Computer-Assisted Surgical Navigation for Primary and Metastatic Bone Malignancy of the Pelvis: Current Evidence and Future Directions

Christ, Alexander B.; Hansen, David V.; Healey, John H.; Fabbri, Nicola

doi:10.1177/15563316211028137

Cited by 7 publications

(4 citation statements)

References 53 publications

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“…Various robot-assisted orthopedic surgery (RAOS) is currently available on the market, each addressing specific surgeries and characterized by a series of special features that may involve different requirements or modus operandi. RAOS has been utilized in a variety of orthopedic operations, including fracture fixation for traumatic surgery, total hip and total knee arthroplasty [ 18 , 19 ], spine surgery [ 20 , 21 ], bone tumor surgery [ 22 ], arthroscopy [ 23 ], and fracture fixation for traumatic surgery [ 24 ]. However, robotic in fracture reduction remains at an infant stage.…”

Section: Discussionmentioning

confidence: 99%

Design and evaluation of an intelligent reduction robot system for the minimally invasive reduction in pelvic fractures

Zhao

Wang

et al. 2022

J Orthop Surg Res

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Introduction Pelvic fracture is a severe high-energy injury with the highest disability and mortality of all fractures. Traditional open surgery is associated with extensive soft tissue damages and many complications. Minimally invasive surgery potentially mitigates the risks of open surgical procedures and is becoming a new standard for pelvic fracture treatment. The accurate reduction has been recognized as the cornerstone of minimally invasive surgery for pelvic fracture. At present, the closed reduction in pelvic fractures is limited by the current sub-optimal 2D intra-operative imaging (fluoroscopy) and by the high forces of soft tissue involved in the fragment manipulation, which might result in fracture malreduction. To overcome these shortcomings and facilitate pelvic fracture reduction, we developed an intelligent robot-assisted fracture reduction (RAFR) system for pelvic fracture. Methods The presented method is divided into three parts. The first part is the preparation of 20 pelvic fracture models. In the second part, we offer an automatic reduction algorithm of our robotic reduction system, including Intraoperative real-time 3D navigation, reduction path planning, control and fixation, and robotic-assisted fracture reduction. In the third part, image registration accuracy and fracture reduction accuracy were calculated and analyzed. Results All 20 pelvic fracture bone models were reduced by the RAFR system; the mean registration error E1 of the 20 models was 1.29 ± 0.57 mm. The mean reduction error E2 of the 20 models was 2.72 ± 0.82 mm. The global error analysis of registration and reduction results showed that higher errors are mainly located at the edge of the pelvis, such as the iliac wing. Conclusion The accuracy of image registration error and fracture reduction error in our study was excellent, which could reach the requirements of the clinical environment. Our study demonstrated the precision and effectiveness of our RAFR system and its applicability and usability in clinical practice, thus paving the way toward robot minimally invasive pelvic fracture surgeries.

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Section: Discussionmentioning

confidence: 99%

Design and evaluation of an intelligent reduction robot system for the minimally invasive reduction in pelvic fractures

Zhao

Wang

et al. 2022

J Orthop Surg Res

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“…biodro, łono), o tyle guzy tylnego odcinka kości biodrowej mogą stanowić zagrożenie dla odcinka lędźwiowo-krzyżowego, zwiększając ryzyko stenozy rdzenia. Guzy panewki mogą poważnie upośledzać funkcje stawu biodrowego i nośności kończyny dolnej [32]. Zmiany nowotworowe zlokalizowane w talerzu kości biodrowej, przednim łuku miednicy czy stawie krzyżowo-biodrowym skutecznie mogą być leczone radioterapią, ponieważ jest małe ryzyko uszkodzeń mechanicznych.…”

Section: Przerzuty Do Miednicyunclassified

“…Nową metodą leczenia nowotworów kości miednicy jest nawigacja wspomagana komputerowo i chirurgia robotyczna. Chociaż dopiero się rozwija, wydaje się optymalna, biorąc pod uwagę anatomiczną złożoność kości miednicy, problemy związane z operowaniem guzów znajdujących się w tym obszarze, bliskość ważnych struktur [32]. U większości pacjentów z zaawansowanym rakiem z przerzutami do kości całkowita resekcja lub rozszerzone łyżeczkowanie przerzutu z rekonstrukcją często nie jest możliwe ze względu na ich zły stan ogólny i inne towarzyszące przerzuty.…”

Section: Przerzuty Do Miednicyunclassified

Bone metastases – aetiopathogenesis and treatment possibilities. Review of literature

