CN112618234B - Operating bed assisting positioning of robot spinal minimally invasive surgery and positioning method thereof - Google Patents

Operating bed assisting positioning of robot spinal minimally invasive surgery and positioning method thereof Download PDF

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CN112618234B
CN112618234B CN202110020362.7A CN202110020362A CN112618234B CN 112618234 B CN112618234 B CN 112618234B CN 202110020362 A CN202110020362 A CN 202110020362A CN 112618234 B CN112618234 B CN 112618234B
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vertebral body
pedicle
positioning
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bed surface
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CN112618234A (en
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刘洪升
张聪
张坚
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Beijing Zhuzheng Robot Co ltd
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G13/00—Operating tables; Auxiliary appliances therefor
    • A61G13/0036—Orthopaedic operating tables
    • A61G13/0054—Orthopaedic operating tables specially adapted for back or spinal surgeries
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G13/00—Operating tables; Auxiliary appliances therefor
    • A61G13/02—Adjustable operating tables; Controls therefor
    • A61G13/06—Adjustable operating tables; Controls therefor raising or lowering of the whole table surface
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G13/00—Operating tables; Auxiliary appliances therefor
    • A61G13/10—Parts, details or accessories
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G13/00—Operating tables; Auxiliary appliances therefor
    • A61G13/10—Parts, details or accessories
    • A61G13/107—Supply appliances
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B2034/301—Surgical robots for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B2034/303—Surgical robots specifically adapted for manipulations within body lumens, e.g. within lumen of gut, spine, or blood vessels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G2203/00—General characteristics of devices
    • A61G2203/10—General characteristics of devices characterised by specific control means, e.g. for adjustment or steering
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G2210/00—Devices for specific treatment or diagnosis
    • A61G2210/10—Devices for specific treatment or diagnosis for orthopedics

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Abstract

The invention relates to the technical field of medical equipment, and provides an operating bed for assisting positioning of minimally invasive spine surgery of a robot and a positioning method thereof, wherein the operating bed comprises: an operating bed frame; the control moving units are respectively arranged on the upper surface of the operating bed frame and are provided with movable bed surfaces capable of ascending and descending, and the movable bed surfaces of the control moving units are spliced together to form the operating bed surface; and the control system is electrically connected with each control moving unit and controls the sub bed surface of each control moving unit to lift so that the pedicle of vertebral arch of the target vertebral body and the robot positioning device are in a relatively static state. The invention monitors the respiratory frequency and respiratory gas capacity of a patient, obtains the position variable of the pedicle of the vertebral arch of a target vertebral body by some calculation methods, transmits the position variable to the control system of the operating bed, and adjusts the position of the pedicle of the vertebral arch by adjusting the upper position and the lower position of the movable bed surface in real time by the control system, thereby effectively reducing the operation risk caused by inaccurate positioning of the pedicle of the vertebral arch due to respiration.

Description

Operating bed assisting positioning of robot spinal minimally invasive surgery and positioning method thereof
Technical Field
The invention relates to the technical field of medical equipment, in particular to an operating table for assisting positioning of a robot spinal minimally invasive surgery and a positioning method thereof.
Background
In recent years, in spinal surgery, robots are widely adopted to assist doctors to perform minimally invasive spine surgery, for example, various minimally invasive spine surgery such as spinal interbody bone grafting fusion internal fixation, percutaneous lumbar vertebroplasty (PVP), and the like, and the key link of the surgery lies in whether the robot can accurately position the pedicle of a diseased vertebral body, and once the pedicle of a vertebral body is positioned with a large error, other tissues except the vertebral body are injured by surgical instruments, so that serious consequences can be caused to patients.
Certain spinal surgical systems exist that include three components: an optical tracking system; a mechanical arm; operating the platform; wherein: the optical tracking system is responsible for capturing the spatial position information of the patient in real time; the manipulator can carry out space positioning according to the position planned in the operation; the operation platform helps the operator to perform operation planning on the obtained image information. The operation process of the spinal surgical system is briefly described as follows:
1) in the operation process, after anesthesia is carried out on a patient, the patient stands on an operation bed in a prone position, and a C-shaped arm X-ray machine is utilized to determine a nailed vertebral body, namely a target vertebral body in a perspective mode.
