发表机构
King’s College London; University of Thessaly; Queen Mary University London; Institute of Psychiatry, Psychology & Neuroscience, King’s College London（伦敦国王学院; 色萨利大学; 伦敦玛丽女王大学; 伦敦国王学院精神病学、心理学与神经科学研究所）
机构由 AI 辅助整理，请以论文原文为准。AI 中文总结
研究脊髓蛛网膜下腔安全导航问题，提出直径2毫米的外翻生长机器人平台，经多种验证，该平台能实现摩擦最小化伸展和转向，为鞘内干预建立基础，后续还需更大队列和生理条件下的进一步验证。
AI 中文摘要
脊髓蛛网膜下腔的安全导航受其狭窄、顺应性和脆弱解剖结构的限制。传统导管和连续体机器人依靠近端推动，在组织与设备界面产生摩擦和剪切，限制远端可控性并增加神经损伤风险。本文提出一个直径2毫米的外翻生长机器人平台，通过计算建模、模型实验和完整人体尸体研究验证，能在人体脊髓蛛网膜下腔内实现摩擦最小化的伸展和转向。该机器人集成微型内窥镜用于实时鞘内可视化，通过压力驱动尖端外翻前进，将运动定位到远端尖端，同时最小化展开主体的平移滑动。模型实验表明，与基于推送的插入相比，平均相互作用力降低65.2%，峰值相互作用力降低48.0%。基于物理的建模显示，外翻生长重新分配了组织负荷，相对于传统插入减少了局部应力集中和界面剪切。在完整人体尸体中，该系统通过荧光镜和内窥镜可视化实现了150毫米的可控鞘内伸展，从标准腰椎入口点跨越多个椎体水平。术后椎板切除术和硬脊膜切开术显示硬脑膜或周围神经结构无明显宏观破坏。这些结果首次在完整人体脊髓解剖结构中对基于外翻的机器人导航进行了机械表征和多模态验证，为未来鞘内干预建立了定量和程序基础。在临床转化之前，需要在更大的解剖队列和生理条件下进行进一步验证。
英文摘要
Safe navigation within the spinal subarachnoid space is constrained by its narrow, compliant, and delicate anatomy. Conventional catheters and continuum robots rely on proximal pushing, generating friction and shear along the tissue device interface that limit distal controllability and increase the risk of neural injury. Here, we present a 2 mm diameter eversion-growing robotic platform that enables friction minimised extension and steering within the human spinal subarachnoid space, validated through computational modelling, phantom experiments, and intact human cadaver studies. The robot integrates a miniature endoscope for real time intrathecal visualisation and advances by pressure driven tip eversion, localising motion to the distal tip while minimising translational sliding of the deployed body. Phantom experiments demonstrated reductions of 65.2% in mean interaction force and 48.0% in peak interaction force compared with matched push-based insertion. Physics based modelling showed that eversion based growth redistributed tissue loading, reducing local stress concentrations and interfacial shear relative to conventional insertion. In an intact human cadaver, the system achieved 150 mm of controlled intrathecal extension with concurrent fluoroscopic and endoscopic visualisation, providing access across multiple vertebral levels from a standard lumbar entry point. Postprocedural laminectomy and durotomy revealed no observable macroscopic disruption of the dura mater or surrounding neural structures. These results provide the first mechanically characterised and multimodally validated demonstration of eversion-based robotic navigation in intact human spinal anatomy, establishing a quantitative and procedural foundation for future intrathecal interventions. Further validation in larger anatomical cohorts and under physiological conditions will be required before clinical translation.
