end to end to the intersection point of bisector; Or described specified point be with described left and right pedicle of vertebral arch end to end bisector be the line of predetermined angle and the described intersection point being parallel to the line of long axis direction.
Preferably, this surgical machine hands a vertebra carry out left and right pedicle of vertebral arch insert time, once need to lock the specified point on two or more vertebra rear surface simultaneously.
Preferably, this surgical machine hands is by observe or the change of the signal such as length, pressure of acquisition probe is carried out robot arm and manually or automatically controlled pose adjustment.
Preferably, the equal flexible of all locking pins is also distributed in the equal flexible of all locking pins of probe and is distributed in the surrounding of probe or puncture needle, the tip of locking pin all first contacts with surface of bone lower than probe or puncture needle, avoid they and specified point or slippage after inserting point cantact, locking specified point is also determined to insert a little and placing direction.
Preferably, servo-actuated bindiny mechanism comprises connecting plate, column, spring composition.
Preferably, the Detection location unit of Thoracolumbar disk private part, by the probe mechanism of two covers or more, locking pin mechanism, conversion pin mechanism, is inserted performance element and is made up of the puncture needle mechanism etc. of two covers or more; Probe mechanism comprises probe, lead, the guide cylinder of groove with a scale, spring, indicateing arm; Locking pin mechanism comprises locking pin, guide pipe, spring, indicateing arm; Conversion pin mechanism comprises conversion pin, guide pipe, displacement and angular adjustment seat etc.; Puncture needle mechanism comprises puncture needle, interior guide cylinder, the outer guide cylinder of open-close type, displacement and angular adjustment seat; The outer guide cylinder of puncture needle, interior guide cylinder, open-close type is that hollow out or nonopaque material are made.
Preferably, atlas private part Detection location unit and insert performance element and comprise the probe of two covers or more, locking pin or puncture needle and adjustment seat etc., its locking pin is made up of locking plate, spring etc.; Each locking plate can independent telescope, and its lower end can be spine or other shapes.
Preferably, the Detection location unit of described robot arm and insert performance element, is located at the relative both sides of the Connection Block of described robot arm respectively.
The present invention also provides the localization method of the self-align navigating surgery robot arm of a kind of follow-up spine, and described localization method comprises the steps:
1) specified point on selected target vertebra;
2) lock the position of described specified point with described probe and locking pin Detection location unit, and then determine inserting a little and placing direction of described targeted vertebra.
Preferably, described targeted vertebra is atlas, described step 1) be specially:
Selected described arch of posterior atlas trailing edge line has the same center of circle but point on two of different radii circular arcs as specified point; Obtain two specific spacing and the first and second arc radius on the first and second described circular arcs respectively;
Described step 2) be specially:
21) spacing arranging two probes of described Detection location unit equals the specific spacing of two on the first circular arc; The robot of described robot arm determines the center of circle according to the radius of this spacing and the first circular arc;
22) described robot arm is with the described center of circle for the center of circle, rotates for radius with the radius of described second circular arc, makes two puncture needles touch arch of posterior atlas trailing edge line;
23) described robot arm moves along by two puncture needles at the vertical line of the mid point of the touch points of arch of posterior atlas trailing edge line (the second circular arc), locking specified point;
Described step 2) after also comprise step 3):
By the puncture needle of inserting performance element of described robot arm, according to the track adjustment attitude tailing edge atlas preset, " pedicle of vertebral arch " is inserted.
Preferably, described targeted vertebra is sixth cervical vertebra, described step 1) be specially:
The left and right sides edge line of selected described sixth cervical vertebra and pedicle of vertebral arch end to end to two intersection points of bisector as specified point; Obtain left and right two pedicles of vertebral arch insert a little with the first distance of median line, and described left and right two pedicle of vertebral arch insert a little with the second distance of the marginal point of vertebral plate head or tail side;
Described step 2) be specially:
21) spacing arranging two probes of described Detection location unit equals the spacing of specified point described in two, and mobile described probe makes it touch the marginal point of described targeted vertebra vertebral plate head or tail side, then two probes is moved second distance to tail or head side;
22) move described robot arm, make specified point described in end in contact under the slide cartridge of described Detection location unit, by described robot arm with virtual rotary middle point for center of circle small angle rotation in perpendicular, make the indicateing arm height of two the described probes in left and right identical;
23) described robot arm is revolved turnback around its place, axle center horizontal line, then described performance element of inserting is moved described first distance to the left or to the right, more described puncture needle of inserting performance element is adjusted attitude according to the track preset.
