Computer‐assisted Orthopaedic Surgery

Hernandez, David A.; Garimella, Roja; Eltorai, Adam E.M.; Daniels, Alan H.

doi:10.1111/os.12323

Cited by 72 publications

(52 citation statements)

References 45 publications

(54 reference statements)

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“…Once installed the application in the computer, the surgical support with image fusion is possible. In recent years, clinical applications of computer-assisted surgery have been widely reported in orthopedic surgery [17–20]. Computer-assisted surgery for artificial joints and in spine surgery is known to be useful and is becoming established [17–19].…”

Section: Discussionmentioning

confidence: 99%

Utility of an image fusion system for 3D preoperative planning and fluoroscopy in the osteosynthesis of distal radius fractures

Yoshii

Totoki

Sashida³

et al. 2019

J Orthop Surg Res

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BackgroundRecently, computerized virtual surgery planning has been increasingly applied in various orthopedic procedures. In this study, we developed an image fusion system for 3D preoperative planning and fluoroscopy for the osteosynthesis. To assess the utility of image fusion system, we evaluated the reproducibility of preoperative planning in the osteosynthesis of distal radius fractures with using the image fusion system, and compared with the reproducibility of the patients without using the image fusion system.MethodsForty-two wrists of 42 distal radius fracture patients who underwent osteosynthesis using volar locking plates were evaluated. The patients were divided into two groups. Image fusion group utilized three-dimensional (3D) preoperative planning and image fusion system. Control group utilized only 3D preoperative planning. In both groups, 3D preoperative planning was performed in order to determine reduction, placement, and choice of implants. In the image fusion group, the outline of planned image was displayed on a monitor overlapping with fluoroscopy images during surgery. Reductions were evaluated by volar tilt and radial inclination of 3D images. Plate positions were evaluated with distance to joint surface, plate center axis position, and inclination relative to the radius axis. Screw choices were recorded for the plan and actual choices for each screw hole. Differences in the parameters between pre- and postoperative images were evaluated. Differences in reduction shape, plate positions, and screw choices were compared between groups.ResultsThe differences in the distance from plate to joint surface were significantly smaller in the image fusion group compared to the control group (P < 0.01). The differences in the distal screw choices were significantly smaller in the image fusion group compared to the control group (P < 0.01).ConclusionsThe image fusion system was useful to reproduce the planned plate position and distal screw choices in the osteosynthesis of distal radius fractures.Trial registrationClinicalTrials.gov, NCT03764501

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Section: Discussionmentioning

confidence: 99%

Utility of an image fusion system for 3D preoperative planning and fluoroscopy in the osteosynthesis of distal radius fractures

Yoshii

Totoki

Sashida³

et al. 2019

J Orthop Surg Res

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“…Many robot- and computer-assisted surgical techniques have been described [11, 12]. We used the TINAVI robot-assisted surgery system to implant two transsacral–transiliac screws, thereby decreasing the surgery and fluoroscopy times.…”

Section: Discussionmentioning

confidence: 99%

Using the Starr Frame and Da Vinci surgery system for pelvic fracture and sacral nerve injury

Zhang

et al. 2019

J Orthop Surg Res

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BackgroundSacral fracture and sacral nerve injury remain problems in orthopedics, especially in a sacral fracture combined with an anterior sacral nerve injury. Treating a sacral nerve injury with open reduction neurolysis or more conservative treatment cannot meet the clinical needs. Open reduction sacral nerve neurolysis will increase the number of severe, life-threatening injuries, regardless of whether the anterior or posterior approach is used. In recent years, computer- and robot-assisted orthopedic surgery has emerged as part of many clinical treatments.MethodsFor an unstable pelvic fracture with an anterior sacral nerve injury, we established a comprehensive and integrated solution. To achieve closed reduction, minimally invasive fixation, and minimally invasive anterior sacral nerve neurolysis, the Starr Frame, navigation robot, and Da Vinci robot were jointly applied.ResultsThe Starr Frame is very helpful for closed reduction percutaneous fixation in complex pelvic fractures. In this study, a minimally invasive fixation technique for the navigation robot in the pelvic fracture was explored. Although the patient had delayed anterior sacral nerve compression pain after surgery, we developed an approach and surgical method using the Da Vinci robot to explore the sacral nerve by celiac decompression. The patient was relieved of nerve pressure and pain.ConclusionsThis treatment method could be an alternative treatment for pelvic fractures and sacral nerve injury. The application of this treatment is a safe and feasible option that can be employed to manage early and late nerve repair with sacral fractures when open surgery or conservative treatment is unsuitable.

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“…Indeed, RAN has been proved to be a safe technique for spinal decompression, oncologic spine surgery, and MISS including cage positioning. 9,[15][16][17][18] AR is a new promising technology consisting in dedicated software and hardware capable of showing images directly onto special lenses or monitors, hence allowing the surgeon to visualize key information about the patient and the procedure in real time.…”

Section: Introductionmentioning

confidence: 99%

Robotic Spine Surgery and Augmented Reality Systems: A State of the Art

et al. 2020

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Instrumented spine procedures have been performed for decades to treat a wide variety of spinal disorders. New technologies have been employed to obtain a high degree of precision, to minimize risks of damage to neurovascular structures and to diminish harmful exposure of patients and the operative team to ionizing radiations. Robotic spine surgery comprehends 3 major categories: telesurgical robotic systems, robotic-assisted navigation (RAN) and virtual augmented reality (AR) systems, including AR and virtual reality. Telesurgical systems encompass devices that can be operated from a remote command station, allowing to perform surgery via instruments being manipulated by the robot. On the other hand, RAN technologies are characterized by the robotic guidance of surgeon-operated instruments based on real-time imaging. Virtual AR systems are able to show images directly on special visors and screens allowing the surgeon to visualize information about the patient and the procedure (i.e., anatomical landmarks, screw direction and inclination, distance from neurological and vascular structures etc.). The aim of this review is to focus on the current state of the art of robotics and AR in spine surgery and perspectives of these emerging technologies that hold promises for future applications.

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Computer‐assisted Orthopaedic Surgery

Cited by 72 publications

References 45 publications

Utility of an image fusion system for 3D preoperative planning and fluoroscopy in the osteosynthesis of distal radius fractures

Utility of an image fusion system for 3D preoperative planning and fluoroscopy in the osteosynthesis of distal radius fractures

Using the Starr Frame and Da Vinci surgery system for pelvic fracture and sacral nerve injury

Robotic Spine Surgery and Augmented Reality Systems: A State of the Art

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