Error analysis of a robot positioning system based on biplanar navigation technology

Background: Some problems have been found in the clinical application of biplanar navigation technology. In particular, conical distortions caused by the X-ray image intensifier and deleterious effects on the navigation image caused by respiratory motion are occasionally ignored by surgeons. This paper discusses possible errors in the practical application of biplanar navigation technology and performs an analysis of the experimental correction for the conical distortion caused by X-rays.Methods: Five patients with unstable fractures of the pelvic posterior ring were included in this study. In four of these cases, the patient received a sacroiliac screw placement using biplanar navigation technology, while one received a respiratory motion test. The standard pelvic inlet and outlet positions were used for positioning precision verification. Using the images and manual tests, the point positioning error was measured and analyzed, and the image distortion was corrected by means of a geometric transformation mapping. A circle was fitted to the corrected lines, and the radius of this circle was used to evaluate the correction. Results: The preoperative planning agreed with the sacroiliac screw placement performed using biplanar navigation technology (representing precise positioning) in only one of the four cases. The other three cases presented deviations. Because of the possibility to cut out the nailing channel, the positioning operation was converted to a manual method. The breathing motion test showed that the pelvis can vibrate back and forth with breathing movement, especially the sacral promontory, with a maximum amplitude above 5 mm. The positioning error of the points in space with the biplanar technology was within 2 mm (entrance point, 1.60±0.28 mm; exit point, 1.28±0.43 mm). The corrected image curvature was significantly reduced, and the error can be greatly reduced. Conclusions: Conical distortion error and respiratory motion can affect the accuracy of biplanar navigation systems.

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