CN114848143A - Operation navigation system and method based on spine operation auxiliary robot - Google Patents

Abstract

The invention discloses a surgery navigation system and a surgery navigation method based on a spine surgery auxiliary robot. The method comprises preoperative planning, intraoperative execution and postoperative evaluation. According to the spine vertebral body pathological change position and the operation direction confirmed by the doctor in the image, the spine auxiliary operation robot can be automatically moved to position the operation direction under the robot coordinate system so as to guide the doctor to carry out the operation, so that the spine auxiliary operation robot is convenient for the doctor to carry out the operation, the operation efficiency is improved, and the operation accuracy and safety are improved. Meanwhile, the space registration of the image coordinate system and the robot coordinate system is completed in a mode that the set space registration probe is picked up and stuck on the back target point of the patient, so that secondary trauma to the patient is avoided.

Description

A surgical navigation system and method based on a spinal surgery assistant robot

technical field

The invention relates to the technical field of medical devices, in particular to a surgical navigation system and method based on an auxiliary robot for spinal surgery.

Background technique

At present, China is gradually entering an aging society, and the problem of osteoporosis has attracted more and more attention, and it has become one of the common metabolic bone diseases. Osteoporotic vertebral compression fracture (Osteoporotic Vertebral Compression Fracture, OVCF) is one of the common complications of osteoporosis, which is very harmful to the health of patients. Percutaneous Vertebroplasty (PVP) refers to the percutaneous injection of biological cement into the vertebral body through the pedicle or the outside of the pedicle to increase the strength and stability of the vertebral body, prevent collapse, relieve pain, and even partially recover. A minimally invasive spinal surgery technique for the purpose of vertebral body height. Compared with conservative treatment, PVP treatment of osteoporosis can relieve pain quickly, basically restore vertebral body shape and height, curb the vicious circle, and improve the survival status of patients. It has become the main method for clinical treatment of OVCF. However, during traditional PVP surgery, doctors mostly rely on two-dimensional medical images to judge the lesions of the spinal and vertebral bodies, and determine the lesion location and surgical direction based on experience. During the whole operation process, medical staff operate with bare hands, which is intensive and inefficient, increases the pain of patients, and exposes doctors and patients to the radiation environment for many times.

At present, the surgical navigation system related to spine surgery still relies on two-dimensional medical image information, which cannot intuitively reflect the three-dimensional shape of the spine and vertebrae, and the observation of the lesions is not intuitive. Problems such as difficult planning and low precision affect the accuracy and safety of surgery. In addition, in order to establish the spatial registration relationship between the patient and the surgical navigation system, the existing surgical navigation system needs to install a fixation device on the normal vertebral body or other parts of the human body as a reference, causing secondary trauma to the patient.

SUMMARY OF THE INVENTION

Aiming at the defects of the prior art, the main purpose of the present invention is to provide a surgical navigation system and method based on an auxiliary robot for spinal surgery, aiming to solve the problem that the existing surgical navigation system does not have an example of three-dimensional reconstruction of spinal vertebrae and cannot intuitively determine vertebral body lesions The situation and reflect the PVP surgical process, and relying on the installation of fixation devices on the normal vertebral body or other parts of the human body as a reference to complete the spatial registration and cause secondary trauma to the patient.

To achieve the above object, the present invention adopts the following technical solutions:

The spinal surgery assistant robot of the present invention includes a three-coordinate platform, a six-axis parallel robot and a doctor's work platform.

A surgical navigation system based on a spinal surgery assistant robot, comprising:

an image processing module for processing the CT data of the patient's spine, segmenting the spine vertebra instance from the rest of the human body, and reconstructing the segmented spine vertebra instance in three dimensions;

The spatial registration module is used to calculate the spatial registration relationship between the image coordinate system and the robot coordinate system;

a surgical navigation module, used by the doctor to select the position of the lesion area and the surgical direction in the three-dimensional reconstructed spinal vertebra instance, and obtain the position of the lesion area and the surgical direction in the robot coordinate system according to the spatial registration relationship, and According to the position of the lesion area and the surgical direction in the robot coordinate system, the doctor selects the installation direction of the end effector and the moving distance in the Z-axis direction to generate the surgical navigation command;

The motion control module is used to control the motion of the three-coordinate platform and the six-axis parallel robot of the spinal surgery assistant robot according to the surgical navigation instruction, so that the end effector reaches a designated posture.

Preferably, in the spatial registration module, the bio-electrodes are pasted on the back of the patient as the target points, and the doctor picks up these target points in the image coordinate system and the robot coordinate system, respectively, to obtain the target point coordinate values, and determine the image coordinates through Helmert transformation. The spatial registration relationship between the system and the robot coordinate system.

Preferably, the number of the target points is at least 5, and the method of picking up the target points in the robot coordinate system is that the doctor controls the space registration probe under the Y-axis end of the three-coordinate platform to contact these target points through a teleoperation stick, Get the coordinate values of these targets in the robot coordinate system.