2) The patient tracer is fixed on the spinous process by using a spinous process clamp on the spinous process of the upper vertebral body or the spinous process of the lower vertebral body of the target vertebral body, and then the mechanical arm is sleeved with the sterile sleeve and the robot tracer.
3) And performing annular scanning on the lumbar vertebra of the patient by using a C-shaped arm X-ray machine, transmitting the three-dimensional data of the vertebral body to an operation platform, and planning the pedicle screw placement path according to the three-dimensional vertebral body image data.
4) After the nail placing path is planned, after the operation platform is clicked, the mechanical arm moves to a set position according to the planned path, then guide pins are sequentially driven into the mechanical arm by a tool, and after the mechanical arm is moved away, the guide pin position is confirmed by a C-shaped arm X-ray machine.
5) Tapping along the guide pin, screwing in the pedicle screw, and finishing the pedicle screw placing operation.
Through the analysis of the existing pedicle positioning robot technology, we can find the problems of the prior art:
although the missing devices are arranged at the spinous process position of the vertebral body of the patient and the tail end of the robot, the large displacement of the vertebral body caused by body movement can be monitored in real time, so that the path of the robot arm is re-planned, and the risk of failure in positioning the vertebral pedicle is reduced to a certain extent. However, in this embodiment, if no major change in position of the vertebral body is detected, and the robotic path is planned and moved to the appropriate position, the vertebral body is defaulted to be stationary.
Actually, a human body is continuously breathing, the chest and abdomen can be regularly expanded or contracted, and the position of a vertebral body is in the continuous changing process; furthermore, since the respiratory rate and the expiratory volume of a human body are different depending on various differences in age, sex, etc., the amount of change in the position of the vertebral body due to the expansion and contraction of the thoracic and abdominal regions is also different. If the centrum carries out the guide pin and squeezes into the pedicle of vertebral arch at the constantly changeable in-process in position, and the pedicle of vertebral arch position takes place the deviation with planning position before the art this moment, and it squeezes into the direction deviation to lead to the guide pin extremely probably, and the serious person can appear penetrating out the pedicle of vertebral arch, injures other tissues, produces very big harm to the patient.
Therefore, in some existing robot devices for assisting manual positioning, the change of the position of the vertebral body caused by body movement during the operation is considered, but the influence of the chest and abdomen expansion or contraction generated by breathing on the position of the vertebral body is not considered, and the breathing frequency and the lung expansion degree are not consistent due to the difference of human individuals, so that the existing pedicle positioning robot is difficult to effectively adapt to patients with different individual differences.
In view of the above, the present invention is particularly proposed.
Disclosure of Invention
In view of the fact that in the existing spine minimally invasive surgery, the robot-assisted pedicle positioning system does not effectively consider the influence of human breathing motion on accurate positioning of the pedicle, and is difficult to be suitable for patients with different individual differences.
The invention provides an operating table for assisting positioning of minimally invasive spine surgery of a robot, and particularly adopts the following technical scheme:
an operating bed for assisting positioning of minimally invasive spine surgery of a robot, comprising:
an operating bed frame;
the control moving units are respectively arranged on the upper surface of the operating bed frame and are provided with a movable bed surface capable of being lifted, and the movable bed surfaces of the control moving units are spliced together to form the operating bed surface;
and the control system is electrically connected with each control moving unit and controls the sub bed surface of each control moving unit to lift so that the pedicle of vertebral arch of the target vertebral body and the robot positioning device are in a relatively static state.
Furthermore, the control moving unit comprises a motor and a transmission part, and the transmission part is respectively in transmission connection with the movable bed surface and a motor shaft of the motor and is used for converting the rotation of the motor shaft into the linear reciprocating motion for driving the movable bed surface to ascend and descend.
