International Journal of Medical Robotics and Computer Assisted Surgery · 2020 · 11 citations · 25 references
MedicineOrthopedic SurgerySurgeryMedical RoboticsOrthopedicsSpine SurgeryImage-guided RoboticsIntraoperative NavigationMinimally Invasive Spine SurgeryRobot-assisted SurgerySurgical RoboticsAccuracyFixation OffsetImage-guided Spine SurgeryNavigation-guided Spine SurgeryPorcine ModelsRegistration-based NavigationRobotic-assisted Spinal SurgeryRobotic-assisted Spine Surgery
BACKGROUND: We assessed pedicle screw accuracy utilizing a novel navigation-based spine surgery robotic system by comparing planned pathways with placed pathways in a porcine model. METHODS: We placed three mini screws per vertebra for accuracy evaluation and used a reference frame for registration in four pigs (46 screws in 23 vertebrae). We planned screw paths and performed screw insertion under robot guidance. Using C-arm and CT images, we evaluated accuracy by comparing the 3D distance of the placed screw head/tip from the planned screw head/tip and 3D angular offset. RESULTS: Mean registration deviation between the preoperative 3D space (C-arm) and postoperative CT scans was 0.475 ± 0.119 mm. The average offset from preoperative plan to final placement was 4.8 ± 2.0 mm from the head (tail), 5.3 ± 2.3 mm from the tip and 3.9 ± 2.4 degrees of angulation. CONCLUSIONS: Our spine surgery robot showed good accuracy in executing an intended planned trajectory and screw path. This faster and more accurate robotic system will be applied in future studies, first in cadavers and subsequently in the clinical field.
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Complications Associated with Pedicle Screws*
John E. Lonstein, Francis Denis, Joseph H. Perra et al. · Journal of Bone and Joint Surgery · 1999 · 539 citations
Dennis P. Devito, Leon Kaplan, Rupert Dietl et al. · Spine · 2010 · 410 citations