Preferably, the teleoperation lever is a controller for manually controlling a three-coordinate platform and a six-axis parallel robot, and the space registration probe located below the end of the Y-axis of the three-coordinate platform is a high-precision ruby probe, It is also designed as a foldable structure, which can be rotated 90° to hide after the doctor has finished picking up the target to avoid collision with the skin on the back of the human body during the operation.

Preferably, the surgical navigation instruction includes the movement amount of each axis of the three-coordinate platform, the pose of the six-axis parallel robot, and the depth of needle insertion that the doctor allows to operate.

Preferably, the pose of the six-axis parallel robot includes the movement amount of the X axis, the rotation angle β around the Y axis and the rotation angle γ around the Z axis.

Preferably, the navigation system further includes a navigation display module located on the doctor's work platform, for interacting with the doctor during the entire operation, displaying the reconstruction result of the spine vertebra instance, and the doctor selecting the spine vertebra instance in the image coordinate system The position and direction of the lesion are displayed, and the real-time information of the three-coordinate platform and the six-axis parallel robot is displayed for the doctor to make an operation reference during the operation.

A surgical navigation method based on a spinal surgery assistant robot, including preoperative planning, intraoperative execution, and postoperative evaluation;

1) The steps of the preoperative planning include:

1-1) The patient is anesthetized, and the target for the spatial registration is pasted on the back of the patient, and the patient is scanned by CT and the CT data of the patient's spine is transmitted to the doctor's work platform;

1-2) According to the spine CT data of the patient, segment the spine vertebra instance from the rest of the human body, and three-dimensionally reconstruct the segmented spine vertebra instance;

1-3) The doctor picks up the target point under the image coordinate system and the robot coordinate system respectively, obtains the coordinate value of the target point, and determines the spatial registration relationship between the image coordinate system and the robot coordinate system through Helmert transformation;

1-4) The doctor selects the position and operation direction of the lesion area in the reconstructed spinal vertebra instance, and obtains the position and operation direction of the lesion area under the robot coordinate system according to the spatial registration relationship;

1-5) The doctor selects the installation direction of the end effector and the moving distance in the Z-axis direction according to the position of the lesion area and the surgical direction under the robot coordinate system, and generates a surgical navigation command;

2) The steps performed during the operation include:

2-1) Register patient, guide tube, puncture needle;

2-2) Data analysis, the three-coordinate platform and the six-axis parallel robot execute the surgical navigation command to make the end effector reach the specified pose;

2-3) The doctor installs the puncture guide tube and manually inserts the puncture needle into the lesion area of the patient;

3) The steps of the postoperative assessment include:

3-1) CT scan the patient again, and transmit the spine CT data to the doctor's work platform for image analysis, and compare whether the puncture needle has reached the lesion location; otherwise, reconfirm the lesion location and surgical direction, and generate surgical navigation instructions. Then inject bio-cement;

3-2) After the current spine and vertebrae surgery is completed, the patient will undergo CT scan again to evaluate the effect of bio-cement filling;

3-3) Determine whether there are other vertebral bodies that need to be operated on, and if so, continue the above process, if not, the spinal surgery assistant robot will return to the origin.

Compared with the prior art, the surgical navigation system and method based on an auxiliary robot for spinal surgery according to the present invention adopts the above technical solution, and achieves the following technical effects:

It can complete spinal vertebra instance segmentation and three-dimensional reconstruction based on spine CT images, more intuitively reflect the three-dimensional shape of spinal vertebrae, and more convenient for doctors to confirm the lesion location and surgical direction in percutaneous vertebroplasty (PVP). In addition, by pasting the target point on the skin and using a high-precision ruby probe as a spatial registration probe, the spatial registration of the image coordinate system and the robot coordinate system is realized without causing secondary trauma to the patient. Furthermore, the surgical navigation system and method based on the spinal surgery assistant robot of the present invention can generate the navigation command according to the lesion position and the surgical direction confirmed by the doctor in the image, and control the movement of the three-coordinate platform and the six-axis parallel robot, so that the The end effector can be moved to a designated position, reducing the number of CT scans, adjusting the needle insertion position and the surgical direction of the patient, and for patients with multiple spinal vertebrae trauma, continuous surgery can be performed, which facilitates the doctor’s surgery and improves the surgical efficiency.

Description of drawings

FIG. 1 is an illustration of a preferred embodiment of a surgical navigation system based on a spinal surgery assistant robot of the present invention.

2 is a diagram depicting an embodiment of a six-axis parallel robot at the end of the Y-axis of the three-coordinate platform of the spine surgery assistant robot, a rotatable hidden spatial registration probe, and an interchangeable or alternative end effector.

FIG. 3 is a functional block diagram of the spinal surgery assistance robot in FIG. 1 .

FIG. 4 is a flow chart of a preferred embodiment of a surgical navigation method based on a spinal surgery assistant robot of the present invention.

Detailed ways

In order to further illustrate the technical means and effects adopted by the present invention to achieve the above-mentioned objects, the specific embodiments, structures, features and effects of the present invention are described in detail below with reference to the accompanying drawings and preferred embodiments. It should be understood that the specific embodiments described herein are only used to explain the present invention, but not to limit the present invention.