Furthermore, the movable bed surface comprises a supporting part for bearing and a connecting part connected with the non-bearing side of the supporting part;
the control moving unit also comprises a mounting seat fixed on the upper surface of the operating bed frame, and a slide way for slidably mounting the connecting part of the movable bed surface is arranged in the mounting seat;
the transmission part comprises a transmission shaft, the transmission shaft is fixedly connected with a motor shaft of the motor, and the other end of the transmission shaft extends into the slide way of the mounting seat and is in threaded connection with the connecting part of the movable bed surface.
Furthermore, one end of the transmission shaft is provided with an installation shaft hole, and the motor shaft is inserted into the installation shaft hole and fixedly connected through a jackscrew; the other end of the transmission shaft is provided with an external thread structure, and the connecting part of the movable bed surface is provided with an internal thread structure in threaded connection with the external thread structure.
Furthermore, a limiting structure used for limiting the rotation of the movable bed surface is arranged in the slide way of the mounting seat, and a matching structure matched with the limiting structure is arranged on the connecting part of the movable bed surface.
The second invention aims to provide a positioning method of an operating bed for assisting positioning of minimally invasive spine surgery of a robot, and specifically adopts the following technical scheme:
a positioning method of an operating bed for assisting positioning of minimally invasive spine surgery of a robot comprises the following steps:
the control system obtains the position variable delta i of the pedicle of the vertebral arch of the target vertebral body, and adjusts the lifting of the movable bed surface of the corresponding control moving unit so that the pedicle of the vertebral arch of the target vertebral body and the robot positioning device are in a relatively static state.
Further, the control system acquiring the position variable of the pedicle of the target vertebral body comprises:
the control system receives the patient's respiratory frequency f monitored in real time p And the breathing gas volume delta Q, and the position variable delta i of the vertebral pedicle of the target vertebral body is obtained through calculation.
Further, the method for calculating the position variable Δ i of the pedicle of the target vertebral body comprises the following steps:
step S1, establishing xy coordinate system with the first segment atlas of cervical vertebra as origin, and irradiating the positive lateral position for multiple times by C-arm X-ray machineShooting the spine, then obtaining position data of each segment of the spine through image processing, and fitting a mathematical curve of the whole spine of the patient through mathematical operation: y is ax 3 +bx 2 + cx + d (where a, b, c, d are all constants);
step S2, an ellipsoidal air bag is used to approximately simulate the unilateral lung of a human body, the highest point of an ellipsoid is opposite to a thoracic vertebra T8, the lung is irradiated by an X-ray machine in multiple angles, and the length (2 a) of the unilateral lung of a patient during expiration (namely, when the lung volume is minimum) is measured e ) Width (2 c) e ) High (2 b) e ) Taking the parameters as the three axial lengths of xyz of the ellipsoid, the volume of the ellipsoid:
Figure GDA0003764577010000041
step S3, monitoring the respiratory frequency f of the patient in real time through the instrument p And the breathing gas volume, Δ Q (i.e., the expanded volume of the lung), from which the total volume of the expanded lung can be derived, is approximately twice the expanded total volume of a single ellipsoidal balloon:
Figure GDA0003764577010000051
in step S4, since the lung expands mainly anteroposteriorly, a can be considered approximately e 、c e Not changed, only b e The change is that after expansion, the air sac still is approximately regarded as an ellipsoid, and the half axis in the Y direction becomes
Figure GDA0003764577010000052
From this, it can be calculated that the variation in the expanded ellipsoid Y direction is: Δ b ═ 2 (b) 2 -b e ) When the human body inhales, the distance of upward movement of the thoracic vertebra T8 is delta b;
step S5, when the respiration expands, the vertebral body of each segment expands along the normal vector direction of the vertebral body curve, and the displacement delta b of each vertebral body along the normal vector can be obtained by the method of linear difference i The rotation angle theta of each vertebral body cross section can be calculated i And then passing through the geometric characteristic data of the vertebral bodyThe position variable deltai of the pedicle of the vertebral body of interest can be calculated.
Furthermore, the control system is connected with binocular optical positioning equipment for monitoring the displacement of the target vertebral body in real time to form a closed-loop control system.
