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WO2022267838A1 - 用于置钉操作的脊柱手术机器人系统 - Google Patents

用于置钉操作的脊柱手术机器人系统 Download PDF

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Publication number
WO2022267838A1
WO2022267838A1 PCT/CN2022/096112 CN2022096112W WO2022267838A1 WO 2022267838 A1 WO2022267838 A1 WO 2022267838A1 CN 2022096112 W CN2022096112 W CN 2022096112W WO 2022267838 A1 WO2022267838 A1 WO 2022267838A1
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Prior art keywords
force
spinal surgery
path
module
operation path
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English (en)
French (fr)
Inventor
吕飞舟
邵明昊
唐文彬
宓海
蔡宁
姜建元
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Maestro Surgical Robotics Ltd Co
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Maestro Surgical Robotics Ltd Co
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Publication of WO2022267838A1 publication Critical patent/WO2022267838A1/zh
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    • 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
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/92—Impactors or extractors, e.g. for removing intramedullary devices
    • 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
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • 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
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • 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
    • A61B34/70—Manipulators specially adapted for use in surgery
    • A61B34/76—Manipulators having means for providing feel, e.g. force or tactile feedback
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361—Image-producing devices, e.g. surgical cameras
    • 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
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/101—Computer-aided simulation of surgical operations
    • A61B2034/105—Modelling of the patient, e.g. for ligaments or bones
    • 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
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/107—Visualisation of planned trajectories or target regions
    • 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
    • A61B2034/302—Surgical robots specifically adapted for manipulations within body cavities, e.g. within abdominal or thoracic cavities

Definitions

  • the invention relates to the field of surgical robots, in particular to a spinal surgery robot system used for nail placement.
  • Posterior cervical pedicle screw fixation is a revolutionary innovation in the treatment of spinal diseases.
  • the biomechanical stability of cervical pedicle screw fixation is superior to other cervical spine fixation techniques, even more than anterior titanium plate plus posterior lateral mass
  • the stability of fixation is an ideal fixation method for correcting cervical kyphosis, performing fixed fusion of cervical spine, and treating cervical spine diseases such as fracture and dislocation of cervical spine.
  • the technical problem to be solved by the present invention is to provide a safe and reliable spinal surgery robot system for nail placement.
  • the present invention provides a spinal surgery robot system for nail placement, which is characterized in that it includes: a path planning module for generating a planned operation path for nail placement, and the planned operation path is along the The distribution of the direction in which the tissue density gradient drops the fastest in the working bone of the surgical object; the execution module is used to perform the nail setting operation; and the control module is used to control the execution module to perform the placement according to the planned operation path Nail operation.
  • the path planning module includes: a modeling unit, configured to establish a three-dimensional model of the operating bone according to a preoperative three-dimensional image of the operating bone; a path planning unit, configured to build a three-dimensional model on the three-dimensional model Form the planned operation path.
  • the three-dimensional model includes structural information of the working bone, and the structural information includes tissue density at various positions in the working bone, and the tissue density is related to basic information of the surgical object.
  • the basic information includes age, gender, height, weight and medical history.
  • each position on the planned operation path has a corresponding preoperative simulated feedback force
  • the preoperative simulated feedback force corresponds to the tissue density
  • the performing module includes: a nail setting manipulator, disposed at the end of the surgical performing arm, for performing the nail setting operation; and a force sensing device, disposed in the nail setting manipulator, It is used to detect the action force from the operating bone of the surgical object received by the nail setting manipulator.
  • control module is further configured to generate a surgical operation path according to the planned operation path and the force, and each position on the planned operation path has a corresponding preoperative simulated feedback force, so Each position on the surgical operation path has a corresponding active force, and the first difference between the active force at each position on the surgical operation path and the preoperative simulated feedback active force within a preset threshold range; and the control module controls the execution module to perform the nail setting operation according to the surgical operation path.
  • control module is further configured to adjust the direction of the staple-setting manipulator at each of the positions, obtain multiple acting forces in multiple directions, and compare the multiple acting forces with For the second difference between the preoperative simulated feedback forces at the positions, the direction in which the second difference is the smallest is taken as the operating direction of the nail setting manipulator.
  • it further includes: a human-computer interaction module, configured to generate a simulated force according to the force, so that the operator receives the simulated force and controls the movement of the actuator arm through the control module.
  • a human-computer interaction module configured to generate a simulated force according to the force, so that the operator receives the simulated force and controls the movement of the actuator arm through the control module.
  • a safety module is also included for monitoring the active force in real time, and when the active force exceeds a safe range, the safety module controls the performing arm to stop the surgical operation.
  • a navigation positioning module configured to obtain the spatial pose of the operating skeleton and the spatial pose of the execution arm of the spinal surgery robot, and establish a relationship between the operating skeleton and the execution arm.
  • the spatial mapping relationship the control module also includes: an image registration unit for registering the three-dimensional model with the intraoperative two-dimensional image of the surgical object to obtain spatial information of the registered image; the spatial mapping unit, It is used to map the space information of the registration image, the space pose of the working skeleton and the space pose of the execution arm in unified space coordinates; a path transformation unit is used to transform the planned operation path into the The surgical operation path in the unified spatial coordinates.
  • the planned operation path generated by the path planning module is distributed along the direction in which the tissue density gradient in the operating bone of the surgical object decreases the fastest, so that the execution module can start from the lower-density cancellous mass when performing the nail insertion operation.
  • the resistance received is small, which ensures the safety of the nailing operation.
  • Fig. 1 is a block diagram of a spinal surgery robotic system for nailing operations according to an embodiment of the present invention
  • Fig. 2 is a block diagram of the path planning module in the spinal surgery robot system according to an embodiment of the present invention
  • Fig. 3 is a block diagram of a modeling unit in a spinal surgery robot according to an embodiment of the present invention.
  • Fig. 4 is a block diagram of an execution module in a spinal surgery robot according to an embodiment of the present invention.
  • Fig. 5 is a schematic diagram of a spinal surgery robot system performing a nailing operation according to an embodiment of the present invention
  • FIG. 6 is a block diagram of a spinal surgery robot system according to another embodiment of the present invention.
  • FIG. 7 is a block diagram of a control module in a spinal surgery robot system according to another embodiment of the present invention.
  • Fig. 8 is a schematic diagram of a spinal surgery robot system according to an embodiment of the present invention.
  • orientation words such as “front, back, up, down, left, right", “horizontal, vertical, vertical, horizontal” and “top, bottom” etc. indicate the orientation Or positional relationship is generally based on the orientation or positional relationship shown in the drawings, and is only for the convenience of describing the application and simplifying the description. In the absence of a contrary statement, these orientation words do not indicate or imply the device or element referred to It must have a specific orientation or be constructed and operated in a specific orientation, so it should not be construed as limiting the protection scope of the present application; the orientation words “inner and outer” refer to the inner and outer relative to the outline of each component itself.