Example 1

Referring to Figure 1, a surgical navigation system based on a spinal surgery assistant robot, including:

an image processing module for processing the CT data of the patient's spine, segmenting the spine vertebra instance from the rest of the human body, and reconstructing the segmented spine vertebra instance in three dimensions;

The spatial registration module is used to calculate the spatial registration relationship between the image coordinate system and the robot coordinate system;

a surgical navigation module, used by the doctor to select the position of the lesion area and the surgical direction in the three-dimensional reconstructed spinal vertebra instance, and obtain the position of the lesion area and the surgical direction in the robot coordinate system according to the spatial registration relationship, and According to the position of the lesion area and the surgical direction in the robot coordinate system, the doctor selects the installation direction of the end effector and the moving distance in the Z-axis direction to generate the surgical navigation command;

The motion control module is used to control the motion of the three-coordinate platform and the six-axis parallel robot of the spinal surgery assistant robot according to the surgical navigation instruction, so that the end effector reaches a designated posture.

This embodiment is based on the surgical navigation system of the spine surgery assistant robot, which can automatically move the spine assistant surgery robot to locate the surgical direction in the robot coordinate system to guide the doctor to perform the surgery, which not only facilitates the doctor's surgery but also improves the efficiency of the surgery and improves the accuracy of the surgery. sex and safety.

Embodiment 2

This embodiment is basically the same as the first embodiment, and the special features are:

In this embodiment, the spatial registration module uses bio-electrodes pasted on the back of the patient as the target points, and the doctor picks up these target points in the image coordinate system and the robot coordinate system respectively, obtains the coordinate value of the target point, and performs Helmert transformation, Determine the spatial registration relationship between the image coordinate system and the robot coordinate system.

In this embodiment, the number of the target points is at least 5, and the method of picking up the target points in the robot coordinate system is that the doctor controls the space registration probe under the Y-axis end of the three-coordinate platform through the teleoperation stick to register with these targets. Point contact to get the coordinate values of these target points in the robot coordinate system.

In this embodiment, the remote control lever is a controller for manually controlling a three-coordinate platform and a six-axis parallel robot, and the spatial registration probe located below the end of the Y-axis of the three-coordinate platform is a high-precision ruby The probe is designed as a foldable structure, and is rotated 90° to hide after the doctor finishes picking up the target to avoid collision with the skin of the back of the human body during the operation.

In this embodiment, the surgical navigation instruction includes the movement amount of each axis of the three-coordinate platform, the pose of the six-axis parallel robot, and the depth of needle insertion that the doctor allows to operate.

In this embodiment, the pose of the six-axis parallel robot includes the movement amount of the X axis, the rotation angle β around the Y axis, and the rotation angle γ around the Z axis.

In this embodiment, the navigation system further includes a navigation display module located on the doctor's work platform, which is used to interact with the doctor during the entire operation and display the reconstruction result of the spinal vertebra instance. The doctor selects the The lesion position and direction of the instance of the vertebrae of the spine, and the real-time information of the three-coordinate platform and the six-axis parallel robot are displayed for the doctor to refer to during the operation.

This embodiment can complete spinal vertebra instance segmentation and three-dimensional reconstruction based on spinal CT images, more intuitively reflect the three-dimensional shape of spinal vertebrae, and more convenient for doctors to confirm the lesion location and surgical direction in percutaneous vertebroplasty (PVP). In addition, by pasting the target point on the skin and using a high-precision ruby probe as a spatial registration probe, the spatial registration of the image coordinate system and the robot coordinate system is realized without causing secondary trauma to the patient. The surgical navigation system based on the spinal surgery assistant robot described in this embodiment can generate the navigation command according to the lesion position and the surgical direction confirmed by the doctor in the image, control the movement of the three-coordinate platform and the six-axis parallel robot, and make the end effector reach the Specifying the position and posture reduces the number of CT scans, adjusting the needle insertion position and the surgical direction for patients, and for patients with multiple spinal vertebrae trauma, continuous surgery can also be performed, which facilitates the doctor's surgery and improves the surgical efficiency.

Embodiment 3

This embodiment is basically the same as the above-mentioned embodiment, and the special features are:

In this embodiment, a surgical navigation method based on a spinal surgery assistant robot includes preoperative planning, intraoperative execution, and postoperative evaluation;

1) The steps of the preoperative planning include:

1-1) The patient is anesthetized, and the target for the spatial registration is pasted on the back of the patient, and the patient is scanned by CT and the CT data of the patient's spine is transmitted to the doctor's work platform;

1-2) According to the spine CT data of the patient, segment the spine vertebra instance from the rest of the human body, and three-dimensionally reconstruct the segmented spine vertebra instance;

1-3) The doctor picks up the target point under the image coordinate system and the robot coordinate system respectively, obtains the coordinate value of the target point, and determines the spatial registration relationship between the image coordinate system and the robot coordinate system through Helmert transformation;

