Department of Neurosurgery, La Timone University Hospital, Assistance Publique-Hôpitaux de Marseille, Marseille, France; Spine Unit, La Timone University Hospital, Assistance Publique-Hôpitaux de Marseille, Marseille, France.
Department of Neurosurgery, La Timone University Hospital, Assistance Publique-Hôpitaux de Marseille, Marseille, France; Spine Unit, La Timone University Hospital, Assistance Publique-Hôpitaux de Marseille, Marseille, France.
World Neurosurg. 2021 Jun;150:e777-e782. doi: 10.1016/j.wneu.2021.03.150. Epub 2021 Apr 5.
Accurate screw placement remains challenging, especially in the cervical spine. We present our first experience of minimally invasive posterior cervical and upper thoracic pedicle screw fixation in the lower cervical spine.
This study reports a case series of patients, undergoing posterior percutaneous pedicle fixation using Cirq robotic assistance coupled to the Airo intraoperative computed tomography scan and Brainlab navigation system. Routine computed tomography was performed on postoperative day 2 to evaluate pedicle screw placement. The effective dose was calculated.
Between February 2020 and December 2020, 7 patients (4 men and 3 women) were treated. The mean age was 58.8 years (range, 29-75 years). Fixation was performed with a cannulated PASS OCT Reconstruction System (Medicrea). Overall, 28 screws were placed within cervical and upper thoracic pedicles. According to the Neo and Heary classification, 85.7% were rated as acceptable and 14.3% as poor. The radiation dose received by the patient was 9.1 mSv (range, 7.7-10.6 mSv). The radiation dose received by the surgical staff was 0 mSv. The postoperative course was excellent.
Posterior miniopen fixation using Cirq robotic assistance coupled with an intraoperative computed tomography navigation system is a major innovation that can improve the accuracy of pedicle screw positioning, with acceptable patient radiation and reduced surgical team exposure.
准确放置螺钉仍然具有挑战性，尤其是在颈椎。我们报告了使用 Cirq 机器人辅助与 Airo 术中 CT 扫描和 Brainlab 导航系统结合进行经皮颈椎后路和上胸椎椎弓根螺钉固定在下颈椎的首次经验。
本研究报告了一组接受后路经皮椎弓根固定的患者病例，使用 Cirq 机器人辅助与 Airo 术中 CT 扫描和 Brainlab 导航系统结合。术后第 2 天常规行 CT 检查以评估椎弓根螺钉的位置。计算有效剂量。
2020 年 2 月至 2020 年 12 月，7 例患者（4 名男性和 3 名女性）接受了治疗。平均年龄为 58.8 岁（范围，29-75 岁）。使用可扩张 PASS OCT 重建系统（Medicrea）进行固定。总共在颈椎和上胸椎椎弓根内放置了 28 个螺钉。根据 Neo 和 Heary 分类，85.7%的螺钉被评为可接受，14.3%的螺钉被评为较差。患者接受的辐射剂量为 9.1 mSv（范围，7.7-10.6 mSv）。手术人员接受的辐射剂量为 0 mSv。术后过程良好。
使用 Cirq 机器人辅助与术中 CT 导航系统结合的后路微创固定是一项重大创新，可以提高椎弓根螺钉定位的准确性，同时可接受的患者辐射剂量和减少手术团队的暴露。
