Kirchner Gregory J, Kim Andrew H, Kwart Ariel H, Weddle John B, Bible Jesse E
Department of Orthopaedics & Rehabilitation, 12311Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.
Global Spine J. 2023 Apr;13(3):855-860. doi: 10.1177/21925682221126116. Epub 2022 Sep 8.
Cross-Sectional Analysis.
To summarize medical device reports (MDRs) between August 1, 2017 and November 30, 2021 relating to robot-assisted spine systems within the Manufacturer and User Facility Device Experience (MAUDE) database maintained by The Food and Drug Administration (FDA).
The MAUDE database was abstract for all MDRs relating to each FDA-approved robot-assisted spine system. Event descriptions were reviewed and characterized into specific event types. Outcome measures include specific robot-assisted spine systems and reported events as detailed by the MDRs. All data is de-identified and in compliance with the Health Insurance Portability and Accountability Act (HIPAA).
There were 263 MDRs consisting of 265 reported events. Misplaced screws represented 61.5% (n = 163) of reported events. Of the 163 reported events, 57.1% (n = 93) described greater than 1 misplaced screw, 15.3% (n = 25) required return to the operating room, 8.6% (n = 14) resulted in neurologic injury, 4.3% (n = 7) resulted in dural tear, and 1.2% (n = 2) resulted in hemorrhage or bleeding. Reported events other than misplaced screws included system imprecision detected prior to screw placement (58/265, 21.9%), mechanical failure (23/265, 8.7%), and software failure (18/265, 6.8%).
As more robot-assisted spine systems gain FDA approval and the adoption of these systems continues to grow, documenting and understanding the range of reported events associated with each "tool" is imperative to balancing patient safety with surgical innovation. This study of the MAUDE database provides a unique summary of reported events associated with robot-assisted spine systems that is not directly linked to a research setting.
横断面分析。
总结2017年8月1日至2021年11月30日期间,美国食品药品监督管理局(FDA)维护的制造商和用户设施设备经验(MAUDE)数据库中与机器人辅助脊柱系统相关的医疗器械报告(MDR)。
对MAUDE数据库中与每个FDA批准的机器人辅助脊柱系统相关的所有MDR进行摘要。对事件描述进行审查,并归类为特定的事件类型。结果指标包括特定的机器人辅助脊柱系统以及MDR详细报告的事件。所有数据均经过去识别处理,并符合《健康保险流通与责任法案》(HIPAA)。
共有263份MDR,包含265起报告事件。螺钉放置错误占报告事件的61.5%(n = 163)。在这163起报告事件中,57.1%(n = 93)描述有多于1枚螺钉放置错误,15.3%(n = 25)需要返回手术室,8.6%(n = 14)导致神经损伤,4.3%(n = 7)导致硬脑膜撕裂,1.2%(n = 2)导致出血。除螺钉放置错误外,报告的事件还包括在螺钉放置前检测到系统不精确(58/265,21.9%)、机械故障(23/265,8.7%)和软件故障(18/265,6.8%)。
随着越来越多的机器人辅助脊柱系统获得FDA批准,且这些系统的应用持续增加,记录和了解与每个“工具”相关的报告事件范围对于平衡患者安全与手术创新至关重要。这项对MAUDE数据库的研究提供了与机器人辅助脊柱系统相关的报告事件的独特总结,且该总结与研究环境没有直接关联。