SpineGuard has announced that a research team presented an article at the 2023 Conference on New Technologies for Computer and Robot Assisted Surgery (CRAS; 11–13 September, Paris, France) earlier this month, reporting progress made with the robotic application of the company’s Dynamic Surgical Guidance (DSG) sensing technology designed to secure and streamline the placement of bone implants.
According to a SpineGuard press release, the presentation affirmed experimental data announced earlier in 2023, indicating a 100% success rate and clinical safety. These findings are the result of a collaboration between the company and the Institut des Systèmes Intelligents et de Robotique (IRIS) lab at Sorbonne Université in Paris, France for the application of DSG to surgical robots, and the enhancement of their safety, accuracy and autonomy.
“The innovative and truly unique aspect of DSG technology is that the electrical conductivity data obtained from the tip of the DSG-enhanced surgical drills and taps provides real-time position and guidance information from the tip of traditional robotically navigated surgical instruments,” said Roger Widmann (Hospital for Special Surgery/Weill Cornell Medical College, New York, USA). “DSG data provide confirmatory secondary modality data and confirmation regarding the 3D location of the instrument tip, and—in doing so—can help prevent complications and errors related to loss of registration or failure of traditional navigation before creation of pilot hole or definitive screw placement.”
DSG is based on the local measurement of electrical tissue conductivity in real time—without X-ray imaging—with a sensor located at the tip of the drilling instrument. Its efficacy has been proven via more than 95,000 surgeries across the globe as well as 25 scientific publications, SpineGuard claims.
The experiment presented at CRAS 2023 saw DSG sensing technology being used to automatically stop the drill bit as its tip is aiming at the bone boundary during a vertebral drilling procedure performed autonomously by a robot. The algorithm used for detection in the experiment—which involved an ex-vivo pig vertebra validation model—was tuned before the 50-drilling series was performed, and SpineGuard’s press release notes that no adjustments or calibrations were needed for each specimen. According to the company, a clinically relevant configuration consisting of a pedicular trajectory was utilised.
Overall, 100% of the drillings stopped within a corridor considered to be clinically safe, which consists of 2mm on each side of the interface between bone and the spinal canal. More specifically, all drillings fitted into a -0.9mm/+1.4mm interval, with a mean distance of 0.7mm. This was obtained despite the drilling being performed in a totally ‘blind’ manner, with neither preoperative nor intraoperative imaging being used, according to SpineGuard.
According to the company, this study and the described algorithms are the product of collaborations between SpineGuard, and ISIR, Centre National de la Recherche Scientifique (CNRS) and L’Institut National de la Santé et de la Recherche Médicale (INSERM). Part of this work received funding from the European Union’s (EU) Horizon 2020 research and innovation programme, in the context of the FAROS project.
“The acceptance of this new article in a reference conference of the sector is a new validation by the scientific community of the value and feasibility in using DSG to enhance surgical robots in orthopaedics,” said Stéphane Bette, co-founder and deputy CEO of SpineGuard. “It also displays the richness of our collaboration with ISIR and the hospital practitioners who contributed to this study.”
“The tight collaboration between SpineGuard, the Sorbonne Institute of Spine Surgery and ISIR continuously allows for improving spine surgery,” added Brahim Tamadazte, research director at CNRS, member of ISIR, and co-author of the study. “The know-how combination of SpineGuard for DSG smart instruments with our long-time expertise in surgical robotics and the experience of renowned spine surgeons, such as Raphaël Vialle, Elie Saghbiny and Christina Bobbio, enabled us to develop an algorithmic method for detecting potential bone breaches during pedicle screw insertion.”