cs.ROOct 1, 2026

Ex vivo breach detection using electrical conductivity during robotic pedicle drilling in the spine

Authors: Jorge Andrés Pérez Velásquez, François Teyssere, Thibault Chandanson, Quentin Grimal, Brahim Tamadazte

Organizations: ISIR, Sorbonne Université, CNRS UMR 7222, Inserm U1150, Place de Jussieu, Paris, 75005, France. · SpineGuard SA, 10 cours Louis Lumière, Vincennes, 94300, France. · LIB, Sorbonne Université, CNRS UMR 7371, Inserm U1146, 15 rue de l’Ecole de Médecine, Paris, 75006, France.

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Abstract

Purpose: Pedicle screw placement is technically demanding in scoliosis treatment. High precision is required due to limited visibility, anatomical variability, and the risk of complications. Although robotic systems assist CT-based planning and execution, they still rely on ionizing intraoperative imaging and complex registration. This study proposes robotic pedicle drilling with real-time preventive breach detection using electrical bioimpedance sensing. Methods: We developed a robotic approach combined with a pedicle-drilling tool equipped with a proprioceptive electrical bioimpedance sensor developed by SpineGuard. A real-time detection algorithm was designed to analyze the electrical bioimpedance signal during drilling and identify abrupt changes in conductivity associated with potential breaches towards the spinal canal. The method operates without external devices or sensors. Results: The ex vivo experiments showed that the proposed method prevented breaches in 100 of the 51 drilling cases. These findings demonstrate the system's ability to detect potentially hazardous events during drilling and to stop the procedure before. The ex vivo experiments demonstrated that the proposed method prevented breaches in all 51 drilling cases. Conclusions: This work demonstrates the feasibility of robotic pedicle drilling with electrical bioimpedance sensing for real-time breach prevention. Using only the tool signal, the method eliminates the need for external sensing systems and supports safer pedicle screw placement.

Figures & tables

Figure 1: Left: a typical scoliose deformation. Right: different scenarios for screw insertion into the vertebrae: (1) leading to medial breach, (2) leading to lateral breach, and (3) well-positioned pedicle screw.
Figure 2: From left to right: detail of the drill placed at the entry point, detail of the threaded drill bit, behavior of electrical conductivity in different tissues
Figure 3: A typical DSG signal acquired during a vertebra drilling process.
Figure 4: Illustration of the drilling depth during data collection. The orange window (2–5 mm) denotes the measurement range, the green arrow indicates the detection threshold at 3 mm, and the red marker indicates a detection event.
Figure 5: Examples of breach-detection assessment. (a) Electrical conductivity, drilling depth, and detection time. (b) CT or μ\mu CT scans showing drill-tip deformation, with enlarged views of the onset of canal breach.
Figure 6: Micro-CT scan showing the spinal canal boundary (red dotted line) used to measure cortical deformation, indicated by the yellow line.
Figure 7: RGB images and micro-CT scans of the spinal canal before drilling (a) and after drilling (b). A slight canal deformation is visible when the method automatically stops drilling. Panel (c) shows this non-perforating deformation on the micro-CT scan.
Figure 8: Histogram showing the deformation caused by the drill tip at various distances from the canal. The peak indicates the most frequent deformation range [0.5–1 mm].

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