  • spatially relative terms may be used here, such as “on !, “over !, “on the surface of !, “above”, etc., to describe the The spatial positional relationship between one device or feature shown and other devices or features. It will be understood that the spatially relative terms are intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if the device in the figures is turned over, devices described as “above” or “above” other devices or configurations would then be oriented “beneath” or “above” the other devices or configurations. under other devices or configurations”. Thus, the exemplary term “above” can encompass both an orientation of “above” and “beneath”. The device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptions used herein interpreted accordingly.
  • Fig. 1 is a block diagram of a spinal surgery robotic system for nail placement according to an embodiment of the present invention.
  • the spinal surgery robot system 100 of this embodiment includes a path planning module 110 , an execution module 120 and a control module 130 .
  • the path planning module 110 is used to generate the planned operation path of the nail setting operation, and the planned operation path is distributed along the direction in which the tissue density gradient in the operating bone of the surgical object decreases the fastest;
  • the execution module 120 is used to execute the nail setting operation;
  • the control module 130 is used to control the execution module 120 to execute the nailing operation according to the planned operation path.
  • the present invention does not limit the specific position of the working skeleton.
  • the working bone is the posterior cervical spine in posterior cervical pedicle screw fixation.
  • the bone structure mainly includes cortical bone and cancellous bone, wherein the cortical bone has a higher density on the outside of the bone, while the cancellous bone has a lower density in the middle of the bone.
  • the characteristics of bone structure if the pedicle screw can be accurately placed in the cancellous bone of the cervical lamina without penetrating the cortical bone under the cervical lamina, the safety of the screw insertion operation can be guaranteed.
  • the planned operation path and the operation path of the spinal surgery robot system are distributed along the cancellous bone structure as much as possible, and the resistance encountered is small, thereby ensuring the safety of the nailing operation.
  • Fig. 2 is a block diagram of a path planning module in the spinal surgery robot system according to an embodiment of the present invention.
  • the path planning module 110 includes a modeling unit 210 and a path planning unit 220 .
  • the modeling unit 210 is used for establishing a three-dimensional model of the working bone according to the preoperative three-dimensional image of the working bone;
  • the path planning unit 220 is used for forming a planned operation path on the three-dimensional model.
  • Fig. 3 is a block diagram of a modeling unit in a spinal surgery robot according to an embodiment of the present invention. It shows a block diagram of specific modules that may be included in the modeling unit 210 in the embodiment shown in FIG. 2 .
  • the modeling unit 210 includes an image acquisition unit 211 , an image segmentation unit 212 and a three-dimensional reconstruction unit 213 .
  • the image acquisition unit 211 is used for acquiring a medical tomographic image of the spine of the surgical object.
  • the present invention does not limit the specific source of the image, which may include but not limited to CT, MRI and so on.
  • the image segmentation unit 212 is configured to receive the medical tomographic image, and segment the obtained multiple medical tomographic images to obtain two-dimensional images of different layers of the operating bone of the surgical object.
  • the present invention does not limit the method specifically used for image segmentation.
  • image segmentation is performed using a deep learning algorithm, which may include but not limited to U-Net network algorithm and the like.
  • the three-dimensional reconstruction unit 213 receives two-dimensional images of different layers of the operating skeleton, and performs three-dimensional reconstruction of the image according to these two-dimensional images, to obtain a three-dimensional model of the operating skeleton.
  • the surgeon can select a lesion area on the three-dimensional model, and generate a planned operation path through the path planning unit 220 .
  • the path planning unit 220 can provide a doctor-oriented display and operation interface.
  • the image of the operating skeleton can be displayed on the display and operation interface, and the planned operation path can be displayed on the image.
  • the doctor can select the lesion area on the three-dimensional model through the display and operation interface, and edit and adjust the displayed planned operation path through human-computer interaction.
  • the planned operation path is automatically formed by the path planning unit 220 according to the lesion area, and can be edited and modified by a doctor.
  • the planned manipulation path may differ from the surgical manipulation path actually performed by the spine surgery robot.
  • the spinal surgery robot performs the nail setting operation according to the surgical operation path generated by the planned operation path.
  • the three-dimensional model formed by the modeling unit 210 includes structural information of the operating bone, the structural information includes the tissue density of each position in the operating bone, and the tissue density is related to the basic information of the surgical object.
  • the basic information includes age, gender, height, weight, and medical history.
  • a large number of data of patients with spinal diseases are collected, and the data includes the basic information of the patients and the structural information of their working bones.
  • Structural information of the operating skeleton of each patient may be obtained from medical images of the operating skeleton. After 3D reconstruction of the image, important soft tissue information such as bony structures, nerves, and ligaments in the operating bone area can be obtained. These different structures and tissues have different densities.
  • the structural information included in the three-dimensional model formed by the modeling unit 210 of the present invention includes the tissue density of each position in the working bone, and the tissue density includes the density of non-bone structures in the working bone, such as soft tissues such as ligaments, and bone Sexual structure of bone density.
  • an artificial intelligence algorithm can be used to establish the relationship between the patient's basic information and the tissue density at each position in the operating skeleton.
  • the structural information of the tissue density of each position in the operating bone can be estimated according to the basic information of the surgical object, so that the planned operation path can be generated based on the structural information, so that the planned operation path Distributed along the direction in which the tissue density gradient in the operating bone of the surgical object decreases the fastest.
  • the direction in which the gradient of the tissue density in the operating bone decreases the fastest indicates that the planned operation path moves toward the position where the cancellous bone with a lower density is located.
  • the control module 130 guides the execution module 120 to advance along the planned operation path, so that the screw can be inserted into the position of the cancellous bone, the resistance encountered by the screw is small, and the operation safety is high.
  • Fig. 4 is a block diagram of an execution module in a spinal surgery robot according to an embodiment of the present invention.
  • the execution module 120 in the spinal surgery robot system of the present invention includes a nail setting manipulator 121 and a force sensor 122 .
  • the nail-setting manipulator 121 is arranged at the end of the operation performing arm, and is used for performing the nail-setting operation;
  • the mechanical sensing device 122 is arranged in the nail-setting manipulator, and is used for detecting the operation received by the nail-setting manipulator 121 from the surgical object.
  • Bone force Fr Bone force Fr.
  • control module 130 in the robot system for spinal surgery of the present invention is also used to generate the surgical operation path according to the planned operation path and the force Fr, and each position on the planned operation path has a corresponding preoperative simulation feedback function Force Fs, each position on the surgical operation path has a corresponding force Fr, and the first difference between the active force Fr at each position on the surgical operation path and the preoperative simulated feedback force Fs is within the preset threshold Th within the range; the control module controls the execution module to execute the nail setting operation according to the surgical operation path.
