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Disclaimer: The ULTRATOPIA platform described in this case study is a research and development project conducted by KU Leuven and Balgrist University Hospital. It is not a cleared or approved medical device and is not currently used in clinical care. Performance figures cited reflect research benchmarks, not validated clinical outcomes.

The Challenge: Precision in a Complex Environment

Pedicle screw placement is among the most technically demanding spinal procedures. The pedicle, a narrow bony channel, sits just millimeters from the spinal cord and major vascular structures. Surgeons must operate under several constraints:
  • Limited visibility in minimally invasive approaches
  • Dependence on radiation-based imaging for guidance
  • Physiological motion, such as breathing and tissue interaction
  • Difficulty maintaining precision in dynamic environments
  • Relying on non-real-time imaging and tactile feedback.
These challenges translate into real potential clinical consequences:
Challenge Consequence
Blind drilling or 2D fluoroscopy Sub-optimally placed pedicle screw
Intraoperative CT / X-ray Significant radiation exposure
Patient breathing & movement Registration errors, screw misplacement
Team ULTRATOPIA set out to investigate whether real-time, radiation-free, submillimeter approaches could be developed for this workflow.

A Unified Workflow: Multi-Robot Coordination with Optical Tracking

The system combines ultrasound imaging, robotic positioning, surgical planning, and drilling functions in a seamless loop, with NDI’s optical tracking supporting the workflow at key moments:

  • Initial surface reconstruction
  • Automatic registration of CT plans to ultrasound images
  • Real-time motion tracking during drilling
  • Dynamic adaptation based on optical marker feedback


The ULTRATOPIA platform is designed to explore workflows that reduce reliance on intraoperative fluoroscopy. The system is engineered to enable minimally invasive workflows without compromising accuracy, aiming for the following clinical benchmarks:

  • Drilling Success Rate: ≥90%
  • Linear Precision: ≃ 1 mm
  • Angular Accuracy: ≃ 1°


This synergy between advanced robotics and high-precision optical tracking sets a new standard for safety and reliability in spinal interventions.

Diagram 1: Workflow Architecture of Team Ultratopia’s Robotic Spine Surgery System

Disclaimers

Testimonials in this case study reflect the speakers’ experience with the ULTRATOPIA research platform incorporating NDI tracking components. Outcomes are determined by the research system design, integration choices, and clinical protocol, not by NDI components in isolation

The Polaris Vega® VT is a general metrology product and is not approved, cleared, or developed for medical use. Suitability of this product in a particular application must be determined by the OEM customer or the end user. Clinical applications shown are representative OEM integrations completed by Team ULTRATOPIA. NDI Passive Spheres are FDA-regulated medical devices.