1-4) The doctor selects the position and operation direction of the lesion area in the reconstructed spinal vertebra instance, and obtains the position and operation direction of the lesion area under the robot coordinate system according to the spatial registration relationship;

1-5) The doctor selects the installation direction of the end effector and the moving distance in the Z-axis direction according to the position of the lesion area and the surgical direction under the robot coordinate system, and generates a surgical navigation command;

2) The steps performed during the operation include:

2-1) Register patient, guide tube, puncture needle;

2-2) Data analysis, the three-coordinate platform and the six-axis parallel robot execute the surgical navigation command to make the end effector reach the specified pose;

2-3) The doctor installs the puncture guide tube and manually inserts the puncture needle into the lesion area of the patient;

3) The steps of the postoperative assessment include:

3-1) CT scan the patient again, and transmit the spine CT data to the doctor's work platform for image analysis, and compare whether the puncture needle has reached the lesion location; otherwise, reconfirm the lesion location and surgical direction, and generate surgical navigation instructions. Then inject bio-cement;

3-2) After the current spine and vertebrae surgery is completed, the patient will undergo CT scan again to evaluate the effect of bio-cement filling;

3-3) Determine whether there are other vertebral bodies that need to be operated on, and if so, continue the above process, if not, the spinal surgery assistant robot will return to the origin.

The present embodiment is based on a surgical navigation method of a spinal surgery assistant robot. The method includes: preoperative planning, intraoperative execution, and postoperative evaluation; wherein, the preoperative planning includes steps: anesthetize the patient, paste the target; CT scan, transmit data To the doctor's work platform; medical image processing, spine segmentation and 3D reconstruction; select the target point in the image and move the spatial registration probe to pick up the corresponding target point through the teleoperation stick to complete the spatial registration; select the diseased vertebral body in the 3D image, confirm Lesion location and surgical direction to generate surgical navigation instructions. Intraoperative execution includes steps: register the patient, guide tube, and puncture needle; data analysis, the three-coordinate platform and the six-axis parallel robot execute the surgical navigation command to make the end effector reach the designated position; the doctor installs the puncture guide tube and manually inserts the puncture needle. Into the diseased area of the patient's body. Postoperative evaluation includes steps: CT scan the patient again; transfer the data to the doctor's work platform, image analysis, and compare whether the puncture needle has reached the lesion position; determine whether the needle insertion requirements are met; Surgical navigation command, if yes, inject bio-cement; after completion, the patient will undergo CT scan again to evaluate the effect of bio-cement filling; finally, determine whether there are other vertebral bodies that need surgery, if so, continue the above process, otherwise the surgery is completed, the robot will return to the origin . According to the position of the spinal vertebral lesions and the operation direction confirmed by the doctor in the image, this embodiment can automatically move the spine-assisted surgical robot to locate the operation direction in the robot coordinate system to guide the doctor to perform the operation, which not only facilitates the doctor's operation but also improves the efficiency of the operation. It also improves the accuracy and safety of the surgery. At the same time, in this embodiment, the spatial registration of the image coordinate system and the robot coordinate system is completed by means of the set spatial registration probe picking up and sticking the target point on the back of the patient, thereby avoiding secondary trauma to the patient.

Embodiment 4

This embodiment is basically the same as the above-mentioned embodiment, and the special features are:

In this embodiment, referring to FIG. 1 and FIG. 2 , FIG. 1 is a diagram of a preferred embodiment of a surgical navigation system based on a spinal surgery assistant robot of the present invention, and FIG. An end-of-end six-axis parallel robot, rotatable concealed spatial registration probe, and embodiments with interchangeable or alternative end effectors are shown. In this embodiment, the spinal surgery assistance robot includes, but is not limited to, a three-coordinate platform 102 , a six-axis parallel robot 103 , and a doctor's work platform 106 . The three-coordinate platform 102 is fixed on the operating table 100 on which the patient 101 is prone to perform surgery, and is used for large-scale movement during surgical navigation, ensuring that the operating area can cover the entire spinal range of the patient 101 . A rotatable and hidden space registration probe 203 is also provided below the Y-axis end of the three-coordinate platform 102 for picking up the target point 104 when the image coordinate system and the robot coordinate system are spatially registered, so as to obtain the target point 104 in the robot. Coordinate values in the coordinate system. The six-axis parallel robot 103 is fixed above the end of the Y-axis of the three-coordinate platform 102, and the upper platform 200 of the six-axis parallel robot 103 is a moving platform, on which an end effector 201 for performing surgery is arranged. The posture of the upper platform 200 can make the end effector 201 reach the specified posture for surgery. The doctor's work platform 106 is provided with a display screen 105 and a teleoperation rod 107. The display screen 105 can display in real time the image of the patient's spine and vertebrae during the operation and the entire process of confirming the operation direction of the lesion position, so as to realize communication with the doctor during the operation. interaction, the teleoperation stick 107 can be used by the doctor to manually operate the three-coordinate platform 102 and the six-axis parallel robot 103 . The surgical navigation system 301 is installed and run in the doctor's work platform 106 of the spinal surgery assistant robot.