  • the control module 130 controls the execution module 120 to execute the nailing operation according to the planned operation path.
  • the nail setting manipulator 121 can obtain the force from the working bone in real time through the mechanical sensing device 122, the force Fr is generated by the nail setting manipulator 121 acting on the working bone reaction force.
  • the preoperative simulated feedback force Fs of each position on the working bone can also be established according to the three-dimensional model of the working bone obtained by the modeling unit 210 .
  • the nail setting manipulator 121 advances toward the working bone in a certain direction and speed
  • the force Fr and the preoperative simulated feedback force Fs are related to parameters such as the direction and speed of the nail setting manipulator 121 . That is to say, the preoperative simulated feedback force Fs of each position on the operating bone established by the present invention corresponds to some parameters, these parameters include but not limited to: the position of the force point, the direction and speed of the nail setting manipulator 121, etc. .
  • the force sensing device 122 includes a multi-dimensional torque sensor. According to the force sensing device 122, the forces Fr experienced by the staple setting manipulator 121 in multiple directions can be obtained. Therefore, the force Fr may include multiple forces received in multiple directions.
  • the acting force Fr is also related to the position of the force receiving point, the direction and speed of the nail setting manipulator 121, and the like.
  • the nail setting manipulator 121 can obtain the force Fr in real time, and the control module 130 compares the force Fr at the position of the force point, the direction and speed of the nail setting manipulator 121 with the preoperative simulation Feedback force Fs, if ⁇ Fr-Fs ⁇ Th, then the control module 130 makes the surgical operation path equal to the planned operation path, and controls the nail setting manipulator 121 to advance according to the surgical operation path; if ⁇ Fr-Fs ⁇ >Th, then The control module 130 adjusts the planned operation path, generates the adjusted planned operation path, and obtains a new force Fr_new, if ⁇ Fr_new-Fs ⁇ Th, then makes the adjusted planned operation path as the surgical operation path, if ⁇ Fr_new- Fs ⁇ >Th, then the control module 130 continues to adjust the planned operation path until the first difference between the adjusted force and the preoperative simulated feedback force Fs is within the range of the preset threshold Th.
  • the first difference between the force Fr at each position of the working bone and the preoperative simulated feedback force Fs at that position is all within the range of the preset threshold Th.
  • the preset threshold Th is the same physical quantity as the force Fr and has the same dimension.
  • control module 130 in the robot system for spinal surgery of the present invention is also used to adjust the direction of the nail setting manipulator 121 at each position, obtain multiple acting forces Fr in multiple directions, and compare multiple acting forces. For the second difference between the force Fr and the preoperative simulated feedback force Fs at this position, the direction with the smallest second difference is taken as the operating direction of the nail-setting manipulator.
  • the control module 130 can control the direction of the nail setting manipulator 121 to make the nail setting manipulator 121 move in multiple directions, thereby obtaining multiple acting forces Fr.
  • the second difference between these acting forces Fr and the preoperative simulated feedback acting force Fs are both within the range of the preset threshold Th.
  • the second difference between the obtained acting force Fr and the preoperative simulated feedback acting force Fs may be different.
  • the force obtained in direction B1 is Fr_B1
  • the force obtained in direction B2 is Fr_B2
  • ⁇ Fr_B1-Fs ⁇ Fr_B2-Fs ⁇ Th means the force obtained in direction B1 Fr_B1 is closer to Fs, therefore, selecting direction B1 as the operation direction of the nail-setting manipulator 121 in the surgical operation path can obtain smaller resistance, that is, the minimum resistance can be obtained among the multiple directions.
  • the direction of the staple setting operator 121 changes within a preset direction range Th_d.
  • the preset direction range Th_d is 5 degrees.
  • Fig. 5 is a schematic diagram of a spinal surgery robot system performing a nail placement operation according to an embodiment of the present invention.
  • a screw 520 is provided at the front end of the nail setting manipulator 510 , and the front end of the screw 520 has been implanted into the working bone 530 .
  • Fig. 5 is a schematic diagram of the skeleton of the cervical spine, which is not intended to limit the specific position of the working skeleton of the present invention.
  • the control module 130 controls the position and direction of the screw setting manipulator 510 so as to control the position and direction of screw insertion into the working bone 530 .
  • a mechanical sensor is provided in the staple setting manipulator 510 .
  • the nail setting manipulator 510 shown in FIG. 5 is a specific embodiment of the nail setting manipulator 121 shown in FIG. 4 , the foregoing description can be used to illustrate the nail setting manipulator 510, and the same content will not be expanded .
  • Fig. 6 is a block diagram of a spinal surgery robot system according to another embodiment of the present invention.
  • the spinal surgery robotic system 600 of this embodiment includes a navigation and positioning module 640 in addition to a path planning module 610 , an execution module 620 and a control module 630 , It is used to obtain the spatial pose of the operating skeleton and the spatial pose of the execution arm of the spine surgery robot, and establish the spatial mapping relationship between the operating skeleton and the execution arm.
  • Fig. 7 is a block diagram of a control module in a spinal surgery robot system according to another embodiment of the present invention.
  • the control module 630 further includes an image registration unit 631 , a spatial mapping unit 632 and a path conversion unit 633 .
  • the image registration unit 631 is used to register the 3D model with the intraoperative 2D image of the surgical object to obtain the spatial information of the registered image
  • the spatial mapping unit 632 is used to use the spatial information of the registered image and the spatial position of the operation
  • the posture and the space pose of the execution arm are mapped in the unified space coordinates
  • the path conversion unit 633 is used to transform the planned operation path into the surgical operation path in the unified space coordinates.
  • the robotic system 600 for spinal surgery also includes a human-computer interaction module 650, which is used to generate a simulated force according to the force, so that the operator receives the simulated force and controls the movement of the actuator arm through the control module. move.
  • a human-computer interaction module 650 which is used to generate a simulated force according to the force, so that the operator receives the simulated force and controls the movement of the actuator arm through the control module. move.
  • the human-computer interaction module 650 may be a master-slave hand device, a sensing glove, and the like. According to these embodiments, the operator can directly manually control the execution arm, directly feel the reaction force of the working bone, and control the movement of the operation execution arm in real time according to the force.
  • the robotic system 600 for spinal surgery further includes a safety module 660 for real-time monitoring of the active force, and when the active force exceeds a safe range, the safety module 660 controls the execution arm to stop the surgical operation.
  • the surgical operation needs to be adjusted.
  • the performing arm automatically performs surgical operations, by obtaining the force from the operating bone, it can be used to feed back the specific force of the operating bone.
  • the security range can be set as required.