Furthermore, the binocular optical positioning equipment monitors the displacement of the target vertebral body in real time, calculates the difference between the displacement and the positioning displacement of the robot positioning device, reversely inputs the difference to the control system, and enables the target vertebral body to tend to be relatively static relative to the robot positioning device through multiple iterations.
The invention provides an operating bed for assisting positioning of a minimally invasive spine surgery of a robot, which is characterized in that the position variable of the pedicle of a vertebral arch of a target vertebral body is obtained by monitoring the respiratory frequency and the respiratory gas volume of a patient through some calculation methods, is transmitted to a control system for controlling the operating bed, the position of the pedicle of the vertebral arch is adjusted by adjusting the upper position and the lower position of a movable bed surface in real time, and the pedicle of the vertebral arch is in a static state relative to the robot in the surgery process through a method of multiple iteration of a closed-loop control system, so that the surgery risk caused by inaccurate positioning of the pedicle of the vertebral arch due to respiration can be effectively reduced.
Drawings
Fig. 1 is an overall structural view of an operating table according to an embodiment of the present invention;
fig. 2 is a schematic diagram of the overall structure of a control mobile unit according to an embodiment of the present invention;
FIG. 3 is a schematic view of the operating table of the embodiment of the present invention in combination with a binocular optical positioning apparatus;
FIG. 4 is a schematic view of a human prone position spine curve according to an embodiment of the present invention;
FIG. 5 is a schematic view of an embodiment of the present invention simulating approximately a unilateral lung of a human body with an ellipsoidal balloon;
FIG. 6 is a parametric representation of an ellipsoidal balloon in accordance with an embodiment of the invention;
FIG. 7 is a graph comparing the change in spinal curvature before and after lung expansion in a human in accordance with an embodiment of the present invention;
fig. 8 is a flowchart of a closed-loop control algorithm of a closed-loop control system formed by the operating table and the binocular optical positioning device according to the embodiment of the invention.
Reference numbers in the drawings illustrate:
1-operating bed frame
2-control System
3-controlling a mobile unit
301-movable bed surface 302-mounting seat 303-transmission shaft 304-motor 305-jackscrew
4-binocular optical positioning equipment
5-target vertebral body marking points.
Detailed Description
The following describes in detail an operation table for assisting positioning of minimally invasive spine surgery of a robot and a positioning method thereof in combination with the accompanying drawings:
as shown in fig. 1-2, an operation table for assisting positioning of minimally invasive spine surgery of a robot in the embodiment includes:
an operating bed frame 1;
the control moving units 3 are respectively arranged on the upper surface of the operating bed frame 1, the control moving units 3 are provided with movable bed surfaces 301 capable of being lifted, and the movable bed surfaces 301 of the control moving units 3 are spliced together to form the operating bed surface for bearing an operating patient;
and the control system 2 is electrically connected with each control moving unit 3 and controls the sub bed surface 301 of each control moving unit 3 to lift so that the pedicle of vertebral arch of the target vertebral body and the robot positioning device are in a relatively static state.
Physiological respiratory motion of a human body cannot be avoided in any operation process, and influence on the position of a vertebral body is continuous, so that influence of the respiratory motion of the human body on operation accuracy is very necessary to be considered in minimally invasive spine surgery.
In view of the fact that in the existing spine minimally invasive surgery, the robot-assisted pedicle positioning device does not effectively consider the influence of human breathing motion on accurate positioning of the pedicle, and is difficult to be suitable for patients with different individual differences. The embodiment provides a self-adaptive breathing operating table, which is characterized in that the position variable of the pedicle of the vertebral arch of a target vertebral body is obtained by monitoring the breathing frequency and the breathing gas volume of a patient through some calculation methods, the position variable is transmitted to a control system for controlling the operating table, the position of the pedicle of the vertebral arch is adjusted by adjusting the upper position and the lower position of a movable bed surface in real time, and the pedicle of the vertebral arch is in a static state relative to a robot in the operation process through a method of multiple iteration of a closed-loop control system, so that the operation risk caused by inaccurate positioning of the pedicle of the vertebral arch due to breathing can be effectively reduced.
