Robotic-Navigated Percutaneous Pedicle Screw Placement Has Less Facet Joint Violation Than Fluoroscopy-Guided Percutaneous Screws

Katsevman, Gennadiy A.; Spencer, Raven; Daffner, Scott D.; Bhatia, Sanjay; Marsh, Robert; Cui, Shari; Dekeseredy, Patricia; Sedney, Cara L.

doi:10.1016/j.wneu.2021.04.117

Cited by 8 publications

(4 citation statements)

References 63 publications

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“…While the screw deviation rate with robotics is reported to be as low as 2.2%, ensuring high safety, the deviation rate for robotic-assisted PPS is a concerning 10.3% [ 13 ]. Katsevman et al reported that the deviation rate for the robotic-assisted PPS is 15.4%, not much different from that of the fluoroscopic-assisted PPS [ 14 ]. Since the PPS insertion point is not directly visible, it is hard to notice any skiving of the drill.…”

Section: Discussionmentioning

confidence: 99%

Utility of a Navigated High-Speed Drill in Robotic-Assisted Screw Placement for Spine Surgery

Ito,

Ueno,

Torii

et al. 2024

Cureus

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Purpose To elucidate the utility of a navigated high-speed drill used after the version upgrade in surgeries assisted by a spinal robotics system. Methods The subjects were 166 patients who underwent screw placement using a spinal robotics system between April 2021 to July 2023. A significant change during the study was the introduction of a navigated high-speed drill in 80 post-upgrade cases, aimed at improving drilling accuracy. Screw accuracy was analyzed using the Gertzbein and Robbins classification on postoperative CT scans. Screws placed before (pre-upgrade group: 718 screws in 86 cases) and after the system upgrade (post-upgrade group: 747 screws in 80 cases) were compared in terms of perfect accuracy and deviation rates. Results There were no significant differences in demographics or surgical details between the two groups. No significant differences were observed in the overall perfect accuracy rate and deviation rate (2.4% pre-upgrade vs. 2.0% post-upgrade) between the two groups. For the percutaneous pedicle screw (PPS), the perfect accuracy rate was significantly higher, and the deviation rate was significantly lower in the post-upgrade group (26.1% pre-upgrade vs. 4.4% post-upgrade). Notably, the post-upgrade group achieved 100% perfect accuracy and 0% deviation for the cortical bone trajectory screw (CBT) technique. Conclusions The introduction of the navigated high-speed drill did not significantly alter the overall perfect accuracy or deviation rates for robotic-assisted screw placement. However, its use did demonstrate improved outcomes in specific techniques such as PPS and CBT, indicating its potential value in addressing skiving in robotic-assisted minimally invasive surgeries.

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Section: Discussionmentioning

confidence: 99%

Utility of a Navigated High-Speed Drill in Robotic-Assisted Screw Placement for Spine Surgery

Ito,

Ueno,

Torii

et al. 2024

Cureus

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“…A myriad of papers in the past few years have compared the different screw placement techniques to evaluate which methods optimize outcomes and technical benefits [8,11,12 ▪ ,13 ▪ ,14]. However, the vast majority of these studies evaluate adult-only patient populations.…”

Section: Comparison To Freehand Fluoroscopy-guided and Navigation Tec...mentioning

confidence: 99%

“…Studies comparing robotic usage to other techniques are limited to adult patients, but have found that the robot performs as well as any, or superior to, other methods in regards to accuracy, patient reported outcomes, and revision rates [3–5,11,14,15 ▪ ,16]. Katsevman et al [13 ▪ ] compared robot-guided screw placement to fluoroscopy-guided and found that the robotic screws had significantly less facet joint violation. Additionally, a meta-analysis performed by Perdomo-Pantoja et al [8] in 2019 demonstrated that robotic assisted screw placement in adults had fewer breaches in the thoracic spine compared with freehand and fluoroguided.…”

Section: Comparison To Freehand Fluoroscopy-guided and Navigation Tec...mentioning

confidence: 99%

“…In most cases, robot-assisted pedicle screw placement is combined with surgical navigation so the operating surgeon can visualize the instrument trajectory in all planes and double-check the preplanned screw trajectory in real time [1 ▪▪ ,2,3,5,6]. Robot use in adult spinal surgery has been well documented and demonstrates comparable, if not superior, accuracy in placement of pedicle screws when compared to freehand, fluoroscopy-guided, or other navigated techniques [3–5,7 ▪▪ ,8,9,10 ▪ ,11,12 ▪ ,13 ▪ ,14,15 ▪ ,16].…”

Section: Introductionmentioning

confidence: 99%

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Advances in robotics and pediatric spine surgery

Cirrincione

Widmann²,

Heyer³

2022

Current Opinion in Pediatrics

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Purpose of reviewRobotic-assisted surgical navigation for placement of pedicle screws is one of the most recent technological advancements in spine surgery. Excellent accuracy and reliability results have been documented in the adult population, but adoption of robotic surgical navigation is uncommon in pediatric spinal deformity surgery. Pediatric spinal anatomy and the specific pediatric pathologies present unique challenges to adoption of robotic assisted spinal deformity workflows. The purpose of this article is to review the safety, accuracy and learning curve data for pediatric robotic-assisted surgical navigation as well as to identify ''best use'' cases and technical tips. Recent findingsRobotic navigation has been demonstrated as a safe, accurate and reliable method to place pedicle screws in pediatric patients with a moderate learning curve. There are no prospective studies comparing robotically assisted pedicle screw placement with other techniques for screw placement, however several recent studies in the pediatric literature have demonstrated high accuracy and safety as well as high reliability. In addition to placement of pediatric pedicle screws in the thoracic and lumbar spine, successful and safe placement of screws in the pelvis and sacrum have also been reported with reported advantages over other techniques in the setting of high-grade spondylolisthesis as well as pelvic fixation utilizing S2-alar iliac (S2AI) screws. SummaryEarly studies have demonstrated that robotically assisted surgical navigation for pedicle screws and pelvic fixation for S2AI screws is safe, accurate, and reliable in the pediatric population with a moderate learning curve.

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Assessing the benefits of digital twins in neurosurgery: a systematic review

Chumnanvej,

Tripathi

2024

Neurosurg Rev

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Robotic-Navigated Percutaneous Pedicle Screw Placement Has Less Facet Joint Violation Than Fluoroscopy-Guided Percutaneous Screws

Cited by 8 publications

References 63 publications

Utility of a Navigated High-Speed Drill in Robotic-Assisted Screw Placement for Spine Surgery

Utility of a Navigated High-Speed Drill in Robotic-Assisted Screw Placement for Spine Surgery

Advances in robotics and pediatric spine surgery

Assessing the benefits of digital twins in neurosurgery: a systematic review

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