RoboImplant — Non-Invasive Adjustment System for a Spinal Distraction Implant

An orthopedic medical-device prototype: a motorized implant that lengthens a spinal distraction rod without surgery, driven by an AVR controller and commanded from an Android tablet over Bluetooth.

v1 — 3D-printed housing, acrylic top plate, brass inserts and drive coil. The clinician holds this against the patient over the implant site; the drive coil couples magnetically through tissue to the implant's internal mechanism.

Built ~2012–2013. Author: Arie Meir. Institutional work — see NOTICE.md.

→ Read the one-page case study (PDF)

Reference only. Not a cleared or approved medical device. Not for clinical use. All sample patient data in this repository is fictitious.

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The problem

Early-onset scoliosis is treated with growing rods implanted along the spine. As the child grows, the rods must be lengthened — historically through a repeat surgery every six months or so, each one carrying anesthetic and infection risk and accumulating scar tissue.

This system lengthens the rod without opening the patient. An external driver unit is placed against the skin over the implant, couples to it, and rotates an internal lead screw. A clinician runs the procedure from a tablet, watching live telemetry, and stops the moment anything looks wrong.

How it works

┌─────────────────┐   Bluetooth SPP    ┌──────────────────┐   analog set-value  ┌─────────────┐
│  Android tablet │◄──────────────────►│   ATmega1284P    │────────────────────►│ maxon ESCON │
│   (clinician)   │  ASCII "at…"/"bt…" │   controller     │   via DS1267 pot    │  36/2 DC    │
└─────────────────┘                    └──────────────────┘                     └──────┬──────┘
                                          ▲   ▲                                        │
                              current /   │   │  rotation count                        ▼
                              voltage ADC │   │  (INT2, rising edge)              DC motor
                                          │   └────────────────────────────────────────┤
                                          └────────────────────────────────────────────┘
                                                                                   ┌────▼────┐
                                                                                   │ implant │
                                                                                   │   rod   │
                                                                                   └─────────┘

The clinician enters a dose — the console works in micrometres, typically 20 µm per increment, with cumulative elongation displayed in millimetres. The controller converts the dose to a target number of motor rotations, spins the motor, counts rotations via an interrupt, and stops when the target is reached.

Available drive torque falls off as the distance between actuator and implant grows, which is why the system carries dedicated calibration routines for both coupling and extension behaviour.

Coupling detection is the safety-critical part. The driver is only actually turning the implant when it is mechanically engaged with it. Engagement shows up as a step change in motor current — an uncoupled motor spins nearly free. The firmware thresholds motor current at COUPLING_THRESHOLD_CURRENT (35 mA) to decide whether it is coupled, and reports every transition to the tablet immediately rather than waiting for the next periodic update. If coupling is lost mid-procedure, rotation counting stops, so a rod that isn't turning is never credited with lengthening it didn't do.

v2 — machined polycarbonate body with the controller electronics integrated alongside the coil assembly, shown open on the bench.

The clinician console

The Android app is what the clinician actually operates. Four screens carry the whole workflow:

Procedure screen. Dosage entry, current elongation, and the coupling indicator — red until motor current crosses 35 mA, which is how the system knows the driver is genuinely engaged with the implant rather than spinning free.	Service terminal. The engineering view: current, voltage, angular velocity, and torque derived from the motor constants, plotted live from the bt* telemetry stream.
Calibration. Runs preprogrammed adjustment sequences to characterise actuator-to-implant distance dependence and extension distance, capturing the no-load and loaded currents that set the coupling threshold.	Adjustment history. Per-patient log of every adjustment, with date and lengthening in millimetres. All sample data shown is fictitious.

The 3D spine in the first screenshot was rendered with min3d from the mesh that has since been removed for provenance reasons — see NOTICE.md.