Therefore, the operating table of the embodiment is a hardware basis for realizing the active positioning of the pedicle of the vertebral arch of the target vertebral body in the minimally invasive spine surgery, the creative structural design endows the operating table with the function of actively adjusting the position of the target vertebral body, and the dynamic influence of breathing on the positioning of the robot positioning device is ingeniously overcome.
The operation table frame 1 of the present embodiment is configured as a main body of the operation table for providing a plurality of control moving units 3; the movable bed surfaces 301 of the control moving units 3 are spliced together to form an operation bed surface, and dynamic support can be provided for an operation patient to meet the positioning requirement of a target vertebral body; the control system is used as a central processing unit of the operating table, receives the measurement data of each monitoring instrument in the operation process, and performs real-time data analysis and calculation to control the lifting of the corresponding control mobile unit 3. As shown in fig. 2, as an embodiment of this embodiment, the control moving unit in this embodiment includes a motor 304 and a transmission part, and the transmission part is respectively connected to the moving bed 301 and a motor shaft of the motor 304 in a transmission manner, and is used for converting the rotation of the motor shaft into a linear reciprocating motion for driving the moving bed 301 to move up and down. In this embodiment, a common motor is used as a driving part, and the rotation of the motor shaft is converted into a linear reciprocating motion for driving the movable bed surface 301 to ascend and descend by a transmission part, so as to realize the driving control of the ascending and descending of the movable bed surface 301.
The movable bed surface 301 in this embodiment includes a supporting portion for supporting and a connecting portion connected to a non-supporting side of the supporting portion; the control moving unit 3 further comprises an installation seat 302 fixed on the upper surface of the operating bed frame 1, and a slide way for slidably installing the connecting part of the movable bed surface 301 is arranged in the installation seat 302; the transmission part comprises a transmission shaft 303, the transmission shaft 303 is fixedly connected with a motor shaft of a motor 304, and the other end of the transmission shaft 303 extends into a slide way of the mounting seat 302 and is in threaded connection with a connecting part of the movable bed surface 301.
In this embodiment, the transmission shaft is fixedly connected to the motor shaft and is in threaded connection with the connecting portion of the movable bed surface 301, so that the rotation of the motor shaft is converted into linear reciprocating motion through threaded transmission.
The support portion of the movable bed surface 301 in this embodiment may be a flat plate structure, the upper surface of the flat plate structure bears the surgical patient, and the connecting portion may be a rod-shaped structure connected to the lower surface of the flat plate structure. The supporting part and the connecting part of the embodiment can be assembled into a whole and can also be integrally formed.
Furthermore, a limiting structure for limiting the rotation of the movable bed surface 301 is arranged in the slide way of the mounting seat 302, and a matching structure matched with the limiting structure is arranged on the connecting part of the movable bed surface 301. Like this, remove bed surface 301 and only carry out elevating movement and do not rotate, avoid causing unnecessary displacement, as an implementation, limit structure can be for setting up the spacing spout in the slide of mount pad 302, cooperation structure can be for setting up the spacing slider on the connecting portion of removing bed surface 301, spacing slider slidable set up in spacing spout. Of course, the limit structure may also be a limit slide block, and accordingly, the matching structure is a limit sliding groove.
Further, in this embodiment, one end of the transmission shaft 303 has a mounting shaft hole, and the motor shaft is inserted into the mounting shaft hole and fixedly connected through a jackscrew 305; the other end of the transmission shaft 303 is provided with an external thread structure, and the connecting part of the movable bed surface 301 is provided with an internal thread structure in threaded connection with the external thread structure.
The embodiment simultaneously provides a positioning method adopting the positioning device for the operating table and the robot, and the positioning method comprises the following steps:
the control system obtains the position variable delta i of the pedicle of the vertebral arch of the target vertebral body, and adjusts the lifting of the movable bed surface of the corresponding control moving unit so that the pedicle of the vertebral arch of the target vertebral body and the robot positioning device are in a relatively static state.
