  Towards reducing the failure rate of spinal fixation surgical procedures in
osteoporotic patients, we propose a unique biomechanically-aware framework for
the design of a novel concentric tube steerable drilling robot (CT-SDR). The
proposed framework leverages a patient-specific finite element (FE)
biomechanics model developed based on Quantitative Computed Tomography (QCT)
scans of the patient's vertebra to calculate a biomechanically-optimal and
feasible drilling and implantation trajectory. The FE output is then used as a
design requirement for the design and evaluation of the CT-SDR. Providing a
balance between the necessary flexibility to create curved optimal trajectories
obtained by the FE module with the required strength to not buckle during
drilling through a hard simulated bone material, we showed that the CT-SDR can
reliably recreate this drilling trajectory with errors between 1.7-2.2%
