Robotic surgical systems and methods for mitigating skiving between rotary cutting tool and cortical bone
Surgical systems and methods involve manipulation of a bone. A robotic manipulator supports and moves a surgical tool that has a cutting bur rotatable about a cutting axis. Controller(s) control the manipulator to align the cutting axis to a target axis associated with the bone and advance the cutting bur along the target axis towards a cortical region of the bone. The controller(s) control the surgical tool to rotate the cutting bur about the cutting axis and contact the cortical region. The controller(s) detect, from sensor(s), forces applied to the cutting bur by the cortical region and compare the sensed forces to a threshold indicative of skiving of the cutting bur relative the cortical region. In response to the sensed forces exceeding the threshold, the controller(s) adjust control of the manipulator and/or surgical tool to reduce forces applied to the cutting bur by the cortical region.
1 . A surgical system configured for manipulation of a bone structure comprising a cortical region, the surgical system comprising:
a surgical tool comprising a cutting bur rotatable about a cutting axis;
a robotic manipulator comprising a plurality of links and joints and being configured to support and move the surgical tool;
one or more sensors configured to sense forces applied to the cutting bur; and
one or more controllers coupled to the surgical tool, the robotic manipulator, and the one or more sensors, and being configured to:
control the robotic manipulator to align the cutting axis to a target axis associated with the bone structure and to advance the cutting bur along the target axis towards the cortical region;
control the surgical tool to rotate the cutting bur about the cutting axis and to contact the cortical region of the bone structure with the cutting bur;
detect, from the one or more sensors, forces applied to the cutting bur by the cortical region;
compare the sensed forces to a predetermined force threshold that is indicative of skiving of the cutting bur relative the cortical region; and
in response to the sensed forces exceeding the predetermined force threshold, adjust control of one or both of the robotic manipulator and surgical tool to reduce forces applied to the cutting bur by the cortical region.
2 . The surgical system of claim 1 , wherein to reduce forces applied to the cutting bur by the cortical region, the one or more controllers are configured to adjust control of the surgical tool to reduce a rotational cutting speed of the cutting bur.
3 . The surgical system of claim 1 , wherein to reduce forces applied to the cutting bur by the cortical region, the one or more controllers are configured to adjust control of the surgical tool to reverse a rotational cutting direction of the cutting bur.
4 . The surgical system of claim 1 , wherein to reduce forces applied to the cutting bur by the cortical region, the one or more controllers are configured to adjust control of the robotic manipulator to reduce a feed rate of the surgical tool along the target axis.
5 . The surgical system of claim 1 , wherein to reduce forces applied to the cutting bur by the cortical region, the one or more controllers are configured to adjust control of the robotic manipulator to reorient the cutting axis.
6 . The surgical system of claim 1 , wherein to reduce forces applied to the cutting bur by the cortical region, the one or more controllers are configured to adjust control of the robotic manipulator to pull the surgical tool away from the cortical region.
7 . The surgical system of claim 1 , wherein the one or more sensors are configured to sense lateral force applied transverse to the cutting axis.
8 . The surgical system of claim 1 , wherein the one or more sensors are configured to sense both lateral force applied transverse to the cutting axis and axial force applied along the cutting axis.
9 . The surgical system of claim 1 , wherein the one or more controllers are configured to reduce forces applied to the cutting bur by the cortical region until the sensed forces no longer exceed the predetermined force threshold.
10 . The surgical system of claim 1 , wherein the one or more controllers are configured to reduce forces applied to the cutting bur by the cortical region so that the sensed forces are maintained at the predetermined force threshold.
11 . The surgical system of claim 1 , wherein the bone structure comprises an outer cortical region, an inner cortical region, and a cancellous bone region between the outer and inner cortical regions, and wherein the cortical region is the outer cortical region or the inner cortical region, and wherein the one or more controllers are configured to:
detect, based on the sensed forces, a transition between the outer cortical region and the cancellous bone region or between the cancellous bone region and the inner cortical region; and
in response to detection of the transition, adjust control of one or both of the robotic manipulator and the surgical tool.
12 . The surgical system of claim 11 , wherein:
the bone structure is a vertebral body;
the cortical region is a pedicle surface of the vertebral body;
the target axis is an axis for a planned pedicle screw; and
the one or more controllers are configured to control the surgical tool to rotate the cutting bur about the cutting axis and to contact the pedicle surface of the vertebral body with the cutting bur to facilitate creation of a pedicle entry point.
13 . A method of operating a surgical system configured for manipulation of a bone structure comprising a cortical region, the surgical system including a surgical tool comprising a cutting bur rotatable about a cutting axis, a robotic manipulator comprising a plurality of links and joints and being configured to support and move the surgical tool, one or more sensors configured to sense forces applied to the cutting bur, and one or more controllers being configured to perform the following steps:
controlling the robotic manipulator for aligning the cutting axis to a target axis associated with the bone structure and for advancing the cutting bur along the target axis towards the cortical region;
controlling the surgical tool for rotating the cutting bur about the cutting axis and for contacting the cortical region of the bone structure with the cutting bur;
detecting, from the one or more sensors, forces applied to the cutting bur by the cortical region;
comparing the sensed forces to a predetermined force threshold that is indicative of skiving of the cutting bur relative the cortical region; and
in response to the sensed forces exceeding the predetermined force threshold, adjusting control of one or both of the robotic manipulator and surgical tool for reducing forces applied to the cutting bur by the cortical region.
14 . The method of claim 13 , comprising the one or more controllers reducing forces applied to the cutting bur by the cortical region by adjusting control of the surgical tool for reducing a rotational cutting speed of the cutting bur.
15 . The method of claim 13 , comprising the one or more controllers reducing forces applied to the cutting bur by the cortical region by adjusting control of the surgical tool for reversing a rotational cutting direction of the cutting bur.
16 . The method of claim 13 , comprising the one or more controllers reducing forces applied to the cutting bur by the cortical region by adjusting control of the robotic manipulator for reducing a feed rate of the surgical tool along the target axis.
17 . The method of claim 13 , comprising the one or more controllers reducing forces applied to the cutting bur by the cortical region by adjusting control of the robotic manipulator for reorienting the cutting axis.
18 . The method of claim 13 , comprising the one or more controllers reducing forces applied to the cutting bur by the cortical region by adjusting control of the robotic manipulator for pulling the surgical tool away from the cortical region.
19 . The method of claim 13 , comprising the one or more controllers reducing forces applied to the cutting bur by the cortical region:
until the sensed forces no longer exceed the predetermined force threshold, or
so that the sensed forces are maintained at the predetermined force threshold.
20 . The method of claim 13 , wherein the bone structure is a vertebral body, the cortical region is a pedicle surface of the vertebral body, the target axis is an axis for a planned pedicle screw, and comprising the one or more controllers:
controlling the surgical tool for rotating the cutting bur about the cutting axis and for contacting the pedicle surface of the vertebral body with the cutting bur for facilitating creation of a pedicle entry point.