  • the safety module 660 sends a signal to the control module 630, and the control module 630 controls the execution module 620, that is, the execution arm stops the surgical operation to further ensure the safety of the operation.
  • the robot system for spinal surgery of the present invention may further include a control mode selection unit for selecting an automatic control mode or a manual control mode.
  • the performing arm can perform a surgical operation according to the obtained surgical operation path.
  • an operator such as a doctor can control the execution arm to perform a surgical operation according to the surgical operation path.
  • the surgical manipulator is driven by the execution arm to perform the nail placement operation, which can improve the efficiency and accuracy of the operation, and reduce the risk of radiation exposure to the doctor during the operation.
  • Fig. 8 is a schematic diagram of a spinal surgery robot system according to an embodiment of the present invention.
  • FIG. 8 it includes a console 810 , an execution arm 820 , a navigation and positioning device 830 , and an intraoperative imaging device 840 .
  • the surgical object is set on the surgical bed 850 .
  • the route planning module 610 , the control module 630 , the security module 660 and the human-computer interaction module 650 can all be included in the console 810 .
  • the execution module 620 may include an execution arm 820 , and at the end of the execution arm 820 , a nail setting manipulator 821 .
  • the navigation and positioning module 640 may include a navigation and positioning device 830, which is set in the operating environment and used to obtain the spatial pose of the operating skeleton 801 and the execution arm 820 in real time.
  • the intraoperative imaging device 840 is used to acquire the intraoperative two-dimensional image of the surgical object, and send it to the image registration unit 631 to obtain the spatial information of the registered image.
  • the intraoperative imaging device 840 is a C-arm machine or an O-arm machine.
  • the console 810 may include a display device and an input device, and the doctor may use the path planning module 610 to perform operations such as selecting a lesion area, editing and planning an operation path, etc. on the three-dimensional model of the operating skeleton.
  • the console 810 further includes a control rod 811 through which the doctor can directly control the movement of the staple manipulator 821 .
  • the control rod 811 is a pen-holding device, which meets the design requirements of ergonomics and is convenient for doctors to use.
  • the control rod 811 can belong to the human-computer interaction module 650, and the force is fed back to the operator through the control rod 811, so that the operator can perceive the reaction force of the surgical manipulator from the operating bone in real time.
  • the performing arm can be used to automatically perform the operation of nailing, which improves the operation efficiency and precision, greatly reduces the burden on the doctor, and reduces the radiation risk suffered by the doctor during the operation; in the nailing operation, through