Referring to FIG. 3 , FIG. 3 is a functional block diagram of the spinal surgery assistance robot 300 in FIG. 1 . In this embodiment, the spinal surgery assistant robot includes, but is not limited to, a surgical navigation system 301, a three-coordinate platform driver 310, a six-axis parallel robot driver 311, a display screen 105, a teleoperation stick 107, a memory 312, and a microprocessor device 313. The three-coordinate platform driver 310 , the six-axis parallel robot driver 311 , the display screen 105 , the teleoperation stick 107 and the memory 312 are all connected to the microprocessor 313 through the data bus and can communicate with the surgical navigation through the microprocessor 313 . The system 301 performs information exchange. The memory 312 may be a read-only storage unit ROM, an electrically erasable and rewritable storage unit EEPROM or a flash storage unit FLASH and other storage units for storing program instruction codes constituting the surgical navigation system 301 . The microprocessor 313 can be a microcontroller (MCU), a data processing chip, or an information processing unit with a data processing function, and is used for implementing the surgical navigation system 301 to provide surgical guidance for a patient during surgery.

In this embodiment, the surgical navigation system 301 based on a spinal surgery assistant robot includes, but is not limited to, an image processing module 302 , a spatial registration module 303 , a surgical navigation module 304 , a motion control module 305 and a navigation display module 306 . The module referred to in the present invention refers to a series of computer program instruction segments that can be executed by the microprocessor 313 of the spinal surgery assistant robot 300 and can complete the fixation function, which are stored in the memory of the spinal surgery assistant robot 300 312.

The image processing module 302 is used to process the CT data of the patient's spine, segment the spine vertebra instance from the rest of the human body, and reconstruct the segmented spine vertebra instance in three dimensions. In this embodiment, the CT data of the patient's spine is in DICOM file format, and the method for segmenting spinal vertebrae instances from the rest of the human body is a U-NET-based deep learning image segmentation method. The method for the segmented spinal vertebra instance is a three-dimensional reconstruction method based on surface rendering.

The spatial registration module 303 is used to calculate the spatial registration relationship between the CT image coordinate system and the robot coordinate system. In this embodiment, in order to achieve spatial registration, the doctor pastes the target point 104 on the back of the patient, and picks up the target point 104 in the image coordinate system and the robot coordinate system respectively to obtain the coordinate value of the target point 104 . The spatial registration module 303 records the coordinate values of the target point 104 in the image coordinate system and the robot coordinate system, and determines the spatial registration relationship between the image coordinate system and the robot coordinate system through Helmert transformation. The target is a biological electrode commonly used in medical treatment, and the number is 5. The method of picking up the target in the robot coordinate system is that the doctor controls the space configuration below the Y-axis end of the three-coordinate platform 102 through the teleoperation stick 107. The quasi-probe 203 is in contact with the target point 104, and the coordinate values of the target point 104 in the robot coordinate system are sequentially obtained.

In this embodiment, the remote control lever 107 is a controller for manually controlling the three-coordinate platform 102 and the six-axis parallel robot 103, and can control the three-coordinate platform 102 along the X axis, the Y axis, and the Z axis. You can also control the six axes of the six-axis parallel robot 103 to extend and retract independently, or control the moving platform 200 of the six-axis parallel robot 103 to move along the X-axis, Y-axis, and Z-axis and move around the X-axis, Y-axis, Rotation in the Z-axis direction. The spatial registration probe 203 located below the end of the Y-axis of the three-coordinate platform is a high-precision ruby probe, and is designed as a foldable structure. After the doctor completes the registration, it can be rotated 90° to hide, so as to avoid contact with the human body during the operation. The back skin collided. A force sensor 204 is also installed behind the spatial registration probe 203 for sensing the force and direction of the spatial registration probe 203 in contact with the target point 104 to improve the accuracy of the spatial registration.

The surgical navigation module 304 is used by the doctor to select the position and surgical direction of the lesion area in the reconstructed spinal vertebra instance, and obtain the position and surgical direction of the lesion area in the robot coordinate system according to the spatial registration relationship, And according to the position of the lesion area and the surgical direction in the robot coordinate system, the doctor selects the installation direction of the end effector 201 and the movement distance in the Z-axis direction to generate a surgical navigation command; in this embodiment, the surgical navigation command includes: The movement amount of each axis of the three-coordinate platform 102, the pose of the six-axis parallel robot 103, and the depth of needle insertion that the doctor allows to operate. The pose of the six-axis parallel robot 103 also includes the amount of movement along the X-axis, the rotation angle β around the Y-axis, and the rotation angle γ around the Z-axis; the end effector 201 In the direction of surgery, you can choose to install it on the moving platform 200 of the six-axis parallel robot 103 along the positive or negative direction of the X-axis, so that the pose change of the six-axis parallel robot 103 is minimized. The scope of the implementation of the operation, while reducing the time to reach the designated posture, improve the efficiency of the operation.

