Department of Neurology and Clinical Neurophysiology, Fornaca Clinic, Corso Vittorio Emanuele II, 91 10128, Turin, TO, Italy.
Musculoskeletal Education and Research Center (MERC), A Division of Globus Medical, Inc, 2560 General Armistead Avenue, Audubon, PA, 19403, USA.
BMC Surg. 2022 Nov 10;22(1):385. doi: 10.1186/s12893-022-01838-y.
Traditional minimally invasive fluoroscopy-based techniques for pedicle screw placement utilize guidance, which may require fluoroscopic shots. Computerized tomography (CT) navigation results in more accurate screw placement. Robotic surgery seeks to establish access and trajectory with greater accuracy.
This study evaluated the screw placement accuracy of a robotic platform.
Demographic data, preoperative/postoperative CT scans, and complication rates of 127 patients who underwent lumbosacral pedicle screw placement with minimally invasive navigated robotic guidance using preoperative CT were analyzed.
On the GRS scale, 97.9% (711/726) of screws were graded A or B, 1.7% (12/726) of screws graded C, 0.4% (3/726) of screws graded D, and 0% graded E. Average offset from preoperative plan to final screw placement was 1.9 ± 1.5 mm from tip, 2.2 ± 1.4 mm from tail and 2.9 ± 2.3° of angulation.
Robotic-assisted surgery utilizing preoperative CT workflow with intraoperative fluoroscopy-based registration improves pedicle screw placement accuracy within a patient's pedicles.
传统的经皮微创透视引导技术用于椎弓根螺钉放置时需要使用透视引导，这可能需要进行多次透视拍摄。计算机断层扫描 (CT) 导航可实现更精确的螺钉放置。机器人手术旨在更精确地建立通道和轨迹。
本研究评估了一种机器人平台的螺钉放置准确性。
分析了 127 例接受微创导航机器人辅助下经皮椎弓根螺钉置入术的患者的人口统计学数据、术前/术后 CT 扫描和并发症发生率，这些患者均采用术前 CT 进行了手术规划。
在 GRS 分级中，97.9%（711/726）的螺钉为 A 或 B 级，1.7%（12/726）的螺钉为 C 级，0.4%（3/726）的螺钉为 D 级，0%的螺钉为 E 级。从术前计划到最终螺钉放置的平均偏移量为尖端处 1.9 ± 1.5 毫米，尾部处 2.2 ± 1.4 毫米，成角处 2.9 ± 2.3°。
使用术前 CT 工作流程和术中基于透视的注册的机器人辅助手术可提高患者椎弓根内的椎弓根螺钉放置准确性。