Accompanying drawing explanation
Fig. 1 is follow-up spine self-align navigating surgery robot arm front view;
Fig. 2 is follow-up spine self-align navigating surgery robot arm side view;
Fig. 3 is follow-up spine self-align navigating surgery robot arm top view;
Fig. 4 is for replacing interior guide cylinder structure chart;
Fig. 5 is follow-up spine self-align navigating surgery robot arm Thoracolumbar disk operation principle schematic diagram;
Fig. 6 is follow-up spine self-align navigating surgery robot arm atlas operation principle schematic diagram;
Fig. 7 is follow-up spine self-align navigating surgery robot arm atlas private part front view;
Fig. 8 is the partial enlarged drawing of bottom Z-direction in Fig. 7;
Fig. 9 is the end-view of the another kind of detailed description of the invention of surgical machine hands provided by the present invention;
Figure 10 is the side view of Fig. 9;
Figure 11 is the top view of Fig. 9;
The end-view of the robot of Figure 12 belonging to robot arm shown in Fig. 9;
Figure 13 is the FB(flow block) of a kind of detailed description of the invention of the localization method of surgical machine hands provided by the present invention;
Figure 14 is robot arm spinal column positioning navigation method schematic diagram;
Figure 15 is position, the side schematic diagram of sixth cervical vertebra in Figure 14.
Wherein, the Reference numeral in Fig. 1 to Figure 15 and the corresponding relation between component names are:
1. attitude regulation mechanism 3. of servo-actuated bindiny mechanism 2. adjustable plate 4. locking pin mechanism 5. probe mechanism 6. changes puncture needle mechanism 8. of pin mechanism 7. connecting plate 9. column 10. spring 11. rotating shaft 12. shaft seat 13. locking bed 14,14 '. displacement steel wire 15. gathering sill 16. gathering sill 17. is end to end to locking pin about 18. to locking pin 19. guide pipe 20. spring 21. indicateing arm 22,22 '. guide cylinder 29. spring 30 of probe 23. specified point 24. specified point 25. specified point 26. specified point 27. lead 28. groove with a scale, 30 '. the tip 32. of indicateing arm 31. probe in " ﹣ " shape is changed guide cylinder 40. in outer guide cylinder 38. displacement of guide cylinder 37. open-close type in pin 33. guide pipe 34. displacement and angular adjustment seat 35. puncture needle 36. and angular adjustment seat 39. and is added locking pin 41. slide cartridge 42. spring 43,43 '. probe 44. adjustment seat 45,45 '. puncture needle 46. adjustment seat 47. locking pin 48. locking plate 49. spring 50. " eight " word structure 51,51 '. specified point 52,52 '. specified point 53,53 '. specified point 54,54 '. indicateing arm 55,55 '. indicateing arm
101. 102. The machine hand surgery robot 103. Table 104 X direction guide rail and motor 105. The Y direction guide rail and motor 106. 107. The Z direction guide rail and motor positioning unit to detect 108. The connection seat 109. Put into execution units 110. Axis Q111. Probe 112. Probe 113. Adjust the fastening device 114. 115. Quick change device locking pin 116. Locking pin 117. The locking pin 118. The sliding barrel 119. The sliding barrel 120. The slider 121. The slider 122. Spring 123. Spring 124. Limit 125. Limit 126. The indicator 127. 128. The indicator to detect positioning unit horizontal line 129 vertebrae horizontal line 130. 131. The mechanical arm needle 132. Pipe run 133. The guide cylinder 134. Locking pin 135. The locking pin 136. Locking pin 137. The end cap 138. Spring 139. Pedicle placement point E140. Pedicle placement point E '141. Specific point A142. Specific point A' 143. The pedicle planning route 144. The pedicle planned route 145. Midline 146. Virtual axis of rotation 146. Vertebral plate P148 caudal edge points. The end to the "pedicle" bisectrix and the distance of the point P m149. The left pedicle planning route 143 and midline 145 Angle alpha 145 right pedicle planning routes and Angle of midline of '151. The head and tail to the left "pedicle" bisectrix 152. Vertebral plate 153 left vertebral pedicle n154 right in the first point and the midline distance at both vertebral pedicle in distance from the midline of the first n'.
Detailed description of the invention
Core of the present invention is for providing a kind of self-align navigating surgery robot arm of follow-up spine based on specified point locking, and it can determine inserting a little and placing direction of pedicle nail accurately, improves the precision of spinal operation.On this basis, another core of the present invention is to provide the localization method of the self-align navigating surgery robot arm of a kind of above-mentioned trailing type.
In order to make those skilled in the art understand technical scheme of the present invention better, below in conjunction with the drawings and specific embodiments, the present invention is described in further detail.