The motion control module 305 is configured to control the movement of the three-coordinate platform 102 and the six-axis parallel robot 103 according to the surgical navigation instruction, so that the end effector 201 reaches a specified pose. In this embodiment, the method of controlling the three-coordinate platform 102 is to control the six-axis parallel robot by controlling the three-coordinate platform driver 310, and then controlling the movement of the motors and nut screws of each axis of the three-coordinate platform 102. The method of 103 is to calculate the movement amount of each axis of the six-axis parallel robot 103 corresponding to the pose of the six-axis parallel robot 103 in the surgical navigation instruction through an inverse kinematics solution, and then control the six-axis parallel robot driver. 311 is output to make each axis of the six-axis parallel robot 103 reach a specified length.

The navigation display module 306 is used for interacting with the doctor during the whole operation, displaying the reconstruction result of the spine vertebra instance, processing the lesion position and operation direction of the spine vertebra instance selected by the doctor in the image coordinate system, and displaying the The real-time information of the three-coordinate platform 102 and the six-axis parallel robot 103 can be used for reference by the doctor during the operation. In this embodiment, the navigation display module 306 can display the result of the segmentation and reconstruction of the CT image of the spine, and can zoom in or zoom out the local area according to visualization requirements, so that the doctor can observe the lesion area more carefully, and in the image The target point 104 is selected and the lesion location and surgical direction are confirmed. The navigation display module 306 also retains and displays the two-dimensional slice information of the original spine CT image, and maps the lesion location and operation direction confirmed by the doctor in the three-dimensional reconstructed spine vertebra instance image to the two-dimensional slice of the original spine CT image. It not only retains the habit of doctors to read two-dimensional slices of CT images, but also helps doctors to determine whether the direction of surgery has an impact on the rest of the tissue around the diseased area, and improves the accuracy and safety of the surgical implementation process.

The present invention also provides a surgical navigation method based on a spinal surgery assistant robot, which is applied to the spinal surgery assistant robot 300 . Referring to FIG. 4 , FIG. 4 is a flowchart of a preferred embodiment of a surgical navigation method based on a spinal surgery assistant robot of the present invention. In this embodiment, as shown in FIG. 1 , FIG. 2 and FIG. 3 , the surgical navigation method based on a spinal surgery assistant robot includes the following steps: preoperative planning 410 , intraoperative execution 420 , and postoperative evaluation 430 ; specifically , the preoperative planning 410 further includes the steps:

Step S411 , the patient is anesthetized, and the target point 104 for the spatial registration is pasted on the back of the patient, and the pasting of the target point 104 basically covers the entire spinal vertebral region, improving the accuracy of the spatial registration.

Step S412, use CT to scan the patient and transmit the CT data of the patient's spine to the doctor's work platform 106, and the format of the CT data of the spine is the DICOM file format.

Step S413, according to the CT data of the patient's spine, segment the spine vertebra instance from the rest of the human body, and reconstruct the segmented spine vertebra instance in three dimensions; in this embodiment, the image processing module 302 processes the remaining tissues from the human body. The method for segmenting a spinal vertebra instance is a U-NET-based deep learning image segmentation method, and the method for three-dimensional reconstruction of the segmented spinal vertebral instance is a three-dimensional reconstruction method based on surface rendering.

In step S414, the doctor selects the target points in the image coordinate system respectively, and moves the spatial registration probe to pick up the target point 104 in the robot coordinate system, obtains the coordinate value of the target point 104, and determines the coordinate value of the target point 104 through Helmert transformation. The spatial registration relationship between the image coordinate system and the robot coordinate system; specifically, the spatial registration module 303 calculates the spatial registration relationship between the CT image coordinate system and the robot spatial coordinate system. In this embodiment, the space registration module 303 records the coordinate values of the target point 104 in the CT image coordinate system and the robot space coordinate system, and determines the space between the image coordinate system and the robot coordinate system through Helmert transformation registration relationship. The target is a bio-electrode commonly used in medical treatment, and the number is 5. The method of picking up the target in the robot space coordinate system is that the doctor controls the space below the Y-axis end of the three-coordinate platform 102 through the teleoperation stick 107. The registration probe 203 is in contact with the target point 104, and the coordinate values of the target point 104 in the robot coordinate system are sequentially obtained.

In step S415, the doctor selects the diseased vertebral body in the three-dimensionally reconstructed spinal vertebra instance and confirms the diseased position and the operation direction. Specifically, the surgical navigation module 304 processes the doctor to select the position and surgical direction of the lesion area in the reconstructed vertebra instance, and obtains the position and surgical direction of the lesion area in the robot coordinate system according to the spatial registration relationship, and According to the position of the lesion area and the surgical direction in the robot space coordinate system, the doctor selects the installation direction of the end effector 201 and the movement distance in the Z-axis direction to generate surgical navigation instructions. In this embodiment, the surgical navigation instruction includes the movement amount of each axis of the three-coordinate platform 102 , the pose of the six-axis parallel robot 103 , and the depth of needle insertion allowed by the doctor. The pose of the six-axis parallel robot 103 also includes the amount of movement along the X-axis, the rotation angle β around the Y-axis, and the rotation angle γ around the Z-axis; the end effector 201 In the direction of surgery, you can choose to install it in the positive or negative direction of the moving platform 200 of the six-axis parallel robot 103 along the X-axis, so that the pose change of the six-axis parallel robot 103 is minimized. The scope of the implementation of the operation, while reducing the time to reach the designated posture, improve the efficiency of the operation.

