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Robotique avancé et traitement des signaux pour l'amélioration de positionnement de vis pédiculaire

Year: 2025
Type: dissertation
Abstract: As robotic systems enter the operating room, they are expected to deliver millimetric-level precision in pedicle screw placement. However, positional accuracy alone does not guarantee the correct gesture during the procedure, since preoperative surgical plans represent an idealized version of intraoperative reality, subject to patient motion, tissue deformation, and other dynamic factors. In practice, the surgeon temporarily abandons the initial plan and relies on their senses and experience to make tactical decisions about the entry point and drilling trajectory. This thesis addresses the challenge of guiding pedicle screw insertion safely and in real time by proposing a cooperative system that integrates a single-element ultrasound transducer with a surgical robotic arm. The core hypothesis is that when a single-element ultrasound pulse is aligned with the pedicle channel, it propagates through cancellous bone and produces a characteristic echo at the cancellous-cortical interface; detecting this echo enables identification of the optimal drilling trajectory. To validate this methodology, a complete procedure has been developed, which included a two-dimensional modeling of ultrasonic wave propagation in vertebrae as well the design of a tool changer that allows instruments to be changed on the robotic platform. As part of this work, a graphical user interface was implemented for real-time acquisition, visualization, and processing of ultrasound signal; also a scanning algorithm was integrated into the robot controller to estimate the optimal drilling angle. System viability and effectiveness were evaluated sequentially: First, through experiments on simplified vertebra models, and then in an ex vivo setup using porcine vertebrae that demonstrated an integrated surgical protocol in which the robot scans, selects the drilling orientation, and executes drilling, followed by post-measurement assessment of the resulting trajectory. The results demonstrate the feasibility of a robotic platform that performs angular ultrasound measurements and the computing of optimal drilling angles. This work supports the potential of ultrasound guidance as an effective, non-ionizing alternative to conventional techniques, advancing the state of the art in robot-assisted spine surgery.
Language: English
Subfield: Surgery
Field: Medicine
Open Access status: green
OpenAlex ID: W7142559392
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