Further, the control system acquiring the position variable of the pedicle of the target vertebral body comprises:
the control system receives the patient's respiratory frequency f monitored in real time p And the breathing gas volume delta Q, and the position variable delta i of the vertebral pedicle of the target vertebral body is obtained through calculation.
As an implementation manner of this embodiment, the method for calculating the position variable Δ i of the pedicle of the target vertebral body of this embodiment includes:
step S1, establishing an xy coordinate system by taking the first segment of atlas of the cervical vertebra as an origin, irradiating the spine for multiple times in the positive lateral position by using a C-arm X-ray machine, then obtaining position data of each segment of the spine through image processing, and fitting a mathematical curve of the whole spine of the patient through mathematical operation: y is ax 3 +bx 2 + cx + d (where a, b, c, d are all constants).
In clinical surgery, the patient is left standing in the prone position on the operating bed, see fig. 4. When a patient stands on the operation bed, the head, the chest, the abdomen, the lower limbs and the like are tightly attached to the bed surface, the lower part of the whole spine is a lung organ, and the position of each spine section is changed along with the regular expansion or contraction of the lung. The head is stationary during the procedure, the first segment of the atlas C1 of the cervical portion is also approximately considered stationary; the sacrum is connected to the ilium, and the anterior part of the ilium is also considered to be close to the bed surface, so the sacrum S is also considered to be approximately stationary.
Because the spine is movable, each section of the spine is approximately regarded as a section of rigid connecting rod, the intervertebral disc is approximately regarded as a hinged point, and an xy coordinate system is established by taking the first section of the atlas of the cervical vertebra as an origin, as shown in figure 4. The spine is irradiated for a plurality of times in the positive lateral position by using a C-shaped arm X-ray machine, then the position data of each segment of the spine is obtained through image processing, and the mathematical curve of the whole spine of the patient is fitted through mathematical operation.
Step S2, an ellipsoidal air bag is used to approximately simulate the unilateral lung of a human body, the highest point of an ellipsoid G is opposite to a thoracic vertebra T8, the lung is irradiated by an X-ray machine in multiple angles, and the length (2 a) of the unilateral lung of a patient during expiration (namely, when the lung volume is minimum) is measured e ) Width (2 c) e ) High (2 b) e ) Taking the parameters as the three axial lengths of xyz of the ellipsoid, the volume of the ellipsoid G:
Figure GDA0003764577010000101
two lung tissues are arranged on the left and right of a human body, and when the human body breathes, the two lungs expand or contract simultaneously to drive other tissues to jointly enable the spine to be in a constantly changing state. An ellipsoidal balloon is used to approximate the unilateral lung of a human body.
Step S3, before the operation, the patient needs general anesthesia, the patient is driven to breathe by a breathing machine, or the patient is anesthetized locally to make the patient breathe autonomously, and the breathing frequency f of the patient is monitored in real time by a special instrument p And the breathing gas volume, Δ Q (i.e., the expanded volume of the lung), from which the total volume of the expanded lung can be derived, is approximately twice the expanded total volume of a single ellipsoidal balloon:
Figure GDA0003764577010000102
in step S4, since the lung expands mainly anteroposteriorly, a can be considered approximately e 、c e Not changed, only b e The change is that after expansion, the air sac still is approximately regarded as an ellipsoid, and the half axis in the Y direction becomes
Figure GDA0003764577010000111
From this, it can be calculated that the variation in the expanded ellipsoid Y direction is: Δ b ═ 2 (b) 2 -b e ) When the human body inhales, the distance that the thoracic vertebra T8 moves upwards is Δ b.
Step S5, when the respiration expands, the vertebral body of each segment expands along the normal vector direction of the vertebral body curve, and the displacement delta b of each vertebral body along the normal vector can be obtained by the method of linear difference i The rotation angle theta of each cone cross section can be calculated i And then the position variable delta i of the pedicle of the vertebral body can be calculated through the geometric characteristic data of the vertebral body.
In this embodiment, the control system is connected to a binocular optical positioning device for monitoring the displacement of the target vertebral body in real time, so as to form a closed-loop control system.