The intraoperative execution 420 also includes the steps of:

Step S421 , register the patient, the guide tube, and the puncture needle; in this embodiment, the used puncture needle realizes puncture on the patient's back and vertebral body.

Step S422, according to the surgical navigation instruction, control the movement of the three-coordinate platform 102 and the six-axis parallel robot 103, so that the end effector 201 reaches a specified pose. Specifically, the motion control module 305 controls the three-coordinate platform 102 and the six-axis parallel robot 103 according to the surgical navigation instruction, so that the end effector 201 reaches a specified pose. In this embodiment, the method of controlling the three-coordinate platform 102 is to control the six-axis parallel robot by controlling the three-coordinate platform driver 310, and then controlling the movement of the motors and nut screws of each axis of the three-coordinate platform 102. The method of 103 is to calculate the movement amount of each axis of the six-axis parallel robot 103 corresponding to the pose of the six-axis parallel robot 103 in the surgical navigation instruction through the inverse kinematics solution, and then control the six-axis parallel robot driver. 311 is output to make each axis of the six-axis parallel robot 103 reach a specified length.

In step S423, the doctor installs the puncture guide tube and manually inserts the puncture needle into the lesion area in the patient. Specifically, the navigation display module 306 is used for interacting with the doctor during the whole operation, displaying the reconstruction result of the spinal vertebra instance, processing the position and direction of the lesion selected by the doctor in the image coordinate system, and displaying the three-coordinate platform 102 and the real-time information of the six-axis parallel robot 103 for the doctor to use as a reference during the operation. In this embodiment, the navigation display module 306 can display the results of the spine CT image segmentation and reconstruction, and enlarge or reduce the local area according to the visualization requirements, so that the doctor can observe the lesion area more carefully, and select the selected area in the image. the target point 104 and specify the lesion location and surgical direction. The navigation display module 306 also retains the two-dimensional slice information for displaying the original spine CT image, and maps the lesion location and the surgical direction specified by the doctor in the three-dimensional reconstructed spine vertebra instance image to the two-dimensional slice of the original spine CT image, and retains the information of the two-dimensional slice of the original spine CT image. The habit of doctors to read two-dimensional slices of CT images is also helpful for doctors to judge whether the specified surgical direction has an impact on the rest of the tissues around the vertebrae of the spine, and to improve the accuracy and safety of the needle insertion process.

The post-operative assessment 430 also includes the steps of:

Step 431, CT scan of the patient again;

Step 432, the spine CT data in step 431 is transmitted to the doctor's work platform 106, the image processing module 302 performs image analysis, and compares whether the puncture needle has reached the lesion position;

Step 433: Determine whether the requirements for needle insertion are met, if not, re-confirm the lesion location and surgical direction, regenerate the surgical navigation instructions, and if so, inject bio-cement; after the current spine and vertebra surgery is completed, the patient is scanned again by CT to evaluate the effect of bio-cement filling.

In step 434, it is determined whether there are other vertebrae of the spine that need to be operated. If so, continue to perform steps 415 to 433. If not, the operation is completed, and the spine surgery assistance robot returns to the origin.

The surgical navigation system and method based on a spinal surgery assistant robot described in this embodiment can complete the segmentation and three-dimensional reconstruction of spinal vertebrae instances according to spinal CT images, more intuitively reflect the three-dimensional shape of spinal vertebrae, and more convenient for doctors to confirm percutaneous vertebroplasty ( PVP) lesion location and surgical direction. In addition, by pasting the target point on the skin and using a high-precision ruby probe as a spatial registration probe, the spatial registration of the image coordinate system and the robot coordinate system is realized without causing secondary trauma to the patient. Furthermore, the surgical navigation system and method based on the spinal surgery assistant robot of the present invention can control the three-coordinate platform and the six-axis according to the lesion position and surgical direction of the spinal vertebrae confirmed by the doctor in the three-dimensional reconstructed image. The parallel robot movement enables the end effector to reach the designated position, reducing the number of CT scans, adjusting the needle insertion position and the operation direction of the patient, and for patients with multiple spinal vertebrae trauma, continuous operation can also be performed, which facilitates the doctor's operation and improves the efficiency of the operation. surgical efficiency.

The above are only preferred embodiments of the present invention, and are not intended to limit the scope of the present invention. Any equivalent structure or equivalent function transformation made by using the contents of the description and drawings of the present invention, or directly or indirectly applied in other related technical fields , are similarly included in the scope of patent protection of the present invention.

