Autonomous Frameless Spine Registration and Robot‐Assisted Surgery

ABSTRACT Objective Accurate and efficient patient registration remains a critical challenge in robot‐assisted spine surgery, where current methods often rely on invasive bone‐mounted frames or intraoperative imaging that increases radiation exposure and procedural complexity. Method This article presents a novel non‐invasive and contactless spine registration system that integrates a skin‐affixed, radiopaque floating‐point mask with a robot‐mounted monocular camera. The system was evaluated in phantom experiments to quantify registration accuracy and pedicle‐screw‐axis targeting performance. The system autonomously establishes the pose of the pedicle‐screw axis relative to the mask (patient) and surgical robot coordinate systems. A monocular camera mounted on the robot captures live images of the mask in the operating theater, enabling real‐time visual recognition and tracking of the mask's elements. Advanced segmentation and pose estimation algorithms compute the spatial relationship between the vertebrae and the mask, accounting for accurate ang