In order to accurately control the position variable delta i of the pedicle of the target vertebral body and enable the pedicle to be kept static relative to a positioning device of a surgical robot, binocular optical positioning equipment is added to form a closed-loop control system. Binocular optical positioning equipment 4 is placed beside the self-adaptive breathing operation table, and an optical mark point 5 is placed at the position of a target vertebral body on the back of a human body, as shown in fig. 3.
Furthermore, the binocular optical positioning equipment monitors the displacement of the target vertebral body in real time, calculates the difference between the displacement and the positioning displacement of the robot positioning device, reversely inputs the difference to the control system, and enables the target vertebral body to tend to be relatively static relative to the robot positioning device through multiple iterations.
The closed-loop control algorithm flow chart of the embodiment is as shown in fig. 8, the axis variation Δ i of the pedicle of vertebral arch of the target vertebral body is transmitted to the control system 2 for controlling the adaptive respiration operating bed, the displacement of the movable bed surface is adjusted in real time by controlling the plurality of displacement units 3, the position of the target vertebral body is further adjusted, the displacement of the target vertebral body is monitored in real time by the binocular positioning device, the difference between the displacement and the robot positioning device is calculated, the displacement is reversely input to the control system, and the target vertebral body tends to be static relative to the robot positioning device through multiple iterations.
This embodiment is through such closed-loop control system to reach the purpose of the real-time accurate location pedicle of vertebral arch of surgical robot positioner, the operation risk that can reduce to a certain extent because of the pedicle of vertebral arch location is inaccurate to cause.
Although the present invention has been described with reference to a preferred embodiment, it should be understood that various changes, substitutions and alterations can be made herein without departing from the spirit and scope of the invention as defined by the appended claims.

Claims (7)

1. An operation table for assisting positioning of minimally invasive spine surgery of a robot is characterized by comprising:
an operating bed frame;
the control moving units are respectively arranged on the upper surface of the operating bed frame and are provided with movable bed surfaces capable of ascending and descending, and the movable bed surfaces of the control moving units are spliced together to form the operating bed surface;
the control system is electrically connected with each control moving unit and controls the sub bed surface of each control moving unit to lift so that the pedicle of vertebral arch of the target vertebral body and the robot positioning device are in a relatively static state;
the positioning method of the operating table comprises the following steps:
control system obtains position variable of vertebral pedicle of target vertebral body
Figure DEST_PATH_IMAGE001
Adjusting the lifting of the movable bed surface of the corresponding control moving unit to enable the pedicle of vertebral arch of the target vertebral body and the robot positioning device to be in a relatively static state;
the control system acquiring the position variable of the pedicle of the target vertebral body comprises the following steps:
the control system receives the real-time monitored respiratory rate of the patient
Figure 492330DEST_PATH_IMAGE002
And volume of respiratory gas
Figure DEST_PATH_IMAGE003
Obtaining the position variable of the vertebral pedicle of the target vertebral body through calculation
Figure 697047DEST_PATH_IMAGE001
；
Position variation of vertebral pedicle of target vertebral body
Figure 630368DEST_PATH_IMAGE001
The calculating method comprises the following steps:
step S1, establishing an xy coordinate system by taking the first segment of atlas of the cervical vertebra as an origin, irradiating the spine for multiple times in the positive lateral position by using a C-arm X-ray machine, then obtaining position data of each segment of the spine through image processing, and fitting a mathematical curve of the whole spine of the patient through mathematical operation:
Figure 768088DEST_PATH_IMAGE004
whereina、b、c、dAre all constant;
step S2, an ellipsoidal air bag is used to simulate the unilateral lung of a human body approximately, the highest point of an ellipsoid is opposite to a thoracic vertebra T8, the lung is irradiated by an X-ray machine in multiple angles, and the length of the unilateral lung when a patient exhales, namely, when the lung volume is minimum, is measured
Figure DEST_PATH_IMAGE005
Wide and wide
Figure 699135DEST_PATH_IMAGE006
