Robotic navigation during spine surgery: an update of literature

Zhang, Qi; Han, Xiaoguang; Fan, Mingxing; Zhao, Jingwei; Lang, Zhao; Jiang, Jile; He, Da; Liu, Bo; Tian, Wei

doi:10.1080/17434440.2023.2200932

Cited by 4 publications

(2 citation statements)

References 63 publications

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“…Nowadays, the robotic system is just called Mazor. A systematic review on robotics in spine surgery can be found in [60,61].…”

Section: Mazormentioning

confidence: 99%

Robotic Systems and Navigation Techniques in Orthopedics: A Historical Review

Li,

Badre,

Alambeigi

et al. 2023

Applied Sciences

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Since the da Vinci surgical system was approved by the Food and Drug Administration (FDA) in 2000, the development and deployment of various robot-assisted minimally invasive surgery (MIS) systems have been largely expedited and boomed. With the rapid advancement of robotic techniques in recent decades, robot-assisted systems have been widely used in various surgeries including orthopedics. These robot-related techniques are transforming the conventional ways to conduct surgical procedures. Robot-assisted orthopedic surgeries have become more and more popular due to their potential benefits of increased accuracy and precision in surgical outcomes, enhanced reproducibility, reduced technical variability, decreased pain, and faster recovery time. In this paper, robotic systems and navigation techniques in typical orthopedic surgeries are reviewed, especially for arthroplasty. From the perspective of robotics and engineering, the systems and techniques are divided into two main categories, i.e., robotic systems (RSs), and computer-aided navigation systems (CANSs). The former is further divided into autonomous RS, hands-on RS, and teleoperated RS. For the latter, three key elements in CANS are introduced, including 3D modeling, registration, and navigation. Lastly, the potential advantages and disadvantages of the RS and CANS are summarized and discussed. Future perspectives on robotics in orthopedics, as well as the challenges, are presented.

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“…Nowadays, the robotic system is just called Mazor. A systematic review on robotics in spine surgery can be found in [60,61].…”

Section: Mazormentioning

confidence: 99%

Robotic Systems and Navigation Techniques in Orthopedics: A Historical Review

Li,

Badre,

Alambeigi

et al. 2023

Applied Sciences

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“…These two surgical approaches use different methods for inserting pedicle screws. One is the traditional freehand technique ( Karapinar et al, 2008 ; Mattei et al, 2009 ; Vijayeswaran et al, 2019 ; He et al, 2022 ), and the other is the minimally invasive image-guided technique ( Gelalis et al, 2012 ; Lieberman et al, 2020 ; Sun et al, 2020 ; Li et al, 2022 ; Zhang et al, 2023 ). These two techniques also correspond to different pilot hole profiles.…”

Section: Introductionmentioning

confidence: 99%

Influence of various pilot hole profiles on pedicle screw fixation strength in minimally invasive and traditional spinal surgery: a comparative biomechanical study

Li,

Lai,

Hsieh

et al. 2024

Front. Bioeng. Biotechnol.

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Despite advancements in pedicle screw design and surgical techniques, the standard steps for inserting pedicle screws still need to follow a set of fixed procedures. The first step, known as establishing a pilot hole, also referred to as a pre-drilled hole, is crucial for ensuring screw insertion accuracy. In different surgical approaches, such as minimally invasive or traditional surgery, the method of creating pilot holes varies, resulting in different pilot hole profiles, including variations in size and shape. The aim of this study is to evaluate the biomechanical properties of different pilot hole profiles corresponding to various surgical approaches. Commercially available synthetic L4 vertebrae with a density of 0.16 g/cc were utilized as substitutes for human bone. Four different pilot hole profiles were created using a 3.0 mm cylindrical bone biopsy needle, 3.6 mm cylindrical drill, 3.2–5.0 mm conical drill, and 3.2–5.0 mm conical curette for simulating various minimally invasive and traditional spinal surgeries. Two frequently employed screw shapes, namely, cylindrical and conical, were selected. Following specimen preparation, screw pullout tests were performed using a material test machine, and statistical analysis was applied to compare the mean maximal pullout strength of each configuration. Conical and cylindrical screws in these four pilot hole configurations showed similar trends, with the mean maximal pullout strength ranking from high to low as follows: 3.0 mm cylindrical biopsy needle, 3.6 mm cylindrical drill bit, 3.2–5.0 mm conical curette, and 3.2–5.0 mm conical drill bit. Conical screws generally exhibited a greater mean maximal pullout strength than cylindrical screws in three of the four different pilot hole configurations. In the groups with conical pilot holes, created with a 3.2–5.0 mm drill bit and 3.2–5.0 mm curette, both conical screws exhibited a greater mean maximal pullout strength than did cylindrical screws. The strength of this study lies in its comprehensive comparison of the impact of various pilot hole profiles commonly used in clinical procedures on screw fixation stability, a topic rarely reported in the literature. Our results demonstrated that pilot holes created for minimally invasive surgery using image-guided techniques exhibit superior pullout strength compared to those utilized in traditional surgery. Therefore, we recommend prioritizing minimally invasive surgery when screw implantation is anticipated to be difficult or there is a specific need for stronger screw fixation. When opting for traditional surgery, image-guided methods may help establish smaller pilot holes and increase screw fixation strength.

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