  • the planned operation path generated by the path planning module is distributed along the direction of the fastest decline in tissue density gradient in the operating bone of the surgical object, which can ensure the safety of the operation; and by obtaining the force of the operating bone in real time during the operation, the planning can be adjusted in real time
  • the operation path is used to optimize the obtained operation path.
  • numbers describing the quantity of components and attributes are used. It should be understood that such numbers used in the description of the embodiments use the modifiers "about”, “approximately” or “substantially” in some examples. grooming. Unless otherwise stated, “about”, “approximately” or “substantially” indicates that the stated figure allows for a variation of ⁇ 20%. Accordingly, in some embodiments, the numerical parameters used in the specification and claims are approximations that can vary depending upon the desired characteristics of individual embodiments. In some embodiments, numerical parameters shall take into account the specified significant digits and adopt the general digit reservation method. Although the numerical ranges and parameters used in some embodiments of the present application to confirm the breadth of the scope are approximate values, in specific embodiments, such numerical values are set as precisely as practicable.

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Abstract

本发明提供了一种用于置钉操作的脊柱手术机器人系统，包括：路径规划模块，用于生成置钉操作的规划操作路径，所述规划操作路径沿着手术对象的作业骨骼中组织密度梯度下降最快的方向分布；执行模块，用于执行所述置钉操作；以及控制模块，用于控制所述执行模块按照所述规划操作路径执行所述置钉操作。本发明的脊柱手术机器人系统通过路径规划模块生成的规划操作路径沿着手术对象的作业骨骼中组织密度梯度下降最快的方向分布，使执行模块在执行置钉操作时从密度较低的松质骨处置入，所受到的阻力小，保证了置钉手术的安全性。

Description

用于置钉操作的脊柱手术机器人系统 技术领域
本发明涉及手术机器人领域，尤其涉及一种用于置钉操作的脊柱手术机器人系统。
背景技术
随着颈椎外科技术的进步以及对颈椎局部解剖学研究的不断深入，颈椎后路置钉技术得到快速的发展。后路颈椎椎弓根螺钉固定术是脊柱疾病治疗的革命性创新，颈椎椎弓根螺钉固定的生物力学稳定性要优于颈椎其他各种固定技术，甚至超过前路钛板加后路侧块固定的稳定性，是一种矫正颈椎后凸畸形、进行颈椎的固定融合以及治疗颈椎骨折脱位等颈椎疾病的理想固定方法。
在对患者开展后路颈椎椎弓根螺钉术时，需要将椎弓根螺钉置入到人体的后路颈椎中。现有的置入方式都是依靠手术医生徒手执行，这种方式不仅依赖手术医生的经验，而且人手操作容易产生偏差导致椎弓根螺钉置入偏离正确轨道，从而降低手术成功率，手术失误后可能造成脊髓神经根损伤及椎动脉损伤等不可逆性损害甚至危及患者生命。同时在对后路颈椎椎弓根置入螺钉时，受患者具体情况的影响，可能需要对多个后颈椎椎弓根进行螺钉置入，而这种操作无疑更大的加重了手术的难度，更加考验医生的技术。
随着医疗器械技术的发展，机器人技术在手术中的应用越来越多。目前在后路颈椎椎弓根螺钉固定术中，手术机器人主要起到医学影像建模、辅助定位和导航的作用，椎弓根螺钉的植入还是需要由手术医生来完成。由于后路颈椎椎弓根不但细小而且还处于四周由椎动脉、脊髓和上、下位神经根所形成的狭窄空间中，使椎弓根螺钉的置入难度和危险性都相应增大。手术医生即便根据术前影像来规划置入钉道，也无法解决所规划钉道偏移正确位置的问题。
发明内容
本发明要解决的技术问题是提供一种安全可靠的用于置钉操作的脊柱手术机器人系统。
为解决上述技术问题，本发明提供了一种用于置钉操作的脊柱手术机器人系统，其特征在于，包括：路径规划模块，用于生成置钉操作的规划操作路径，所述 规划操作路径沿着手术对象的作业骨骼中组织密度梯度下降最快的方向分布；执行模块，用于执行所述置钉操作；以及控制模块，用于控制所述执行模块按照所述规划操作路径执行所述置钉操作。
在一些实施例中，所述路径规划模块包括：建模单元，用于根据所述作业骨骼的术前三维图像建立所述作业骨骼的三维模型；路径规划单元，用于在所述三维模型上形成所述规划操作路径。
在一些实施例中，所述三维模型包括所述作业骨骼的结构信息，所述结构信息包括所述作业骨骼中各个位置的组织密度，所述组织密度和所述手术对象的基本信息相关。
在一些实施例中，所述基本信息包括年龄、性别、身高、体重和病史。
在一些实施例中，所述规划操作路径上的每一个位置具有对应的术前模拟反馈作用力，所述术前模拟反馈作用力与所述组织密度相对应。
在一些实施例中，所述执行模块包括：置钉操作器，设置在手术执行臂的末端，用于执行所述置钉操作；以及力学传感装置，设置在所述置钉操作器中，用于检测所述置钉操作器受到的来自所述手术对象的作业骨骼的作用力。
在一些实施例中，所述控制模块还用于根据所述规划操作路径和所述作用力生成手术操作路径，所述规划操作路径上的每一个位置具有对应的术前模拟反馈作用力，所述手术操作路径上的每一个位置具有对应的所述作用力，在所述手术操作路径上每个所述位置的所述作用力和所述术前模拟反馈作用力之间的第一差值在预设阈值范围之内；以及所述控制模块控制所述执行模块按照所述手术操作路径执行所述置钉操作。
在一些实施例中，所述控制模块还用于在每个所述位置调整所述置钉操作器的方向，获得多个方向上的多个所述作用力，比较所述多个作用力和所述位置的所述术前模拟反馈作用力之间的第二差值，取所述第二差值最小的方向作为所述置钉操作器的操作方向。
在一些实施例中，还包括：人机交互模块，用于根据所述作用力生成模拟作用力，使操作者接收所述模拟作用力并通过所述控制模块控制所述执行臂的移动。
在一些实施例中，还包括安全模块，用于实时监测所述作用力，当所述作用力超过安全范围时，所述安全模块控制所述执行臂停止所述手术操作。