High, high
Figure DEST_PATH_IMAGE007
Taking the parameters as the three axial lengths of xyz of the ellipsoid, the volume of the ellipsoid:
Figure 391147DEST_PATH_IMAGE008
；
step S3, monitoring the respiratory rate of the patient in real time through the instrument
Figure 862580DEST_PATH_IMAGE002
And volume of respiratory gas
Figure 843088DEST_PATH_IMAGE003
I.e. the volume of the lung expanded, from which the total volume of the lung when expanded can be derived, is approximated as a single ellipsoidal balloon expansionTwice the total volume:
Figure DEST_PATH_IMAGE009
；
at step S4, since the lung expands mainly anteroposteriorly and posteriorly, it is considered that the lung is approximately expanded
Figure 741774DEST_PATH_IMAGE010
、
Figure DEST_PATH_IMAGE011
Is not changed, except that
Figure 186662DEST_PATH_IMAGE012
The change is that after expansion, the air sac still is approximately regarded as an ellipsoid, and the half axis in the Y direction becomes
Figure DEST_PATH_IMAGE013
From this, it can be calculated that the amount of change in the expanded ellipsoid Y direction is:
Figure 665048DEST_PATH_IMAGE014
when the human body inhales, the distance of the thoracic vertebra T8 moving upwards is the same as the distance of the thoracic vertebra T8 moving upwards
Figure DEST_PATH_IMAGE015
；
Step S5, when the respiration expands, the vertebral body of each segment expands along the normal vector direction of the vertebral body curve, and the displacement of each vertebral body along the normal vector is obtained by the method of linear difference
Figure 511781DEST_PATH_IMAGE016
Calculating the rotation angle of each vertebral body cross section
Figure DEST_PATH_IMAGE017
And then calculating the position variable of the vertebral pedicle of the target vertebral body through the geometric characteristic data of the vertebral body
Figure 315789DEST_PATH_IMAGE001
。
2. The surgical bed for assisting positioning of minimally invasive spine surgery of a robot according to claim 1, wherein the control moving unit comprises a motor and a transmission part, and the transmission part is respectively in transmission connection with the movable bed surface and a motor shaft of the motor and is used for converting rotation of the motor shaft into linear reciprocating motion for driving the movable bed surface to ascend and descend.
3. The surgical bed for assisting positioning of minimally invasive spine surgery of a robot of claim 2, wherein the movable bed surface comprises a supporting portion for bearing and a connecting portion connected with a non-bearing side of the supporting portion;
the control moving unit also comprises a mounting seat fixed on the upper surface of the operating bed frame, and a slide way for slidably mounting the connecting part of the movable bed surface is arranged in the mounting seat;
the transmission part comprises a transmission shaft, the transmission shaft is fixedly connected with a motor shaft of the motor, and the other end of the transmission shaft extends into the slide way of the mounting seat and is in threaded connection with the connecting part of the movable bed surface.
4. The operating table for assisting positioning of minimally invasive spine surgery of a robot according to claim 3, wherein one end of the transmission shaft is provided with a mounting shaft hole, and the motor shaft is inserted into the mounting shaft hole and fixedly connected through a jackscrew; the other end of the transmission shaft is provided with an external thread structure, and the connecting part of the movable bed surface is provided with an internal thread structure in threaded connection with the external thread structure.
5. The operating table for assisting positioning of minimally invasive spine surgery of a robot according to claim 3, wherein a limiting structure for limiting rotation of the movable bed surface is arranged in the slide way of the mounting seat, and a matching structure matched with the limiting structure is arranged on the connecting portion of the movable bed surface.
6. The surgical bed for assisting positioning of minimally invasive spine surgery of a robot according to claim 1, wherein the control system is connected with a binocular optical positioning device for monitoring displacement of a target vertebral body in real time to form a closed-loop control system.
7. The surgical bed for assisting positioning of minimally invasive spine surgery of a robot according to claim 6, wherein the binocular optical positioning device monitors the displacement of the target vertebral body in real time, calculates the difference between the displacement and the positioning displacement of the robot positioning device, inputs the difference to the control system in a reverse direction, and enables the target vertebral body to tend to be relatively static relative to the robot positioning device through multiple iterations.
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