Repository layout

Path	Contents
firmware/	AVR C firmware for the ATmega1284P controller
android/	Eclipse ADT project — the clinician console app
hardware/	EAGLE 6.1 schematic and board layout (pcb/), plus SolidWorks parts and assembly for the handheld driver (enclosure/)
models/	3D rod models used by the app's visualization
docs/motor/	maxon ESCON 36/2 servo-controller reference (vendor docs)

Serial protocol

Plain ASCII over Bluetooth SPP, line-oriented. Symmetric halves live in firmware/messageDispatcher.c and android/src/edu/ucsf/roboimplantconsole/MessageDispatcher.java.

Tablet → controller — at-prefixed, terminated \n\r:

Command	Effect
atmotoron / atmotoroff	Enable / disable the motor
atspeed <n>	Set speed (0–255, digital-pot step)
atcw / atccw	Set rotation direction
atdosage <n>	Set target lengthening
atstart / atstop	Begin / end a procedure
atreset	Reset counters and statistics
atupdate <0|1>	Toggle periodic telemetry
atupdateinterval <ms>	Set telemetry period (default 2500 ms)
ati / atr / atu / atblink	Info, read, unit, and LED-blink diagnostics

Replies are OK or ERROR.

Controller → tablet — bt-prefixed telemetry:

btcurrent · btcurrentamplitude · btvoltage · btvoltageamplitude · btangularspeed · btmseccounter · btremaining · btterminated · btlostcoupling · btestablishedcoupling

The AVR has no floating-point unit worth using over a serial link, so numeric values are transmitted as integers alongside their scaling factor — each numeric opcode carries <scaledValue> <scalingFactor>, with the factor fixed at 1000 (SCALING_FACTOR in firmware/config.h). The Android side divides on receipt.

State of the code

This is an archival snapshot of a research prototype, published as-is. Being straight about what that means:

• The Android project does not build as shipped. Its Eclipse .classpath and .project reference two dependencies by absolute path on the original developer's Linux machine (/home/ariemeir/…): the min3d 3D engine, linked as a source folder, and achartengine-1.0.0.jar. Neither is included here. See android/README.md.
• Several firmware modules are present but not compiled. The SRC line in firmware/Makefile excludes the SD-card logging subsystem, the AD7715 external ADC, and samples.c. These are experimental paths kept for reference. lcd.c is 8051/Keil code that would not compile against AVR at all.
• Hardware artifacts are in proprietary binary formats. The schematic needs EAGLE 6.x; the enclosure needs SolidWorks. No neutral STEP/STL/PDF exports were made, so neither is viewable directly on GitHub.
• The Android manifest requests several permissions the app does not need (ACCESS_SURFACE_FLINGER, ACCESS_FINE_LOCATION, READ_PHONE_STATE, and ACCESS_BACKGROUND_SERVICE, which is not a real Android permission). Vestigial.
• ConfigDB.java hardcodes the Bluetooth MAC addresses of the original bench hardware.
• The anatomical spine mesh has been removed because its origin could not be verified, so the app's 3D spine view has no geometry to load. Rod geometry is original and retained. See NOTICE.md.

Key sources

Direct links into the code on GitHub:

File	Why it's worth reading
firmware/config.h	System model — every physical parameter, calibration value, and state struct in one place
firmware/main.c	Timer/interrupt setup, procedure state machine, coupling logic
firmware/messageDispatcher.c	Command parser, controller side
firmware/digitalPot.c	DS1267 SPI driver — how motor speed is actually commanded
firmware/adc.c	Current/voltage sensing — the input to coupling detection
AdjustmentActivity.java	The procedure screen the clinician drives
MessageDispatcher.java	Telemetry parser and listener fan-out
BluetoothSerialService.java	Bluetooth SPP connection state machine

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Other projects

• 3D Scanner · turntable photogrammetry rig: iPhone camera server, Python orchestration, IR-driven turntable, Object Capture reconstruction.
• WifeSignal · BLE desk signal light: SwiftUI app, aiohttp and bleak bridge, ESP32-C3 firmware, KiCad board, scripted enclosure.

All published engineering projects are listed at github.com/ariemeir.