在一些实施例中，还包括：导航定位模块，用于获得所述作业骨骼的空间位姿和所述脊柱手术机器人的执行臂的空间位姿，建立所述作业骨骼和所述执行臂之间的空间映射关系；所述控制模块还包括：影像配准单元，用于将所述三维模型与所述手术对象的术中二维图像进行配准，获得配准图像空间信息；空间映射单元，用于将所述配准图像空间信息、所述作业骨骼的空间位姿和所述执行臂的空间位姿映射在统一空间坐标中；路径转换单元，用于将所述规划操作路径转换为所述统一空间坐标中的所述手术操作路径。
本发明的脊柱手术机器人系统通过路径规划模块生成的规划操作路径沿着手术对象的作业骨骼中组织密度梯度下降最快的方向分布，使执行模块在执行置钉操作时从密度较低的松质骨处置入，所受到的阻力小，保证了置钉手术的安全性。
附图概述
包括附图是为提供对本申请进一步的理解，它们被收录并构成本申请的一部分，附图示出了本申请的实施例，并与本说明书一起起到解释本发明原理的作用。
附图中：
图1是本发明一实施例的用于置钉操作的脊柱手术机器人系统的框图；
图2是本发明一实施例的脊柱手术机器人系统中的路径规划模块的框图；
图3是本发明一实施例的脊柱手术机器人中的建模单元的框图；
图4是本发明一实施例的脊柱手术机器人中的执行模块的框图；
图5是根据本发明一实施例的脊柱手术机器人系统执行置钉操作的示意图；
图6是本发明另一实施例的脊柱手术机器人系统的框图；
图7是本发明另一实施例的脊柱手术机器人系统中的控制模块的框图；
图8是本发明一实施例的脊柱手术机器人系统的示意图。
本发明的较佳实施方式
为了更清楚地说明本申请的实施例的技术方案，下面将对实施例描述中所需要使用的附图作简单的介绍。显而易见地，下面描述中的附图仅仅是本申请的一些示例或实施例，对于本领域的普通技术人员来讲，在不付出创造性劳动的前提下，还可以根据这些附图将本申请应用于其他类似情景。除非从语言环境中显而易见或另做说明，图中相同标号代表相同结构或操作。
如本申请和权利要求书中所示，除非上下文明确提示例外情形，“一”、“一个”、“一种”和/或“该”等词并非特指单数，也可包括复数。一般说来，术语“包括”与“包含”仅提示包括已明确标识的步骤和元素，而这些步骤和元素不构成一个排它性的罗列，方法或者设备也可能包含其他的步骤或元素。
除非另外具体说明，否则在这些实施例中阐述的部件和步骤的相对布置、数字表达式和数值不限制本申请的范围。同时，应当明白，为了便于描述，附图中所示出的各个部分的尺寸并不是按照实际的比例关系绘制的。对于相关领域普通技术人员已知的技术、方法和设备可能不作详细讨论，但在适当情况下，所述技术、方法和设备应当被视为授权说明书的一部分。在这里示出和讨论的所有示例中，任何具体值应被解释为仅仅是示例性的，而不是作为限制。因此，示例性实施例的其它示例可以具有不同的值。应注意到：相似的标号和字母在下面的附图中表示类似项，因此，一旦某一项在一个附图中被定义，则在随后的附图中不需要对其进行进一步讨论。
在本申请的描述中，需要理解的是，方位词如“前、后、上、下、左、右”、“横向、竖向、垂直、水平”和“顶、底”等所指示的方位或位置关系通常是基于附图所示的方位或位置关系，仅是为了便于描述本申请和简化描述，在未作相反说明的情况下，这些方位词并不指示和暗示所指的装置或元件必须具有特定的方位或者以特定的方位构造和操作，因此不能理解为对本申请保护范围的限制；方位词“内、外”是指相对于各部件本身的轮廓的内外。
为了便于描述，在这里可以使用空间相对术语，如“在……之上”、“在……上方”、“在……上表面”、“上面的”等，用来描述如在图中所示的一个器件或特征与其他器件或特征的空间位置关系。应当理解的是，空间相对术语旨在包含除了器件在图中所描述的方位之外的在使用或操作中的不同方位。例如，如果附图中的器件被倒置，则描述为“在其他器件或构造上方”或“在其他器件或构造之上”的器件之后将被定位为“在其他器件或构造下方”或“在其他器件或构造之下”。因而，示例性术语“在……上方”可以包括“在……上方”和“在……下方”两种方位。该器件也可以其他不同方式定位(旋转90度或处于其他方位)，并且对这里所使用的空间相对描述作出相应解释。
此外，需要说明的是，使用“第一”、“第二”等词语来限定零部件，仅 仅是为了便于对相应零部件进行区别，如没有另行声明，上述词语并没有特殊含义，因此不能理解为对本申请保护范围的限制。此外，尽管本申请中所使用的术语是从公知公用的术语中选择的，但是本申请说明书中所提及的一些术语可能是申请人按他或她的判断来选择的，其详细含义在本文的描述的相关部分中说明。此外，要求不仅仅通过所使用的实际术语，而是还要通过每个术语所蕴含的意义来理解本申请。
图1是本发明一实施例的用于置钉操作的脊柱手术机器人系统的框图。参考图1所示，该实施例的脊柱手术机器人系统100包括路径规划模块110、执行模块120和控制模块130。其中，路径规划模块110用于生成置钉操作的规划操作路径，规划操作路径沿着手术对象的作业骨骼中组织密度梯度下降最快的方向分布；执行模块120用于执行置钉操作；控制模块130用于控制执行模块120按照规划操作路径执行置钉操作。
本发明对作业骨骼的具体位置不做限制。优选地，作业骨骼是后路颈椎椎弓根螺钉固定术中的后路颈椎。
骨骼结构主要包括皮质骨和松质骨，其中皮质骨位于骨骼外部密度较高，而松质骨位于骨骼中间密度较低。根据骨骼结构特性，如果椎弓根螺钉能准确的置入颈椎椎板松质骨中而不穿透颈椎椎板下层皮质骨则可以保证置钉手术的安全性。本发明根据骨骼结构的特点使脊柱手术机器人系统的规划操作路径和手术操作路径尽量多地沿松质骨结构分布，遇到的阻力小，从而保证置钉手术的安全性。
图2是本发明一实施例的脊柱手术机器人系统中的路径规划模块的框图。参考图2所示，在一些实施例中，路径规划模块110包括建模单元210和路径规划单元220。其中，建模单元210用于根据作业骨骼的术前三维图像建立作业骨骼的三维模型；路径规划单元220用于在三维模型上形成规划操作路径。
图3是本发明一实施例的脊柱手术机器人中的建模单元的框图。其中示出了图2所示实施例中的建模单元210可以包括的具体模块框图。参考图3所示，在一些实施例中，建模单元210包括影像获取单元211、影像分割单元212和三维重建单元213。其中，影像获取单元211用于获取手术对象的脊柱的医学断层扫描影像。本发明对该影像的具体来源不做限制，可以包括但不限于CT、 MRI等。影像分割单元212用于接收该医学断层扫描影像，并对所获得的多张医学断层扫描影像进行分割，获得手术对象作业骨骼不同层面的二维图像。本发明对具体地用于图像分割的方法不做限制。优选地，采用深度学习算法执行图像分割，该深度学习算法可以包括但不限于U-Net网络算法等。三维重建单元213接收作业骨骼不同层面的二维图像，并根据这些二维图像进行图像的三维重建，获得作业骨骼的三维模型。手术医生可以在该三维模型上选取病灶区域，并通过路径规划单元220生成规划操作路径。
路径规划单元220可以提供面向医生的显示及操作界面。在显示及操作界面上可以显示作业骨骼的图像，以及在该图像上显示规划操作路径。医生可以通过该显示及操作界面在三维模型上进行病灶区域的选取，并且通过人机交互方式编辑、调整所显示的规划操作路径。
可以理解，规划操作路径是由路径规划单元220根据病灶区域自动形成，可以由医生进行编辑和修改。规划操作路径可以不同于脊柱手术机器人所实际执行的手术操作路径。脊柱手术机器人根据由该规划操作路径所生成的手术操作路径来执行置钉操作。
在一些实施例中，建模单元210所形成的三维模型包括作业骨骼的结构信息，该结构信息包括作业骨骼中各个位置的组织密度，组织密度和手术对象的基本信息相关。
在一些实施例中，该基本信息包括年龄、性别、身高、体重和病史等。
