Robotic ultrasound-guided facet joint insertion

Javier Esteban, Walter Simson, Sebastian Requena Witzig, Anna Rienmüller, Salvatore Virga, Benjamin Frisch, Oliver Zettinig, Drazen Sakara, Yu Mi Ryang, Nassir Navab, Christoph Hennersperger

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


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.

Original languageEnglish
Pages (from-to)895-904
Number of pages10
JournalInternational Journal of Computer Assisted Radiology and Surgery
Issue number6
StatePublished - 1 Jun 2018


  • Facet joint infiltration
  • Needle guidance
  • Neurosurgery
  • Robotic ultrasound
  • Surgical planning


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