Please refer to Fig. 1 to Fig. 4, Fig. 1 is follow-up spine self-align navigating surgery robot arm front view; Fig. 2 is follow-up spine self-align navigating surgery robot arm side view; Fig. 3 is follow-up spine self-align navigating surgery robot arm top view; Fig. 4 is for replacing interior guide cylinder structure chart.
The ultimate principle of the servo-actuated self-align navigation of this surgical machine hands keeps robot arm and vertebra geo-stationary, himself can touch some specified points on vertebra rear surface, and positive lock can be given from surrounding and top respectively, then determine to insert a little and placing direction, numerical control guides pedicle to insert.So-called specified point, refer to the point (this vertebra rear surface trailing edge line is equivalent to the CT profile vertebra trailing edge line of left and right pedicle of vertebral arch path planning) that the non-same circular arc trailing edge line in vertebra rear surface can play position-limiting action, or above-mentioned specified point is that on vertebra rear surface, there are the line of some and longer axis parallel and left and right pedicle of vertebral arch in the left and right sides end to end to the intersection point of bisector, or above-mentioned specified point is specially with left and right pedicle of vertebral arch end to end to bisector line in a certain angle and the intersection point of line being parallel to major axis.Particularly, the above-mentioned left and right sides edge line, thoracic vertebra costotransverse joint gap line, Facet Joints gap line etc. that can be specially cervical vertebra vertebra with the line of longer axis parallel.
As shown in Figures 1 to 4, the self-align navigating surgery robot arm of this follow-up spine is connected with robot body by mechanical arm, and it comprises general and special two parts.Common segment is made up of servo-actuated bindiny mechanism 1, attitude regulation mechanism 2 and control software design and sensor, adjustable plate 3.Servo-actuated bindiny mechanism 1 comprises connecting plate 8, column 9, spring 10, when robot arm decline contacts with vertebra rear surface, spring 10 is compressed, and robot arm can follow vertebra because breathing moving up and down and move i.e. " servo-actuated " of producing, robot arm thus keep geo-stationary with vertebra.Connecting plate 8 is connected with mechanical arm.Attitude regulation mechanism 2 comprise rotating shaft 11, shaft seat 12, locking bed 13, displacement steel wire 14,14 ', sensor, control software design etc.Displacement steel wire 14,14 ' can by the displacement of two probe 22,22 ' indicateing arms 30,30 ' in robot arm motor process by sensor transmissions to the master control system of robot, master control system then makes adjustable plate 3 translation by the motion of software control robot body and 11 rotates around the shaft, when the length of two indicateing arms 30,30 ' is equal, robot arm stop motion, completes pose adjustment.Adjustable plate 3 there are two gathering sills 15,16, to be connected with private part conversion.Private part comprises Detection location unit and inserts performance element, is divided into Thoracolumbar disk and the special two parts of cervical vertebra.Thoracolumbar disk private part is made up of probe mechanism 5, locking pin mechanism 4, conversion pin mechanism 6, puncture needle mechanism 7 etc.Probe mechanism 5 has two covers, comprises probe 22,22 ', lead 27, groove with a scale guide cylinder 28, spring 29, indicateing arm 30 etc.Specified point 23, in " ﹣ " shape 31, can be touched from top, 24 in the lower end of probe 22.Locking pin mechanism 4 comprises four pullover Caudad locking pins 17, two and overlaps left and right to locking pin 18, guide pipe 19, spring 20, indicateing arm 21 etc.All end to end to locking pin 17, left and right to the tip of locking pin 18 all lower than probe 22, progressively specified point 23 is locked at robot arm decline, probe 22, in the process of 24, contact with vertebra rear surface (can thrust if desired in bone) prior to probe 22 to locking pin 18 to locking pin 17, left and right end to end, its state of whether touching bone surface and bone surface being produced to pressure size can be reflected to locking pin 17, left and right to the indicateing arm 21 of locking pin 18 end to end.Due to the coarse injustice of bone surface, Caudad locking pin 17, left and right reach when certain pressure touches surface of bone to locking pin 18 decline and can prevent probe 22 slippage right overhead, ensure that probe 22 does not depart from specified point 23,25 and left and right do not depart from specified point 24 to locking pin 18,26, can from end to end, left and right directions surrounding positive lock specified point 23,25,24,26.Conversion pin mechanism 6 comprises conversion pin 32, guide pipe 33, displacement and angular adjustment seat 34 etc.In some cases, probe 22 may inserting to form and interfere