在这些实施例中，采集大量脊柱疾病患者的数据，该数据包括患者的基本信息及其作业骨骼的结构信息。可以从每个患者的作业骨骼的医学影像中获取该作业骨骼的结构信息。在对图像进行三维重建之后，可以获得作业骨骼区域中的骨性结构、神经、韧带等重要软组织信息，这些不同的结构、组织的密度各不相同。本发明的建模单元210所形成的三维模型包括的结构信息中包括作业骨骼中各个位置的组织密度，该组织密度包括作业骨骼中的非骨性结构的密度，例如韧带等软组织，也包括骨性结构的骨骼密度。
在一些实施例中，可以采用人工智能算法建立患者的基本信息和作业骨骼中各个位置的组织密度之间的关系。在执行置钉操作时，对于特定的手术对象，可以根据该手术对象的基本信息来估计其作业骨骼中各个位置的组织密度的 结构信息，从而基于该结构信息生成规划操作路径，使规划操作路径沿着该手术对象的作业骨骼中组织密度梯度下降最快的方向分布。
根据上述的实施例，作业骨骼中组织密度梯度下降最快的方向表示该规划操作路径朝向密度较低的松质骨所在的位置行进。这样，在执行置钉操作时，控制模块130引导执行模块120按照规划操作路径行进，可以使螺钉置入松质骨所在的位置，螺钉遇到的阻力小，手术安全性高。
图4是本发明一实施例的脊柱手术机器人中的执行模块的框图。参考图4所示，在一些实施例中，本发明的脊柱手术机器人系统中的执行模块120包括置钉操作器121和力学传感器122。其中，置钉操作器121设置在手术执行臂的末端，用于执行置钉操作；力学传感装置122设置在置钉操作器中，用于检测置钉操作器121受到的来自手术对象的作业骨骼的作用力Fr。
在这些实施例中，本发明的脊柱手术机器人系统中的控制模块130还用于根据规划操作路径和作用力Fr生成手术操作路径，规划操作路径上的每一个位置具有对应的术前模拟反馈作用力Fs，手术操作路径上的每一个位置具有对应的作用力Fr，在手术操作路径上每个位置的作用力Fr和术前模拟反馈作用力Fs之间的第一差值在预设阈值Th范围之内；控制模块控制执行模块按照手术操作路径执行置钉操作。
可以理解，在理想的情况下，控制模块130控制执行模块120按照规划操作路径来执行置钉操作。然而，在具体执行置钉操作的手术时，可能会由于手术对象的骨骼异常或异动等原因造成需要对规划操作路径进行调整。根据上述的实施例，在手术过程中，置钉操作器121可以通过力学传感装置122实时获得来自作业骨骼的作用力，该作用力Fr是由于置钉操作器121作用在作业骨骼上所产生的反作用力。在手术之前，还可以根据建模单元210所获得的作业骨骼的三维模型，建立作业骨骼上各个位置的术前模拟反馈作用力Fs。可以理解，在手术过程中，置钉操作器121以一定的方向和速度向作业骨骼行进，该作用力Fr和术前模拟反馈作用力Fs与置钉操作器121的方向和速度等参数相关。也就是说，本发明所建立的作业骨骼上各个位置的术前模拟反馈作用力Fs对应于一些参数，这些参数包括但不限于：受力点的位置、置钉操作器121的方向和速度等。
在一些实施例中，力学传感装置122包括多维力矩传感器。根据力学传感装置122可以获得置钉操作器121在多个方向上所受到的作用力Fr。因此，作用力Fr可以包括多个方向上所受到的多个作用力。该作用力Fr也与受力点的位置、置钉操作器121的方向和速度等相关。
在执行置钉操作时，置钉操作器121可以实时地获得作用力Fr，控制模块130比较该受力点位置处，该置钉操作器121的方向和速度下的作用力Fr和术前模拟反馈作用力Fs，若│Fr-Fs│≤Th，则控制模块130使手术操作路径等于规划操作路径，并控制置钉操作器121按照手术操作路径行进；若│Fr-Fs│>Th，则控制模块130调整规划操作路径，生成调整后的规划操作路径，获得新的作用力Fr_new，若│Fr_new-Fs│≤Th，则使该调整后的规划操作路径作为手术操作路径，若│Fr_new-Fs│>Th，则控制模块130继续调整规划操作路径，直到调整后的作用力与术前模拟反馈作用力Fs之间的第一差值在预设阈值Th范围之内。
根据本发明的实施例，手术操作路径中，作业骨骼中每个位置的作用力Fr与该位置的术前模拟反馈作用力Fs之间的第一差值都在预设阈值Th范围之内。
可以理解，预设阈值Th是与作用力Fr相同的物理量，具有相同的量纲。
在一些实施例中，本发明的脊柱手术机器人系统中的控制模块130还用于在每个位置调整置钉操作器121的方向，获得多个方向上的多个作用力Fr，比较多个作用力Fr和该位置的术前模拟反馈作用力Fs之间的第二差值，取第二差值最小的方向作为置钉操作器的操作方向。
根据这些实施例，对于作业骨骼中的某一个位置，可以由控制模块130控制置钉操作器121的方向，使置钉操作器121向多个方向行进，从而获得多个作用力Fr。这些作用力Fr和术前模拟反馈作用力Fs之间的第二差值都在预设阈值Th范围之内。但是，对于不同的方向，所获得的作用力Fr与术前模拟反馈作用力Fs之间的第二差值可能不同。举例说明：在位置A，方向B1所获得的作用力为Fr_B1，方向B2所获得的作用力Fr_B2，并且│Fr_B1-Fs│<│Fr_B2-Fs│≤Th，表示在方向B1所获得的作用力Fr_B1更加接近Fs，因此，选择方向B1作为手术操作路径中的置钉操作器121的操作方向，可以获得更小的阻力，也即在该多个方向中可以获得最小的阻力。
在一些实施例中，在调整置钉操作器的方向时，置钉操作器121的方向在一预设方向范围Th_d内变化。在一些实施例中，该预设方向范围Th_d为5度。
图5是根据本发明一实施例的脊柱手术机器人系统执行置钉操作的示意图。参考图5所示，置钉操作器510的前端设置有螺钉520，该螺钉520的前端已植入作业骨骼530中。图5所示为颈椎的骨骼示意图，不用于限制本发明的作业骨骼的具体位置。参考图5所示，可以理解，控制模块130通过控制置钉操作器510的位置和方向从而控制螺钉置入作业骨骼530的位置和方向。在该置钉操作器510中设置有力学传感器。图5中所示的置钉操作器510是图4中所示的置钉操作器121的具体实施例，前文的说明内容可以用于说明该置钉操作器510，相同的内容将不再展开。
图6是本发明另一实施例的脊柱手术机器人系统的框图。参考图6所示，与图1所示的实施例相比，该实施例的脊柱手术机器人系统600除包括路径规划模块610、执行模块620和控制模块630之外，还包括导航定位模块640，用于获得作业骨骼的空间位姿和脊柱手术机器人的执行臂的空间位姿，建立作业骨骼和执行臂之间的空间映射关系。
图7是本发明另一实施例的脊柱手术机器人系统中的控制模块的框图。在这些实施例中，控制模块630还包括影像配准单元631、空间映射单元632和路径转换单元633。其中，影像配准单元631用于将三维模型与手术对象的术中二维图像进行配准，获得配准图像空间信息；空间映射单元632用于将配准图像空间信息、作业骨骼的空间位姿和执行臂的空间位姿映射在统一空间坐标中；路径转换单元633用于将规划操作路径转换为统一空间坐标中的手术操作路径。
参考图6所示，在一些实施例中，脊柱手术机器人系统600还包括人机交互模块650，用于根据作用力生成模拟作用力，使操作者接收模拟作用力并通过控制模块控制执行臂的移动。
在一些实施例中，人机交互模块650可以是主从手装置、传感手套等。根据这些实施例，可以由操作者直接手动控制执行臂，直接感受作业骨骼的反作用力，根据该作用力来实时控制手术执行臂的移动。
参考图6所示，在一些实施例中，脊柱手术机器人系统600还包括安全模 块660，用于实时监测作用力，当作用力超过安全范围时，安全模块660控制执行臂停止手术操作。
