Effectiveness of Tirobot-assisted vertebroplasty in treating thoracolumbar osteoporotic compression fracture

Wang, Boyao; Cao, Jiang; Chang, Jie; Yin, Guoyong; Cai, Weihua; Li, Qingqing; Huang, Zhenfei; Yu, Li; Cao, Xiaojian

doi:10.1186/s13018-021-02211-0

Cited by 26 publications

(19 citation statements)

References 26 publications

(6 reference statements)

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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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“…Xu HT et al proposed a navigation system that supported correct puncturing in PVP working with the C-arm tracker, patient tracker, and puncture needle tracker adjusting the spinal image information [ 28 ]. Wang B et al proposed a method for guiding punctures in Balloon kyphoplasty (BKP) using a system consisting of a reference tracker, a robotic arm, and a monitor [ 29 ]. As a unique attempt, the 3D-printer was used to create a puncture guide adapter for PVP, which had two sockets for inserting needles [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Accuracy of vertebral puncture in percutaneous vertebroplasty

et al. 2021

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Purpose To clarify the accuracy of vertebral puncture of the vertebral tertile area needling (VETERAN) method puncturing the pedicle superimposed on one-third of the width between the lateral vertebral line to the contralateral medial lamina line compared with Cathelin-needle-assisted puncture (CAP) method puncturing using the Cathelin needle as a guide in percutaneous vertebroplasty. Materials and methods 449 punctures by CAP method and 125 punctures by VETERAN method were enrolled. We compared the puncture accuracy of both methods. We estimated a vertebral estimated tilting ratio (VET-ratio) defined as ratio of the distance between the lateral vertebral line and the contralateral medial laminal line to the distance between the vertebral lateral line and the puncture point measured by computed tomography. We also estimated the procedural items and clinical outcomes. Results VETERAN method with 100% of punctures within safe zone (cortical breaches within 2 mm) had significantly higher accuracy than CAP method with 97.8% (p < 0.01) for the 2 mm incremental evaluation. No cases with a VET-ratio of 36% or less had cortical breaches. VETERAN method had shorter operative time per puncture (p < 0.01) and exposure time per puncture (p < 0.05). Conclusion VETERAN method reduced the occurrence of the inaccurate puncture, operative times, and exposure times. A VET-ratio with 36% or less is associated with a safe puncture using VETERAN method.

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“…Robot group: TiRobot system (Tinavi Medical Technologies Co., China) was used as previously detailed [ 16 ] . First, the tracer was fixed to the spinous process of the injured vertebrae in the caudal 2–3 segments with an original device and reinforced with a sterile film.…”

Section: Methodsmentioning

confidence: 99%

“…In recent years, the Tirobot robot has been used in PKP for OVCF in spinal surgery. Preliminary clinical results have shown that robotic assistance can reduce surgical trauma, fluoroscopic exposure, and cement leakage [ 16 – 18 ] . However, the efficacy of robot-assisted PKP for multi-segmental OVCF remains unclear.…”

Section: Introductionmentioning

confidence: 99%

A comparison of robot-assisted and fluoroscopy-assisted kyphoplasty in the treatment of multi-segmental osteoporotic vertebral compression fractures

Li¹,

Wu²,

Huang³

et al. 2022

J Biomed Res

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Osteoporotic vertebral compression fracture (OVCF) has become a major public health issue that becomes more pressing with increasing global aging. Percutaneous kyphoplasty (PKP) is an effective treatment for OVCF. Robot-assisted PKP has been utilized in recent years to improve accuracy and reduce complications. However, the effectiveness of robot-assisted PKP in the treatment of multi-segmental OVCF has yet to be proved. This study was designed to compare the efficacy of robot-assisted and conventional fluoroscopy-assisted multi-segmental PKP. A total of 30 cases with multi-segmental OVCF between April 2019 and April 2021 were included in this study. Fifteen cases were assigned to the robot-assisted PKP group (robot group) and 15 cases to the conventional fluoroscopy-assisted PKP group (conventional fluoroscopy group). The number of fluoroscopic exposures, fluoroscopic dose, operation time, cement leakage rate, visual analog scale (VAS) score, vertebral kyphosis angle (VKA), and height of fractured vertebral body (HFV) were compared between the 2 groups. The number of fluoroscopic exposures, fluoroscopic doses, and cement leakage rates in the robot group were lower than in the conventional fluoroscopy group ( P <0.05) while the operative time in the robot group was longer than in the conventional fluoroscopy group ( P <0.05). VAS score and VKA were decreased and HFV was increased after surgery in both groups ( P <0.05). Therefore, robot-assisted PKP for the treatment of multi-segmental OVCF can reduce the number of fluoroscopic exposures, fluoroscopic doses, and cement leakage compared to conventional treatment. As such, robot-assisted PKP has good application prospects and is potentially more effective in the treatment of multi-segmental OVCF.

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Effectiveness of Tirobot-assisted vertebroplasty in treating thoracolumbar osteoporotic compression fracture

Cited by 26 publications

References 26 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

Accuracy of vertebral puncture in percutaneous vertebroplasty

A comparison of robot-assisted and fluoroscopy-assisted kyphoplasty in the treatment of multi-segmental osteoporotic vertebral compression fractures

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