Division of Neurosurgery, Department of Surgery, Cathay General Hospital, Taipei City, 106, Taiwan.
Division of Neurosurgery, Department of Surgery, Sijhih Cathay General Hospital, New Taipei City, 221, Taiwan.
Int J Comput Assist Radiol Surg. 2022 Dec;17(12):2281-2290. doi: 10.1007/s11548-022-02751-8. Epub 2022 Sep 13.
Pedicle screws placement is very common procedure in spinal surgery. Robotic assisted surgery has been widely used in this operation. We assessed the accuracy of thoracolumbar spine trans-pedicle screws (TPS) implantation utilizing a noval robotic navigation system (i-Navi robotic navigation system) by planning with two-dimensional (2-D) C-arm.
This study was approved by the Institutional Review Board of the Cathay General Hospital on June 21, 2018 (IRB number: CGH-P 106,092), and written informed consents were obtained from all the patients. There are 18 patients were enrolled in the study. All the patients received the posterior fusion with TPS insertion under the assistant of our robotic navigation system.
There are 18 patients were included into our study, there are 2 patients were quitted from the study due to the equipment setup was not complete. Other 16 patients completed the entire procedure successfully. There is total 88 pedicle screws were inserted through i-Navi robotic navigation system. There are 79 of 88 screws were graded A, and 9 screws were graded B; no screws were graded C or D. No vascular or nerve injuries were noted after the operations.
We present our i-Navi robotic navigation system, by planning with 2-D C-arm imaging and pre-operative CT scans. According to the results of study, we think it can provide a reliable and easy tool to perform the TPS in thoracic lumbar spine surgery.
经皮椎弓根螺钉（TPS）置入术在脊柱外科中非常常见。机器人辅助手术已广泛应用于该操作中。我们通过二维（2-D）C 臂影像规划评估了利用新型机器人导航系统（i-Navi 机器人导航系统）进行胸腰椎 TPS 植入的准确性。
本研究于 2018 年 6 月 21 日获得国泰综合医院机构审查委员会的批准（IRB 编号：CGH-P 106,092），并获得所有患者的书面知情同意。共有 18 名患者纳入本研究。所有患者均在我们的机器人导航系统辅助下接受后路融合及 TPS 置入。
共有 18 名患者纳入本研究，其中 2 名患者因设备设置不完整而退出研究。其余 16 名患者成功完成了整个手术过程。总共使用 i-Navi 机器人导航系统置入 88 枚椎弓根螺钉。其中 79 枚螺钉分级为 A，9 枚螺钉分级为 B；无 C 级或 D 级螺钉。术后无血管或神经损伤。
我们提出了 i-Navi 机器人导航系统，该系统通过 2-D C 臂影像和术前 CT 扫描进行规划。根据研究结果，我们认为它可以为胸腰椎脊柱手术中 TPS 的置入提供一种可靠且简便的工具。