puncture needle 35, now conversion pin 32 can be fixed on vertebra rear surface in appropriate location, remove probe 22 so that puncture needle 35 operation of inserting.Puncture needle mechanism 7 is two covers, is made up of puncture needle 35, interior guide cylinder 36, the outer guide cylinder 37 of open-close type, displacement and angular adjustment seat 38.In puncture needle 35, interior guide cylinder 36, replacement, guide cylinder 39, the outer guide cylinder 37 of open-close type are made for hollow out or nonopaque material.In replacing, guide cylinder 39 comprises additional locking pin 40, slide cartridge 41, spring 42, can ensure that puncture needle 35 accurately thrusts and insert a little.Guide cylinder 39 in replacement is replaced by interior guide cylinder 36, to insert process from pedicle of vertebral arch axle position (namely from one end of pedicle of vertebral arch) fluoroscopic observation puncture needle in art, real-time dynamic monitoring, prevents puncture needle 35 from departing from, and ensures that puncture needle 35 is inserted accurately and operation safety.The outer guide cylinder 37 of open-close type is opened, and puncture needle 35 and robot arm can depart from.Atlas private part comprises two cover probes 43,43 ' and adjustment seat 44, two overlaps puncture needle 45,45 ' and adjustment seat 46 etc., and its two locking pin 47 is made up of two locking plates 48, spring 49 etc.Two locking plates 48 can independent telescope, one, its lower end in "/" shape, another in " ", mutually form " eight " word structure 50, can adapt to " mountain ridge shape " structure of arch of posterior atlas, prevent probe 43,43 ' to head or tail side slip.Due to arch of posterior atlas in the form of a ring, puncture needle 45,45 ' when being positioned at cantle highest point and posterior tubercle both sides, can prevent puncture needle 45, and 45 ' left or right side slippage.Two cover probes 43,43 ' fall within specified point 51,51 ', and make puncture needle 45 by adjustable plate 3,45 ' can lock specified point 53 from top, 53 '.Below respectively for the 1st lumbar vertebra (L1) and the operation of the 1st cervical vertebra (atlas), illustrate that this robot arm is in the operational approach of Thoracolumbar disk and cervical vertebra and step.
(1) for Thoracolumbar disk, please refer to Fig. 5, Fig. 5 is follow-up spine self-align navigating surgery robot arm Thoracolumbar disk operation principle schematic diagram.
As shown in Figure 5, preoperatively on the CT profile of pedicle of vertebral arch about waiting point, determining four specified points 23,24,25 end to end, 26 (23,25 is the peak of two bone ridges; 24,26 is the intersection point bottom horizontal line L and two bone ridges) and measure: (1) specified point 23,25 is apart from horizontal difference in height; (2) specified point 24,26 with the vertical dimension of sagittal line M; (3) left and right pedicle of vertebral arch insert some E, E ' spacing; (4) left and right pedicle of vertebral arch planning insert angle [alpha] ', α.Set according to the vertical dimension of specified point 24,26 with vertebra sagittal line M respectively: (1) left or right locking pin 18 and the mesien distance of robot arm; (2) left and right pedicle of vertebral arch inserts the distance between E ', E spacing setting two puncture needle 35 needle point; (3) left and right pedicle of vertebral arch inserts the angle of inclination of angle [alpha], α ' setting puncture needle 35.When conventional therapy, cut after appearing vertebral plate and articular process, under direct-view or photographic head and the supervision of position, side X-ray examination, directly make the tip 31 of two probes 22 just decline to equally divided position end to end to pedicle of vertebral arch and touching the peak 23,25 of two bone ridges.The indicateing arm 30 of both sides probe 22, 30 ' and left and right move on indicateing arm 21 differing heights of locking pin 18, by displacement steel wire 14, 14 ' by its displacement by sensor transmissions to the master control system of robot, master control system is moved by software control robot body then, make adjustable plate 3 translation of robot arm and 11 rotate around the shaft, when bilateral indicateing arm 30, when the length height of 30 ' is equal, the automatic stop motion of robot arm, namely pose adjustment completes, now specified point 23, 2524, namely 26 locked by this robot arm, left and right sides pedicle of vertebral arch inserts an E ', E and insert angle [alpha] ', α is also determined thereupon.Two puncture needles 35 decline accurately can insert in pedicle of vertebral arch by preoperative planning numerical value along guide cylinders 36.In some cases, probe 22 locks specified point 23, may insert to form to puncture needle 35 and interfere, now conversion pin 32 can be fixed on vertebra rear surface in appropriate location, remove probe 22 so that puncture needle 35 operation of inserting after 25.
