Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA; Department of Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA.
Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
World Neurosurg. 2021 Jan;145:435-442. doi: 10.1016/j.wneu.2020.10.010. Epub 2020 Oct 12.
Minimally invasive techniques in spine surgery have continued to advance as robotic technology has evolved over several generations. Although traditional techniques for placing pedicle screws are still widespread in practice, newer technology has increased the reliability of accurately placing instrumentation with smaller incisions and subsequent decreased length of stay. Additionally, advancements in planning software have improved the ability to align posterior instrumentation to assist with rod placement on multilevel constructs.
This paper describes the surgical techniques and operative workflow for placing pedicle screws with the latest robotic technology. The robotic platform, registration, surgical planning, and placement of instrumentation are discussed in detail. Advantages of the Mazor X Stealth Edition compared with the previous generation robot include obviating the need for K wires and eliminating the need for a percutaneous pin, as navigation is integrated into the robot.
Our use of this new technology has been encouraging. Using the techniques described in this paper, the first 90 pedicle screws placed with the Mazor X Stealth Edition robot yielded 100% grade A accuracy on the Gertzbein-Robbins scale confirmed on immediate postoperative CT. There were no complications experienced in any case.
In our experience, this robotic technology has the potential to improve patient outcomes and is associated with advanced surgical planning compared with more traditional techniques.
随着机器人技术历经数代发展，脊柱外科微创手术技术也在不断进步。尽管传统的置钉技术在实践中仍广泛应用，但新技术通过更小的切口和缩短住院时间提高了准确置钉器械的可靠性。此外，规划软件的进步提高了使后向器械与多节段结构的棒置放对准的能力。
本文介绍了使用最新机器人技术置钉的手术技术和手术流程。详细讨论了机器人平台、注册、手术规划和器械的置放。与上一代机器人相比，Mazor X Stealth Edition 的优势包括无需使用 K 线和消除经皮销的需要，因为导航已集成到机器人中。
我们对这项新技术的应用感到鼓舞。使用本文所述技术，在 Mazor X Stealth Edition 机器人上首次置放的 90 枚椎弓根螺钉在 Gertzbein-Robbins 分级中达到了 100%的 A 级准确性，在术后即刻 CT 上得到确认。没有任何病例出现并发症。
根据我们的经验，与更传统的技术相比，这种机器人技术有可能改善患者的预后，并具有先进的手术规划。