Claims (8)

1. a surgical navigation system based on a spinal surgery assistant robot, is characterized in that, comprises: an image processing module for processing the CT data of the patient's spine, segmenting the spine vertebra instance from the rest of the human body, and reconstructing the segmented spine vertebra instance in three dimensions; The spatial registration module is used to calculate the spatial registration relationship between the image coordinate system and the robot coordinate system; a surgical navigation module, used by the doctor to select the position of the lesion area and the surgical direction in the three-dimensional reconstructed spinal vertebra instance, and obtain the position of the lesion area and the surgical direction in the robot coordinate system according to the spatial registration relationship, and According to the position of the lesion area and the surgical direction in the robot coordinate system, the doctor selects the installation direction of the end effector and the moving distance in the Z-axis direction to generate the surgical navigation command; The motion control module is used to control the motion of the three-coordinate platform and the six-axis parallel robot of the spinal surgery assistant robot according to the surgical navigation instruction, so that the end effector reaches a designated posture. 2. The surgical navigation system based on a spinal surgery assistant robot as claimed in claim 1, wherein the spatial registration module is used as a target by pasting biological electrodes on the back of the patient, and the doctor is respectively in the image coordinate system and the robot coordinate system. Pick up these target points, obtain the target point coordinate value, and determine the spatial registration relationship between the image coordinate system and the robot coordinate system through Helmert transformation. 3. The surgical navigation system based on a spinal surgery assistant robot according to claim 2, wherein the number of the target points is at least 5, and the method of picking up the target points under the robot coordinate system is that the doctor operates by teleoperation The rod controls the space registration probe below the Y-axis end of the three-coordinate platform to contact these target points, and the coordinate values of these target points in the robot coordinate system are obtained. 4. The surgical navigation system based on a spinal surgery assistant robot as claimed in claim 3, wherein the teleoperation lever is a controller for manually controlling a three-coordinate platform and a six-axis parallel robot, and the The spatial registration probe under the Y-axis end of the three-coordinate platform is a high-precision ruby probe, and is designed as a foldable structure. After the doctor completes the target picking, it is rotated 90° to hide it to avoid collision with the back skin of the human body during the operation. 5. The surgical navigation system based on a spinal surgery assistant robot according to claim 1, wherein the surgical navigation instruction includes the movement amount of each axis of the three-coordinate platform, the pose of the six-axis parallel robot, The depth of needle penetration allowed by the physician. 6 . The surgical navigation system based on a spinal surgery assistant robot according to claim 5 , wherein the pose of the six-axis parallel robot includes the movement amount of the X-axis, the rotation angle β around the Y-axis and the rotation angle around the Z-axis. 7 . The rotation angle γ. 7. The surgical navigation system based on a spinal surgery assistant robot according to any one of claims 1 to 6, characterized in that, the navigation system further comprises a navigation display module located on a doctor's work platform, for use in the whole operation process Interact with the doctor to display the reconstruction result of the spine vertebra instance. The doctor selects the lesion position and direction of the spine vertebra instance under the image coordinate system, and displays the real-time information of the three-coordinate platform and the six-axis parallel robot for the doctor to use Surgical reference during surgery. 8. A surgical navigation method based on an auxiliary robot for spinal surgery, characterized in that it comprises preoperative planning, intraoperative execution, and postoperative evaluation; 1) The steps of the preoperative planning include: 1-1) The patient is anesthetized, and the target for the spatial registration is pasted on the back of the patient, and the patient is scanned by CT and the CT data of the patient's spine is transmitted to the doctor's work platform; 1-2) According to the spine CT data of the patient, segment the spine vertebra instance from the rest of the human body, and three-dimensionally reconstruct the segmented spine vertebra instance; 1-3) The doctor picks up the target point under the image coordinate system and the robot coordinate system respectively, obtains the coordinate value of the target point, and determines the spatial registration relationship between the image coordinate system and the robot coordinate system through Helmert transformation; 1-4) The doctor selects the position and operation direction of the lesion area in the reconstructed spinal vertebra instance, and obtains the position and operation direction of the lesion area under the robot coordinate system according to the spatial registration relationship; 1-5) The doctor selects the installation direction of the end effector and the moving distance in the Z-axis direction according to the position of the lesion area and the surgical direction under the robot coordinate system, and generates a surgical navigation command; 2) The steps performed during the operation include: 2-1) Register patient, guide tube, puncture needle; 2-2) Data analysis, the three-coordinate platform and the six-axis parallel robot execute the surgical navigation command to make the end effector reach the specified pose; 2-3) The doctor installs the puncture guide tube and manually inserts the puncture needle into the lesion area of the patient; 3) The steps of the postoperative evaluation include: 3-1) CT scan the patient again, and transmit the spine CT data to the doctor's work platform for image analysis, and compare whether the puncture needle has reached the lesion location; otherwise, reconfirm the lesion location and surgical direction, and generate surgical navigation instructions. Then inject bio-cement; 3-2) After the current spine and vertebrae surgery is completed, the patient will undergo CT scan again to evaluate the effect of bio-cement filling; 3-3) Determine whether there are other vertebral bodies that need to be operated on, and if so, continue the above process, if not, the spinal surgery assistant robot will return to the origin.

Images