(2) for atlas, please refer to Fig. 6 to Fig. 8, Fig. 6 is the signal of follow-up spine self-align navigating surgery robot arm atlas operation principle; Fig. 7 is follow-up spine self-align navigating surgery robot arm atlas private part front view; Fig. 8 is the partial enlarged drawing of bottom Z-direction in Fig. 7.
As shown in Figure 6 to 8, preoperative at atlas end to end on the CT profile of decile two " pedicle of vertebral arch ", arch of posterior atlas trailing edge line is chosen and is positioned at the first circular arc D two point of symmetry 51,51 ', determine the second circular arc D ' with the center of circle of the first circular arc D, 2: 52 are chosen again in the upper symmetry of the second circular arc D ', 52 ', point 51,51 ', 52,52 ' as specified point.Measure: the 1. spacing of 51,51 '; 2. the radius r of the first circular arc D, the radius R of the second circular arc D '; 3. a little 53,53 ' spacing and insert angle is inserted in left and right " pedicle of vertebral arch ".Foundation puts the distance between spacing setting two probe 43, the 43 ' needle point of 51,51 ' respectively; Point 52,52 ' sets the distance between two puncture needle 45,45 ' needle points.During operation, get a minimal incision * in cervical vertebra posterior midline, after arch of posterior atlas is appeared, position, side X-ray examination monitoring under first make two probes 43,43 ' just to atlas " pedicle of vertebral arch " end to end to equally divided position.Decline robot arm, probe 43,3 ' touches the first circular arc D.Because the Distance geometry r between two probe 43,43 ' needle points is known, the coordinate of center of circle O can be determined by robot master control system computer.Take O as the center of circle, R is radius rotary machine hands, makes puncture needle 45,45 ' the second circular arc D ' touching arch of posterior atlas surface of bone, along being moved by the vertical line robot arm of the mid point of this second touch points line, two probe 43,43 ', two puncture needles 45,45 ' touches 51,51 ', 52,52 ', now indicateing arm 54,54 ', the puncture needle 45 of two probes 43,43 ', the indicateing arm 55 of 45 ', 55 ' two both heights are equal, show to lock specified point 51,51 ', 52,52 ' is accurately locked.Robot arm stop motion.Insert the angle of angle initialization left and right puncture needle 45,45 ' according to left and right " pedicle of vertebral arch ", left and right " pedicle of vertebral arch " inserts a little 53,53 ' spacing arranges puncture needle 45, the spacing of 45 ', two puncture needles 45,45 ' decline accurately can insert in " pedicle of vertebral arch " by preoperative planning numerical value along guide cylinders.
The present invention has the following advantages: rational in infrastructure ingenious, safe and efficient, easy and simple to handle, can reduce or avoid ray to expose, alleviating the working strength of doctor, and can remote operation, is applicable to the puncture of multiple spinal column pedicle or internal fixation operation.
Please refer to Fig. 9 to Figure 12, Fig. 9 is the end-view of the another kind of detailed description of the invention of surgical machine hands provided by the present invention; Figure 10 is the side view of Fig. 9; Figure 11 is the top view of Fig. 9; The end-view of the robot of Figure 12 belonging to robot arm shown in Fig. 9.
In another kind of detailed description of the invention, as shown above, surgical machine hands 101 provided by the present invention is parts of operating robot 102, and this robot is made up of the part such as mobile unit, master control system.Mobile unit comprises operating-table 103, X-direction (referring to operating-table long axis direction) moving guide rail and motor 104, Y-direction (referring to operating-table short-axis direction) moving guide rail and motor 105, Z (referring to and operating-table vertical direction) direction moving guide rail and motor 106 etc.Master control system is made up of control station, computer, display, hand controller, programming Control software etc.
