Objective        To evaluate the drilling accuracy of minimally invasive spine surgery robotic system (remote type) assisted by computed tomography (CT) and C-arm system

and preliminary investigate the possibility of the combination of the imaging equipment and this robotic system.       Methods       Minimally invasive spine surgery robotic system (remote type)

which is researched and developed jointly by Shenyang Institute of Automation

Chinese Academy of Sciences and our department

is used to drill (remote) in spine surgery. Since the robotic system still lack of the assistant of the navigation system or virtual surgery system

this study in advance was designed to drill holes into the spinous process of bovine spine specimens and put K-wires into the holes as markers

with CT scanning as a basis for surgical planning. In the experiment

under the guide of the C-arm X-ray machine operation robot system

the gas drilling clamp’s position was adjusted. Remote drilling was performed till the coincidence of the image of the gas drilling position and ideal hole position in the spinous process. Then CT scanning was carried out again after the experiment for assessing.       Results       Minimally invasive spine surgery robotic system (remote type) could drill precisely and avoid radiation injury to the doctor. And the system average drilling time was 330 s/hole (ranging from 280 to 378 s)

while the average number of X-ray was 6 times (5 to 8 times). The results of the statistical analysis showed that P value was 0.209 (0.05) between the data of the drilling by CT photography and the surgical plan (one-sample t-test). The system had a certain learning curve

and the angle of deviation could be controlled within 4  after profound learning.       Conclusion        Minimally invasive spine surgery robotic system (remote type) is precise in drilling

with no statistical difference between the preoperative plan and the drilling hole

though a learning process is needed. It is feasible to make drilling with the robotic system assisted by CT scanning.