Robot-Assisted Pedicle Screw Placement

Röser, Florian; Hebela, Nader M.

doi:10.1007/978-1-0716-0993-4_12

Cited by 4 publications

(6 citation statements)

References 47 publications

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“…The precision of both methods is suitable for clinical use. The precision of the Cirq in our study on the second torso corresponds to the above optimizations with the of manufacturers 11 .…”

Section: Subjective Impressionmentioning

confidence: 72%

“…Existing navigation and robotic solutions are therefore also suitable for young residents and can and should be an integral part of clinical training. Nevertheless, it is important to learn and master the instruments in order to recognize technical problems and, if the technology fails, to be able to perform the procedure safely and quickly without risk to the patient 11 . Regarding minimally invasive spine surgery, the uoroscopic technique of pedicle screw placement with a Jamshidi needle is also the standard for kyphoplasty, which continues to be of great importance in spinal surgery and is one of the basics for every spinal surgeon 11 .…”

Section: Discussionmentioning

confidence: 99%

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Precision and effort in robot-assisted placement of pedicle screws compared to standard surgical navigation: a cadaveric study

Sippel,

Groh,

Bräuer

et al. 2024

Preprint

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Background: Aim was to compare image-guided navigation with a robot-assisted solution for performing MISS regardarding precision, required time and subjective aspects. Methods: 90 pedicles were instrumented on two torsos, half with navigation, half robot-assisted. Results: Precision analysis between both solutions didn’t show a significant difference. Time measurement showed a significantly longer duration per wire for the robot-arm on the first torso and a not significant longer duration on the second torso, where a significant reduction in the mean duration was shown. There was no significant difference in the subjective impressions comparing navigation and robot except the possibility to change the procedure. Conclusion: Precision of both methods is suitable for clinical use. A time advantage using the robot-arm couldn`t be demonstrated in the present study. A significant learning curve was shown, so a reduction in the longer duration on the robot can be expected. Further studies in clinical use are necessary.

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Section: Subjective Impressionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Precision and effort in robot-assisted placement of pedicle screws compared to standard surgical navigation: a cadaveric study

Sippel,

Groh,

Bräuer

et al. 2024

Preprint

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“…In this period, three different robotic system were employed The SpineAssist® (Mazor Robotics; presently Medtronic) and its successor the Renaissance® (Mazor Robotics) robot are examples of a framed, supervisory-controlled, parallel robot. 1,13,20 The robot is a cylindrical device equipped with an end-effector with six degrees of freedom. The bone-mounting frame interfaces the robotic device with the patient's head or spine and the robotic arm is positioned according to pre-planned, image-guided trajectories while the surgeon directs the instruments (e.g., drill guide and cannulas).…”

Section: Robotic Systemsmentioning

confidence: 99%

“…Third, the used robot applied a very sophisticated registration process. [8][9][10][11]20 Instead of using time-consuming highresolution (i.e., 3D) intraoperative imaging, the system utilised lowresolution 2D x-ray imaging. This solution reduces intraoperative time and costs.…”

Section: Differences In the Pws Of Framed And Non-framed Robotic Systemsmentioning

confidence: 99%

Framed and non‐framed robotics in neurosurgery: A 10‐year single‐center experience

Naros

Machetanz

Grimm

et al. 2021

Robotics Computer Surgery

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Background: Safety, efficacy and efficiency of neurosurgical robots are defined by their design (i.e., framed and non-framed) and procedural workflow (PW) (from image to surgery). The present study describes the quality indicators of three different robots in brain and spine surgery.Methods: This single-centre study enrolled 252 patients over a 10-year period.Safety (complication rate) and efficacy (diagnostic yield, pedicle screw placement) were determined. Predictors of workflow efficiency (e.g., skin-to-skin) were evaluated and compared to conventional techniques (neuronavigation, stereotaxy).Results: All robots showed excellent reliability (97.5%-100%) with low complication rates (4.5%-5.3%) and high efficacy (94.7%-97.7%). Robotics demonstrated a better time-efficiency than neuronavigation. However, there was no shortening of surgery time compared to conventional stereotaxy. Time-efficiency differed significantly between framed and non-framed workflows. Conclusion:While all neurosurgical robots were reliable, safe and efficacious, there were significant differences in time-efficiency. PWs should be improved to increase the acceptance of robotics in neurosurgery.

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“…The use of assistive techniques with navigation to place pedicle screws has been a major trend in the practice of spinal surgery (Driver and Groff 2021). Compared with freehand procedures, the navigated techniques can improve the accuracy of pedicle screw placement, thereby reducing the complications associated with screw placement and reducing the number of returns to the operating room due to malposition (Overley et al 2017, Du et al 2018, Vaishnav et al 2019, Fatima et al 2021, Roser and Hebela 2021, Tarawneh and Salem 2021. Several studies have shown that the accuracy of pedicle screw fixation assisted by a robot system is better than that of manual surgery guided by fluoroscopy, with an acceptable success rate of 94%-98% (Roser et al 2013.…”

Section: Introductionmentioning

confidence: 99%

Improving pedicle screw path planning by vertebral posture estimation

et al. 2023

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Objective: Robot-assisted pedicle screw placement in spine surgery can reduce the complications associated with the screw placement and reduce the hospital return counts due to malfunctions. However, it requires accurate planning for high quality procedures. The state-of-the-art technologies reported in the literature either ignore the anatomical variations across vertebrae or require substantial human interactions. We present an improved approach that achieves the pedicle screw path planning through multiple projections of a numerically re-oriented vertebra with the estimated posture.Approach: We proposed an improved YOLO-type neural network model (YOLOPOSE3D) to estimate the posture of a vertebra before the pedicle path planning. In YOLOPOSE3D, the vertebral posture is given as a rotation quaternion and 3D location coordinates by optimizing the intersection over union (IoU) of the vertebra with the predicted posture and the actual posture. Then, a new local coordinate system is established for the vertebra based on the estimated posture. Finally, the optimal pedicle screw path trajectory is determined from the multiple projections of the vertebra in the local coordinates. Main results:The experimental results in difficult cases of scoliosis showed that the new YOLOPOSE3D network could detect the location and posture of the vertebra accurately with average translation and orientation errors as small as 1.55 mm and 2.55. The screw path planning achieved 83.1% success rate without breaking the pedicle cortex for the lumbar vertebral L1-L5, which is better than that of doctor’s manual planning, 82.4%. With the clinical class A requirement of allowing less than 2mm out of the pedicle cortex, the success rate achieved nearly 100%. Significance: The proposed YOLOPOSED3D method can accurately determine the vertebral postures. With the improved posture prior, better clinical outcomes can be achieved for pedicle screw placement in spine internal fixation procedures. 

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Robot-Assisted Pedicle Screw Placement

Cited by 4 publications

References 47 publications

Precision and effort in robot-assisted placement of pedicle screws compared to standard surgical navigation: a cadaveric study

Precision and effort in robot-assisted placement of pedicle screws compared to standard surgical navigation: a cadaveric study

Framed and non‐framed robotics in neurosurgery: A 10‐year single‐center experience

Improving pedicle screw path planning by vertebral posture estimation

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