Robot arm 101 comprises Detection location unit 107, Connection Block 108, inserts performance element 109 3 part.Robot arm 101 can rotate around axle center Q110.Detection location unit 107 is by compositions such as two pieces of probes 111,112, adjustment clamp device 113, fast replacing device 114 and locking pins 115,116,117.Probe 111,112 have slide cartridge 118, and 119, slide bar 120,121 and spring 122,123.Slide cartridge 118,119 lower ends are plane or are " ﹁ " shape, and plane person is used for Thoracolumbar disk, is used for cervical vertebra in " ﹁ " shape person." | " part of " ﹁ " shape is banking stop 124,125.Slide bar 120,121 tops are provided with indicateing arm 126,127, and lower end is spine, Rhizoma Sparganii or other shapes, have good antiskid effect.Slide bar 120,121 are positioned at slide cartridge 118, in 119, spring 122,123 its flexible reset favourable of slide bar upper end.Indicateing arm 126,127 can reflect probe 111, the length of 112 and the horizontal line 128 of Detection location unit 107 and angulation between vertebral line 129 or parallel state.Regulate clamp device 113 adjustable and keep probe 111, the mutual spacing of 112.Fast replacing device 114 is conducive to Detection location unit 107 and inserts performance element 109 departing from, and is convenient to the operation technique be used alone when inserting performance element 109.Probe 111, respectively has three pieces of locking pins 115,116,117 and corresponding gathering sill, spring around 112.Gathering sill, spring are conducive to locking pin 115,116,117 stretch.Locking pin 115,116, the tip of 117 lower than probe 111,112 certain lengths.When applying certain pressure decline probe 111, when 112, three pieces of locking pins 115,116,117 are prior to slide bar 120, and 121 tips are three point-like and rough and uneven in surface surface of bone close contact, can prevent probe 111,112 slippages, thus locking specified point.Connection Block 108 connects the mechanical arm 130 of robot 102.Insert performance element 109 to be made up of puncture needle 131, guide pipe 132, guide cylinder 133, locking pin 134,135,136 and tail-hood 137.Puncture needle 131, guide pipe 132 are positioned at the inside of guide cylinder 133, and the two afterbody all has step, in case skid off from guide cylinder 133.Spring 138 is had in tail-hood 137, so that puncture needle 131, guide pipe 132 stretch, so both being conducive to puncture needle 131, guide pipe 132 and guide cylinder 133 enters in body when Minimally Invasive Surgery, is also conducive in puncture needle 131 when guide cylinder 133 contacts bone surface, guide pipe 132 retraction guide cylinder 133.Guide cylinder 133 is made for engraved structure and nonopaque material, so that real-time dynamic monitoring in art.Locking pin 134,135,136 are distributed in guide cylinder 133 around, also have gathering sill and spring to be beneficial to stretch.Locking pin 134,135, the tip of 136 is equally lower than puncture needle 131 certain length, and it is most advanced and sophisticated is three point-like and scraggly bone surface close contact, can prevent guide cylinder 133 slippage, thus some E139, E ' 140 are inserted in locking.Tail-hood 137 is connected with guide cylinder 133, after removing tail-hood 137 and puncture needle 131 and guide pipe 132, locking pin 134,135,136 and guide cylinder 133 continue to retain control and insert a little and placing direction, now can change and carry out pedicle nail by artificial or other machines hand channel guide cylinder 133 and insert operation.
In further scheme, above-mentionedly insert performance element 109 is located at the Connection Block 108 of robot arm respectively relative both sides with Detection location unit 107.
In concrete scheme, above-mentioned angle of inserting between performance element 109 and Detection location unit 107 is 180 °.Adopt this structure, the width of robot arm can be reduced, reduce the volume of robot arm, and in operation process, only robot arm need be overturn around the longitudinal center line of Connection Block the conversion that 180 ° can realize locating and inserting guide function fast, make surgical machine hands have easy to operate feature.Certainly, the angle of said two devices also can be other angles, can reduce width equally like this, and realizes location by rotating to an angle and the function that imports switches.
In addition, the present invention also provides the localization method of the self-align navigating surgery robot arm of a kind of follow-up spine, the preset of the method first on selected target vertebra is as specified point, then left and right probe and locking pin is adopted to lock specified point, virtual rotation axle center is set up so that robot arm adjustment attitude in the coordinate system of robot, and then determine that pedicle of vertebral arch is inserted a little and inserts angle, digitized guides pedicle accurately to insert.
Adopt in this way, can by the known coordinate of specified point to Detection location unit with certain reference, make it have higher precision and accuracy, improve the Position location accuracy of operation.
Below for sixth cervical vertebra, illustrate that this robot arm carries out operational approach and the step of spinal operation location according to specified point.
Please refer to Figure 13 to Figure 15, Figure 13 is the FB(flow block) of a kind of detailed description of the invention of the localization method of surgical machine hands provided by the present invention; Figure 14 is robot arm spinal column positioning navigation method schematic diagram; Figure 15 is position, the side schematic diagram of sixth cervical vertebra in Figure 14.
In another kind of detailed description of the invention, as shown above, when the targeted vertebra of operation is sixth cervical vertebra, above-mentioned localization method can specifically comprise the steps:
S11: preoperatively CT scan is carried out to sixth cervical vertebra and after three-dimensional reconstruction, at sixth cervical vertebra end to end to waiting on point CT profile of left and right " pedicle of vertebral arch ", choose its left and right sides edge line and " pedicle of vertebral arch " end to end to the intersection point of bisector as specified point A141, A ' 142.Determine left and right two " pedicles of vertebral arch " insert angle α, α of some E139, E ' 140 and pedicle of vertebral arch programme path 143,144 and median line 145 ', measure the length of AA ' and EE ' line segment.Measure the first distance n, n ' that left and right two " pedicles of vertebral arch " insert some E139, E ' 140 and median line 145.On the CT profile of point left and right " pedicle of vertebral arch " such as introversion and extroversion, measure second distance m148 and the m ' (not shown) that left and right two " pedicles of vertebral arch " insert some E139, E ' 140 and vertebral plate 152 sides or tail lateral edges point P147, P ' (not shown).These data informations are transferred to the computer of master control system.
