# US 2021/0275260 A1 · Robotic Spine Surgery System And Methods

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- Number: US 2021/0275260 A1
- Document ID: US20210275260A1
- Status: Published application
- Kind: A1
- Application number: 17/313,056
- Filed: 2021-05-06
- Published: 2021-09-09
- Earliest claimed: 2017-05-10
- Assignees: MAKO Surgical Corp.
- Applicants: MAKO Surgical Corp.
- Inventors: Hyosig Kang; Jienan Ding; David Gene Bowling; Christopher Wayne Jones; Greg McEwan; Lucas Gsellman
- Web page: https://patentgrep.com/patent/US20210275260A1

## CPC

- A61B 34/30: Surgical robots
- A61B 17/1671: {for the spine}
- A61B 17/1757: {for the spine}
- A61B 17/7076: {for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation}
- A61B 17/8875: {Screwdrivers, spanners or wrenches}
- A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations
- A61B 34/32: operating autonomously
- A61B 34/71: {Manipulators operated by drive cable mechanisms}
- A61B 34/76: {Manipulators having means for providing feel, e.g. force or tactile feedback}
- A61B 90/98: using electromagnetic means, e.g. transponders
- A61B 17/1615: {Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material}
- A61B 17/1626: {Control means; Display units}
- A61B 17/7032: {Screws or hooks with U-shaped head or back through which longitudinal rods pass}
- A61B 17/7082: {for driving, i.e. rotating, screws or screw parts specially adapted for spinal fixation, e.g. for driving polyaxial or tulip-headed screws}
- A61B 17/7092: {for checking pedicle hole has correct depth or has an intact wall (pedicle drill depth limiters A61B17/1626)}
- A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B 90/03: {Automatic limiting or abutting means, e.g. for safety}
- A61B 2034/105: {Modelling of the patient, e.g. for ligaments or bones}
- A61B 2034/107: {Visualisation of planned trajectories or target regions}
- A61B 2034/2051: {Electromagnetic tracking systems}
- A61B 2034/2055: {Optical tracking systems}
- A61B 2034/2059: {Mechanical position encoders}
- A61B 2034/2068: {using pointers, e.g. pointers having reference marks for determining coordinates of body points}
- A61B 2090/031: {torque limiting}
- A61B 2090/062: {penetration depth}
- A61B 2090/376: {using X-rays, e.g. fluoroscopy}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A robotic system and methods for performing spine surgery are disclosed. The system comprises a robotic manipulator with a tool to hold a screw and to rotate the screw about a rotational axis. The screw is self-tapping and has a known thread geometry that is stored by one or more controllers. A navigation system tracks a position of a target anatomy. Movement of the robotic manipulator is controlled to maintain the rotational axis of the surgical tool along a planned trajectory with respect to the target anatomy based on the tracked position of the target anatomy. In autonomous or manual modes of operation, the rotational rate of the screw about the rotational axis and/or an advancement rate of the screw linearly along the planned trajectory is controlled to be proportional to the known thread geometry stored in the memory.

## Claims

### Claim 1

A surgical robotic system comprising:
a robotic manipulator;
a surgical tool coupled to the robotic manipulator and configured to hold a screw and to rotate the screw about a rotational axis, the screw being self-tapping and having a known thread geometry;
a navigation system configured to track a position of a target anatomy; and
one or more controllers coupled to the robotic manipulator and the navigation system and comprising memory for storing the known thread geometry and wherein the one or more controllers are configured to:
control movement of the robotic manipulator to maintain the rotational axis of the surgical tool along a planned trajectory with respect to the target anatomy based on the tracked position of the target anatomy, and
autonomously control a rotational rate of the surgical tool to rotate the screw about the rotational axis and an advancement rate of the surgical tool to linearly advance the screw along the planned trajectory wherein the rotational rate of the surgical tool and the advancement rate of the surgical tool are proportional to the known thread geometry stored in the memory.

### Claim 2 (depends on 1)

The surgical robotic system of claim 1, wherein the surgical tool comprises a screw driver.

### Claim 3 (depends on 1)

The surgical robotic system of claim 1, wherein the planned trajectory is defined by a haptic object.

### Claim 4 (depends on 3)

The surgical robotic system of claim 3, wherein the haptic object comprises a line haptic object, and the one or more controllers are configured to control the robotic manipulator to generate haptic feedback to a user to indicate that the screw has reached a planned insertion depth at the target anatomy.

### Claim 5 (depends on 1)

The surgical robotic system of claim 1, wherein the one or more controllers are configured to cause autonomous movement of the surgical tool to place the rotational axis along the planned trajectory.