Bazaliński,

Florek,

Szelast

et al. 2023

pcia

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Przerzuty do kości generują dodatkowe obciążenia w systemie ochrony zdrowia z racji zalecanej terapii w zaawansowanej fazie choroby. Ból, patologiczne złamania, niestabilność szkieletu osiowego i neurologiczne dysfunkcje to najczęstsze konsekwencje zewnątrzoponowych przerzutów do kręgosłupa i jego kompresji. Analizując piśmiennictwo, dokonano przeglądu dostępnej w bazie PubMed literatury z lat 2015-2023. W wyszukiwaniu duplikatów zastosowano słowa kluczowe: "spinal metastases". Zidentyfikowano 3069 prac, z których usunięto 2567 niezwiązanych bezpośrednio z zaplanowaną analizą. Do analizy wybrano 36 prac (w tym przeglądy i metaanalizy) podejmujących problematykę analizowanych zagadnień. Przerzuty nowotworów złośliwych dotyczą najczęściej szkieletu osiowego, powodując kompresję rdzenia i objawy neurologiczne z tym związane. Odbarczenie chirurgiczne zwiększa funkcjonalność i poprawia jakość życia chorych.Słowa kluczowe: leczenie, problemy zdrowotne, przerzuty do kręgosłupa. WstępWzrost zachorowań na nowotwory złośliwe jest bardzo zauważalny. Możliwości diagnozowania i leczenia w ostatnim czasie były ograniczone, co stanowi narastający problem zdrowotny, społeczny i ekonomiczny.Według szacunków GLOBOCAN tylko w 2020 r. na całym świecie zdiagnozowano około 19,3 mln nowych przypadków raka, a prawie 10 mln osób zmarło z powodu nowotworu [1]. W 2020 r. na diagnostykę i leczenie raka negatywnie wpłynęła pandemia COVID-19. Ograniczone

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“…Each addresses specific surgeries and is characterized by special features that may involve different requirements or modus operandi. RAOS has been utilized in a variety of orthopedic operations, including fracture fixation for traumatic surgery, total hip and total knee arthroplasty [ 14 , 15 ], spine surgery [ 16 , 17 ], bone tumor surgery [ 18 ], arthroscopy [ 19 ], and fracture fixation for traumatic surgery [ 20 ]. However, few RAOS focus on screw implantation in pelvic fractures.…”

Section: Introductionmentioning

confidence: 99%

TiRobot‑assisted versus conventional fluoroscopy-assisted percutaneous sacroiliac screw fixation for pelvic ring injuries: a meta‑analysis

et al. 2022

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Background The TiRobot is the only robot that has been reported in the literature for posterior pelvic injuries. We aim to compare TiRobot-assisted pelvic screw fixation with the conventional fluoroscopy-assisted percutaneous sacroiliac screw fixation. Methods We conducted a meta-analysis to identify studies involving TiRobot‑assisted versus conventional percutaneous sacroiliac screw fixation for pelvic ring injuries in electronic databases, including Web of Science, Embase, PubMed, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CBM, CNKI, VIP, and WanFang database, up to April 2022. The following keywords were used: “TiRobot,” “robot,” “robotic,” “pelvic fracture,” “screw fixation,” “percutaneous,” and “pelvic ring injury.” Pooled effects of this meta-analysis were calculated using STATA SE version 15.0. Results Compared with conventional fluoroscopy-assisted percutaneous sacroiliac screw fixation, TiRobot will result in less radiation exposure time of screw implantation (P = 0.000), less frequency of intraoperative fluoroscopy (P = 0.000), fewer guide wire attempts (P = 0.000), less intraoperative blood loss (P = 0.005), better screw accuracy (P = 0.011), better Majeed score (P = 0.031), and higher overall excellent and good rates of Majeed score (P = 0.018). However, there were no significant differences in terms of operative time (P = 0.055), fracture healing time (P = 0.365), and overall excellent and good rate of reduction accuracy (P = 0.426) between the two groups. Conclusion TiRobot-assisted fixation has less intraoperative fluoroscopy and intraoperative blood loss, superior screw accuracy, and Majeed score compared with conventional percutaneous sacroiliac screw fixation. TiRobot has no significant effect on operative time, fracture healing time, and reduction accuracy. Given the relevant possible biases in our meta-analysis, we required more adequately powered and better-designed RCT studies with long-term follow-up to reach a firmer conclusion.

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Computer-Assisted Surgical Navigation for Primary and Metastatic Bone Malignancy of the Pelvis: Current Evidence and Future Directions

Cited by 7 publications

References 53 publications

Design and evaluation of an intelligent reduction robot system for the minimally invasive reduction in pelvic fractures

Design and evaluation of an intelligent reduction robot system for the minimally invasive reduction in pelvic fractures

Bone metastases – aetiopathogenesis and treatment possibilities. Review of literature

TiRobot‑assisted versus conventional fluoroscopy-assisted percutaneous sacroiliac screw fixation for pelvic ring injuries: a meta‑analysis

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