S12: fully appear sixth cervical vertebra in art and fix stable.The spacing arranging two probes 111,112 of Detection location unit structure equals two specified point A, the spacing of A '.Under the perspective monitoring of position, C-arm X-ray machine side, this robot arm 1 mobile, its probe 111,112 touch points P147 and P ' move second distance m148 and m ' in backward head side, make probe 111, two centrages of 112, end to end to the left and right " pedicle of vertebral arch " bisector and the center of C-arm X-ray machine are thrown and are overlapped according to line.Because C arm machine x-ray is that daylight is radial, when left and right pedicle of vertebral arch has slight distance to depart from the throwing of C arm X-ray machine center according to line to the arbitrary line in bisector or two probe core lines end to end, due to " projective amplification effect ", namely there is very large ranging offset and be identified in the projection of deviated line, such specified point is just very high to positioning precision end to end.
S13: under programming software controls, decline probe 111,12, make slide cartridge 118, " | " 124 of 119 lower ends, 125 banking stops and both sides specified point A, A ' contact, slide bar 120, specified point A, A ' inner side bone surface is touched at 12 tips, and robot arm is that radius rotates in perpendicular around virtual rotary middle point 146 with the spacing of its axle center Q10 and virtual rotary middle point 146 (mid point of both sides specified point A, A ' line), the attitude of automatic adjusting machine device hands 1, when probe 111, when the indicateing arm 126,127 of 12 reaches same height, this robot arm 1 stop motion.Now 107 horizontal lines 128 of Detection location unit namely with vertebral line 129 keeping parallelism.
S14: the hands 101 that starts the machine moves, probe 111,112 exit surgical field of view after rotate 180 ° around Q110 place, axle center horizontal line, insert the puncture needle 131 of performance element 9, guide pipe 132, guide cylinder 133, locking pin 134,135,136 grades are respectively left or after move right the first distance n, n ', E139 and E ' 140 is inserted in the vertical successively locking that declines, then puncture needle 131, guide pipe 132, guide cylinder 133, locking pin 134,135,136 grade are pressed α and α ' angle and are rotated adjustment attitude.Now robot arm 101 is inserted a little left and right pedicle of vertebral arch and namely the position fixing process of placing direction has accused.
From above-mentioned position fixing process, specified point can be improved the Position location accuracy of Detection location unit as datum mark, thus ensure safety and the curative effect of spinal surgery.
For Thoracolumbar disk, due to adopt thoracic vertebra costotransverse joint gap line or Facet Joints gap line etc. and left and right pedicle of vertebral arch end to end to the intersection point of bisector as specified point, in the plane that they may not be formed to bisector end to end in left and right pedicle of vertebral arch, after CT measures the vertical dimension of these specified points and this plane, specified point can be moved to by this distance by this plane, realize the horizontal line 128 of Detection location unit 107 parallel with vertebral line 129 after, be back to again in plane that left and right pedicle of vertebral arch forms to bisector end to end and adjust attitude, complete location and guide left and right pedicle of vertebral arch to insert.
The present invention has the following advantages: rational in infrastructure, error link is few, and precision is high, is applicable to through multiple spinal operations such as vertebral arch internal fixtion or vertebra grinding decompressions.
Above a kind of locking-type spinal column location navigation surgical machine hands based on specified point provided by the present invention and localization method thereof are described in detail.Apply specific case herein to set forth principle of the present invention and embodiment, the explanation of above embodiment just understands method of the present invention and core concept thereof for helping.It should be pointed out that for those skilled in the art, under the premise without departing from the principles of the invention, can also carry out some improvement and modification to the present invention, these improve and modify and also fall in the protection domain of the claims in the present invention.