在实际的手术操作中会遇到一些特殊情况，例如作业骨骼特别坚硬，或者手术对象发生晃动等，需要调整手术操作。对于执行臂自动执行手术操作的情况，通过获得来自作业骨骼的作用力，可以用来反馈作业骨骼的具体受力情况。该安全范围可以根据需要来设置。当该作用力超过安全范围时，安全模块660发送信号至控制模块630，控制模块630控制执行模块620，也就是执行臂停止手术操作，进一步保证手术的安全性。
在一些实施例中，本发明的脊柱手术机器人系统还可以包括控制模式选择单元，用于选择自动控制模式或手动控制模式。在自动控制模式下，执行臂可以根据所获得的手术操作路径执行手术操作。在手动控制模式下，可以由医生等操作者控制执行臂，按照手术操作路径执行手术操作。无论是自动控制还是手动控制，都是由执行臂带动手术操作器来执行置钉操作，可以提高手术效率和精度，并且降低医生在术中所受辐射的危险。
图8是本发明一实施例的脊柱手术机器人系统的示意图。参考图8所示，其中包括控制台810、执行臂820、导航定位设备830、术中成像设备840。手术对象被设置在手术床850上。结合图6和图7所示的实施例，路径规划模块610、控制模块630、安全模块660和人机交互模块650都可以包括在控制台810中。执行模块620可以包括执行臂820，在执行臂820的末端还包括置钉操作器821。导航定位模块640可以包括导航定位设备830，设置在手术环境中，用于实时获取作业骨骼801和执行臂820的空间位姿。术中成像设备840用于获取手术对象的术中二维图像，并发送至影像配准单元631用于获得配准图像空间信息。在一些实施例中，术中成像设备840是C臂机或O臂机。
参考图8所示，控制台810可以包括显示设备和输入设备，医生可以通过路径规划模块610在作业骨骼的三维模型上执行选取病灶区域，编辑规划操作路径等操作。在一些实施例中，控制台810还包括控制杆811，医生可以通过该控制杆811来直接控制置钉操作器821的移动。在图8所示的实施例中，控制杆811是一种执笔式设备，符合人机工程学的设计要求，方便医生使用。在一些实施例中，控制杆811可以属于人机交互模块650，通过控制杆811将作 用力反馈至操作者，使操作者实时感知手术操作器所受到的来自作业骨骼的反作用力。
根据本发明的脊柱手术机器人系统可以采用执行臂自动执行置钉操作，提高了手术效率和手术精度，大大减轻医生的负担，降低医生在术中所受的辐射风险；在置钉手术中，通过路径规划模块生成的规划操作路径沿着手术对象的作业骨骼中组织密度梯度下降最快的方向分布，可以保证手术的安全性；并且通过在手术过程中实时获得作业骨骼的作用力，实时调整规划操作路径，使所获得的手术操作路径最优。
上文已对基本概念做了描述，显然，对于本领域技术人员来说，上述发明披露仅仅作为示例，而并不构成对本申请的限定。虽然此处并没有明确说明，本领域技术人员可能会对本申请进行各种修改、改进和修正。该类修改、改进和修正在本申请中被建议，所以该类修改、改进、修正仍属于本申请示范实施例的精神和范围。
同时，本申请使用了特定词语来描述本申请的实施例。如“一个实施例”、“一实施例”、和/或“一些实施例”意指与本申请至少一个实施例相关的某一特征、结构或特点。因此，应强调并注意的是，本说明书中在不同位置两次或多次提及的“一实施例”或“一个实施例”或“一替代性实施例”并不一定是指同一实施例。此外，本申请的一个或多个实施例中的某些特征、结构或特点可以进行适当的组合。
同理，应当注意的是，为了简化本申请披露的表述，从而帮助对一个或多个发明实施例的理解，前文对本申请实施例的描述中，有时会将多种特征归并至一个实施例、附图或对其的描述中。但是，这种披露方法并不意味着本申请对象所需要的特征比权利要求中提及的特征多。实际上，实施例的特征要少于上述披露的单个实施例的全部特征。
一些实施例中使用了描述成分、属性数量的数字，应当理解的是，此类用于实施例描述的数字，在一些示例中使用了修饰词“大约”、“近似”或“大体上”来修饰。除非另外说明，“大约”、“近似”或“大体上”表明所述数字允许有±20％的变化。相应地，在一些实施例中，说明书和权利要求中使用的数值参数均为近似值，该近似值根据个别实施例所需特点可以发生改变。在一 些实施例中，数值参数应考虑规定的有效数位并采用一般位数保留的方法。尽管本申请一些实施例中用于确认其范围广度的数值域和参数为近似值，在具体实施例中，此类数值的设定在可行范围内尽可能精确。

Claims (11)

  1. 一种用于置钉操作的脊柱手术机器人系统，其特征在于，包括：
    路径规划模块，用于生成置钉操作的规划操作路径，所述规划操作路径沿着手术对象的作业骨骼中组织密度梯度下降最快的方向分布；
    执行模块，用于执行所述置钉操作；以及
    控制模块，用于控制所述执行模块按照所述规划操作路径执行所述置钉操作。
  2. 如权利要求1所述的脊柱手术机器人系统，其特征在于，所述路径规划模块包括：
    建模单元，用于根据所述作业骨骼的术前三维图像建立所述作业骨骼的三维模型；
    路径规划单元，用于在所述三维模型上形成所述规划操作路径。
  3. 如权利要求2所述的脊柱手术机器人系统，其特征在于，所述三维模型包括所述作业骨骼的结构信息，所述结构信息包括所述作业骨骼中各个位置的组织密度，所述组织密度和所述手术对象的基本信息相关。
  4. 如权利要求3所述的脊柱手术机器人系统，其特征在于，所述基本信息包括年龄、性别、身高、体重和病史。
  5. 如权利要求2所述的脊柱手术机器人系统，其特征在于，所述规划操作路径上的每一个位置具有对应的术前模拟反馈作用力，所述术前模拟反馈作用力与所述组织密度相对应。
  6. 如权利要求1所述的脊柱手术机器人系统，其特征在于，所述执行模块包括：
    置钉操作器，设置在手术执行臂的末端，用于执行所述置钉操作；以及
    力学传感装置，设置在所述置钉操作器中，用于检测所述置钉操作器受到的来自所述手术对象的作业骨骼的作用力。
  7. 如权利要求6所述的脊柱手术机器人系统，其特征在于，所述控制模块还用于根据所述规划操作路径和所述作用力生成手术操作路径，所述规划操作路径上的每一个位置具有对应的术前模拟反馈作用力，所述手术操作路径上的每一个位置具有对应的所述作用力，在所述手术操作路径上每个所述位置的所述作用力和所述术前模拟反馈作用力之间的第一差值在预设阈值范围之内；以 及
    所述控制模块控制所述执行模块按照所述手术操作路径执行所述置钉操作。
  8. 如权利要求7所述的脊柱手术机器人系统，其特征在于，所述控制模块还用于在每个所述位置调整所述置钉操作器的方向，获得多个方向上的多个所述作用力，比较所述多个作用力和所述位置的所述术前模拟反馈作用力之间的第二差值，取所述第二差值最小的方向作为所述置钉操作器的操作方向。
  9. 如权利要求6所述的脊柱手术机器人系统，其特征在于，还包括：人机交互模块，用于根据所述作用力生成模拟作用力，使操作者接收所述模拟作用力并通过所述控制模块控制所述执行臂的移动。
  10. 如权利要求6所述的脊柱手术机器人系统，其特征在于，还包括安全模块，用于实时监测所述作用力，当所述作用力超过安全范围时，所述安全模块控制所述执行臂停止所述手术操作。
  11. 如权利要求2所述的脊柱手术机器人系统，其特征在于，还包括：
    导航定位模块，用于获得所述作业骨骼的空间位姿和所述脊柱手术机器人的执行臂的空间位姿，建立所述作业骨骼和所述执行臂之间的空间映射关系；
    所述控制模块还包括：影像配准单元，用于将所述三维模型与所述手术对象的术中二维图像进行配准，获得配准图像空间信息；空间映射单元，用于将所述配准图像空间信息、所述作业骨骼的空间位姿和所述执行臂的空间位姿映射在统一空间坐标中；路径转换单元，用于将所述规划操作路径转换为所述统一空间坐标中的所述手术操作路径。
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