### Claim 6 (depends on 1)

The surgical robotic system of claim 1, comprising a torque sensor to determine a torque being applied to drive the screw, wherein the one or more controllers are configured to stop the surgical tool from driving the screw into the target anatomy once the torque meets or exceeds a torque threshold.

### Claim 7 (depends on 6)

The surgical robotic system of claim 6, wherein the torque sensor comprises a current measuring circuit.

### Claim 8 (depends on 1)

The surgical robotic system of claim 1, wherein the navigation system comprises a navigation controller, and an imaging device coupled to the navigation controller.

### Claim 9 (depends on 8)

The surgical robotic system of claim 8, wherein the navigation system comprises a first tracker to track the surgical tool and a second tracker to track the target anatomy.

### Claim 10 (depends on 8)

The surgical robotic system of claim 8, comprising a display coupled to the navigation controller, wherein the navigation controller is configured to output, on the display, information relating to a location of the screw relative to the target anatomy.

### Claim 11 (depends on 1)

The surgical robotic system of claim 1, wherein the rotational rate of the surgical tool and the advancement rate of the surgical tool are proportional to the known thread geometry according to a relationship
δ
⁢
θ
δ
⁢
t
=
δ
⁢
D
δ
⁢
t
*
Pitch
2
⁢
π
,
wherein
δ
⁢
θ
δ
⁢
t
is the rotational rate or the surgical tool,
δ
⁢
D
δ
⁢
t
is the advancement rate of the surgical tool, and Pitch is a number of threads per unit length of the screw.

### Claim 12

A surgical robotic system comprising:
a robotic manipulator comprising a sensor;
a surgical tool coupled to the robotic manipulator and configured to hold a screw and to rotate the screw about a rotational axis, the screw being self-tapping and having a known thread geometry;
a navigation system configured to track a position of a target anatomy; and
one or more controllers coupled to the robotic manipulator and the navigation system and comprising a memory for storing the known thread geometry and wherein the one or more controllers are configured to:
control movement of the robotic manipulator to maintain the rotational axis of the surgical tool on a planned trajectory with respect to the target anatomy based on the tracked position of the target anatomy,
detect, with the sensor, a force applied by a user;
control one of a rotational rate of the surgical tool to insert the screw about the rotational axis or an advancement rate of the surgical tool to insert the screw linearly along the planned trajectory based on the forces applied by the user to implant the screw into the target anatomy; and
autonomously control the other of the advancement rate of the surgical tool or the rotational rate of the surgical tool so that the advancement rate of the surgical tool and the rotational rate of the surgical tool are proportional to the force applied by the user and to the known thread geometry stored in the memory.

### Claim 13 (depends on 12)

The surgical robotic system of claim 12, wherein the surgical tool comprises a trigger, the sensor coupled to the trigger and configured to generate a signal indicative of a user's input.

### Claim 14 (depends on 13)

The surgical robotic system of claim 13, wherein the one or more controllers control the rotational rate of the surgical tool based on the signal, and autonomously control the advancement rate of the surgical tool to be proportional to the rotational rate of the surgical tool and the known thread geometry.

### Claim 15 (depends on 14)

The surgical robotic system of claim 14, wherein the one or more controllers autonomously control the advancement rate of the surgical tool to be proportional to the rotational rate of the surgical tool and the known thread geometry according to a relationship
δ
⁢
θ
δ
⁢
t
=
δ
⁢
D
δ
⁢
t
*
Pitch
2
⁢
π
,
wherein
δ
⁢
θ
δ
⁢
t
is the rotational rate of the surgical tool,
δ
⁢
D
δ
⁢
t
is the advancement rate or the surgical tool, and Pitch is a number of threads per unit length of the screw.

### Claim 16 (depends on 13)

The surgical robotic system of claim 13, wherein the one or more controllers control the advancement rate of the surgical tool based on the signal, and autonomously control the rotational rate of the surgical tool to be proportional to the advancement rate of the surgical tool and the known thread geometry.

### Claim 17 (depends on 16)

The surgical robotic system of claim 16, wherein the one or more controllers autonomously control the rotational rate of the surgical tool to be proportional to the advancement rate of the surgical tool and the known thread geometry according to a relationship
δ
⁢
θ
δ
⁢
t
=
δ
⁢
D
δ
⁢
t
*
Pitch
2
⁢
π
,
wherein
δ
⁢
θ
δ
⁢
t
is the rotational rate of the surgical tool.
δ
⁢
D
δ
⁢
t
is the advancement rate of the surgical tool, and Pitch is a number of threads per unit length of the screw.