Claims (7)
1. the self-align navigating surgery robot arm of follow-up spine, it comprises common segment and private part; Common segment is made up of servo-actuated bindiny mechanism, attitude regulation mechanism and control software design and sensor, adjustable plate, and private part comprises Detection location unit and inserts performance element, is divided into the special two parts of Thoracolumbar disk, cervical vertebra; It is characterized in that:
The Detection location unit of Thoracolumbar disk private part with insert performance element by two probe mechanism, the locking pin mechanisms of to overlap or more, change pin mechanism, puncture needle mechanism forms; Probe mechanism comprises probe, lead, the guide cylinder of groove with a scale, spring, indicateing arm; Locking pin mechanism comprises end to end to locking pin, left and right to locking pin, guide pipe, spring, indicateing arm; Conversion pin mechanism comprises conversion pin, guide pipe, displacement and angular adjustment seat; Puncture needle mechanism comprises puncture needle, interior guide cylinder, replaces guide cylinder, displacement and angular adjustment seat outside interior guide cylinder, open-close type, and in replacing, guide cylinder comprises additional locking pin, slide cartridge, spring; The outer guide cylinder of puncture needle, interior guide cylinder, open-close type is that hollow out or nonopaque material are made;
This surgical machine hands keeps and targeted vertebra geo-stationary by its follower, again by the preset on selected target vertebra as specified point, then adopt left and right probe and to locking pin, specified point locked to locking pin, left and right end to end, virtual rotation axle center is set up so that robot arm adjustment attitude in the coordinate system of robot, and then determine that pedicle of vertebral arch is inserted a little and inserts angle, digitized guides pedicle accurately to insert;
Described specified point is that on vertebra rear surface, the left and right sides is parallel to the line of long axis direction and left and right pedicle of vertebral arch end to end to the intersection point of bisector; Or described specified point be with described left and right pedicle of vertebral arch end to end bisector be the line of predetermined angle and the described intersection point being parallel to the line of long axis direction.
2. the self-align navigating surgery robot arm of follow-up spine according to claim 1, is characterized in that: this surgical machine hands a vertebra carry out left and right pedicle of vertebral arch insert time, once need to lock the specified point on two or more vertebra rear surface simultaneously.
3. the self-align navigating surgery robot arm of follow-up spine according to claim 1, is characterized in that: this surgical machine hands is by observe or the length of acquisition probe, the change of pressure signal are carried out robot arm and manually or automatically controlled pose adjustment.
4. the self-align navigating surgery robot arm of follow-up spine according to claim 1, it is characterized in that: the equal flexible of all locking pins is also distributed in the surrounding of probe or puncture needle, the tip of locking pin all first contacts with surface of bone lower than probe or puncture needle, avoid probe or puncture needle and specified point or slippage after inserting point cantact, locking specified point is to determine to insert a little and placing direction.
5. the self-align navigating surgery robot arm of follow-up spine according to claim 1, is characterized in that: servo-actuated bindiny mechanism comprises connecting plate, column, spring.
6. the self-align navigating surgery robot arm of follow-up spine according to claim 1, it is characterized in that: the Detection location unit of cervical vertebra private part comprises the probe of two covers or more, locking pin, puncture needle and adjustment seat with inserting performance element, its locking pin is made up of locking plate, spring; Each locking plate can independent telescope, and its lower end is spine shape.
7. the self-align navigating surgery robot arm of the follow-up spine according to any one of claim 1-6, is characterized in that, the Detection location unit of described robot arm is located at the relative both sides of the Connection Block of described robot arm respectively with inserting performance element.
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| CN103393447B (en) * | 2013-08-22 | 2015-04-01 | 厦门大学 | Miniature numerical control scalpel |
| CN104688341B (en) * | 2013-12-09 | 2017-08-25 | 苏州点合医疗科技有限公司 | A kind of vertebral column digital operation device positioned based on microgap |
| CN105852971A (en) * | 2016-05-04 | 2016-08-17 | 苏州点合医疗科技有限公司 | Registration navigation method based on skeleton three-dimensional point cloud |
| CN106725858B (en) * | 2016-12-13 | 2023-11-24 | 苏州点合医疗科技有限公司 | Vertebra motion semi-restriction type spinal surgery robot |
| CN107374752B (en) * | 2017-07-31 | 2023-12-26 | 中国人民解放军第二军医大学第二附属医院 | Vertebra support distance measuring device |
| CN108078627A (en) * | 2017-12-26 | 2018-05-29 | 北京天智航医疗科技股份有限公司 | A kind of guider |
| CN110151239B (en) * | 2019-05-07 | 2020-11-10 | 张为 | Centrum struts measuring device |
| CN113813005B (en) * | 2021-08-20 | 2023-01-24 | 中国科学院深圳先进技术研究院 | Robot for cutting vertebral plate of spine |
| CN114848400A (en) * | 2022-05-26 | 2022-08-05 | 南开大学 | Motion planning and applying method for tibial fracture healing and functional rehabilitation |
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