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Robotic ultrasound-guided facet joint insertion

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Facet joint insertion is a common treatment of chronic pain in the back and spine. This procedure is often performed under fluoroscopic guidance, where the staff’s repetitive radiation exposure remains an unsolved problem. Robotic ultrasound (rUS) has the potential to reduce or even eliminate the use of radiation by using ultrasound with a robotic-guided needle insertion. This work presents first clinical data of rUS-based needle insertions extending previous work of our group.

Methods

Our system implements an automatic US acquisition protocol combined with a calibrated needle targeting system. This approach assists the physician by positioning the needle holder on a trajectory selected in a 3D US volume of the spine.

Results

By the time of submission, nine facets were treated with our approach as first data from an ongoing clinical study. The insertion success rate was shown to be comparable to current clinical practice. Furthermore, US imaging offers additional anatomical context for needle trajectory planning.

Conclusion

This work shows first clinical data for robotic ultrasound-assisted facet joint insertion as a promising solution that can easily be incorporated into the clinical workflow. Presented results show the clinical value of such a system.

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Notes

  1. https://github.com/SalvoVirga/iiwa_stack.

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Authors and Affiliations

  1. Technical University of Munich, Garching bei München, Germany

    Javier Esteban, Walter Simson, Sebastian Requena Witzig, Salvatore Virga, Nassir Navab & Christoph Hennersperger

  2. Imfusion GmbH, Munich, Germany

    Oliver Zettinig

  3. Medidee Services SA, Epalinges, Switzerland

    Benjamin Frisch

  4. Klinikum rechts der Isar, Munich, Germany

    Anna Rienmüller, Drazen Sakara & Yu-Mi Ryang

  5. Johns Hopkins University, Baltimore, USA

    Nassir Navab

Authors
  1. Javier Esteban
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  2. Walter Simson
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  3. Sebastian Requena Witzig
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  4. Anna Rienmüller
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  5. Salvatore Virga
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  6. Benjamin Frisch
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  7. Oliver Zettinig
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  8. Drazen Sakara
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  9. Yu-Mi Ryang
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  10. Nassir Navab
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  11. Christoph Hennersperger
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Corresponding author

Correspondence to Javier Esteban.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Esteban, J., Simson, W., Requena Witzig, S. et al. Robotic ultrasound-guided facet joint insertion. Int J CARS 13, 895–904 (2018). https://doi.org/10.1007/s11548-018-1759-x

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  • DOI: https://doi.org/10.1007/s11548-018-1759-x

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