Robotic Tissue Manipulation and Resection in Spine Surgery

Trybula, S. Joy; Oyon, Daniel E.; Wolinsky, Jean Paul

doi:10.1016/j.nec.2019.08.014

Cited by 11 publications

(7 citation statements)

References 50 publications

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“…While these initial studies are promising, the evidence is currently limited due to the small number of cases reported. The integration of navigation with robotics will likely promote an increase in their utilization in this arena given the ability to determine depth with real-time navigation (52,53). This should theoretically improve procedural efficiency and safety.…”

Section: Other Applications Of Navigated Robotic Guidancementioning

confidence: 99%

The current state of navigation in robotic spine surgery

Huang¹,

Tetreault²,

Vaishnav³

et al. 2021

Ann Transl Med

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The advent and widespread adoption of pedicle screw instrumentation prompted the need for image guidance in spine surgery to improve accuracy and safety. Although the conventional method, fluoroscopy, is readily available and inexpensive, concerns regarding radiation exposure and the drive to provide better visual guidance spurred the development of computer-assisted navigation.Contemporaneously, a non-navigated robotic guidance platform was also introduced as a competing modality for pedicle screw placement. Although the robot could provide high precision trajectory guidance by restricting four of the six degrees of freedom (DOF), the lack of real-time depth control and high capital acquisition cost diminished its popularity, while computer-assisted navigation platforms became increasingly sophisticated and accepted. The recent integration of real-time 3D navigation with robotic platforms has resulted in a resurgence of interest in robotics in spine surgery with the recent introduction of numerous navigated robotic platforms. The currently available navigated robotic spine surgery platforms include the

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Section: Other Applications Of Navigated Robotic Guidancementioning

confidence: 99%

The current state of navigation in robotic spine surgery

Huang¹,

Tetreault²,

Vaishnav³

et al. 2021

Ann Transl Med

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show abstract

“…The da Vinci surgical system has been widely used in urology and gynecology operations (26). However, due to the lack of bone resection equipment, its application in spinal surgery is limited (27). Ponnusamy et al, installed prototype burr and rongeur instruments to the da Vinci robot component, and performed posterior spinal surgery on pigs.…”

Section: Nathoo Type B: Robotic Telesurgical Systemmentioning

confidence: 99%

Robot-assisted laminectomy in spinal surgery: a systematic review

Li¹,

Yu²,

Jiang³

et al. 2021

Ann Transl Med

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This study aimed to summarize the current progress in the field of robot-assisted laminectomy in spinal surgery. A systematic search of the Institute of Electrical and Electronics Engineers (IEEE) Xplore, PubMed, Embase, Web of science, The Cochrane Library, Wanfang Data, China National Knowledge Infrastructure (CNKI), and Chinese Biomedicine Literature Database (CBM-SinoMed) was performed for papers related to robotic-assisted laminectomy. A total of 27 articles were selected for inclusion in our study. Among the articles, 10 robotic system, 2 bone cutting strategies, 6 state recognition strategies were founded.The most commonly adopted type of robot system was the Nathoo A type (6/10). Bone cutting strategies were mainly formulated based on force information and medical image information, and state recognition was based on a variety of factors, including force, sound, vibration, medical images, current or a combination of parameters. Early research on robot-assisted laminectomy did not reflect good continuity, and the studies mainly focused on the type of robotic system. In recent years, more researchers have chosen the Nathoo A as the robot system type, and the focus of research has gradually shifted to laminectomy path planning and safety control strategies, such as state recognition. Although these studies have been able to perform laminectomy without penetrating the inner cortex of the lamina, most experiments have been performed in vitro, and clinical application is still untested.

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“…to the patient, surgeon, and staff), shorter operative/postoperative recovery times, a shorter average length of stay, smaller incisions, reduced blood loss, and lower infection rates [ Table 1 ]. [ 2 , 6 , 7 , 9 , 11 - 14 , 16 ] Further, future RA techniques could be applied to; the resection of spinal tumors, ablations, vertebroplasties, spinal deformity, bony decompressions, dural closures, and pre-planned osteotomies. [ 2 , 7 , 13 , 14 , 16 ]…”

Section: Minimal Learning Curve and Pros For Ra Versus Fh Tl Ps Placementmentioning

confidence: 99%

“…[ 2 , 6 , 7 , 9 , 11 - 14 , 16 ] Further, future RA techniques could be applied to; the resection of spinal tumors, ablations, vertebroplasties, spinal deformity, bony decompressions, dural closures, and pre-planned osteotomies. [ 2 , 7 , 13 , 14 , 16 ]…”

Section: Minimal Learning Curve and Pros For Ra Versus Fh Tl Ps Placementmentioning

confidence: 99%

Perspective on robotic spine surgery: Who’s doing the thinking?

Epstein¹

2021

Surgical Neurology International

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Background: Robotic assisted (RA) spine surgery was developed to reduce the morbidity for misplaced thoracolumbar (TL) pedicle screws (PS) resulting in neurovascular injuries, dural fistulas, and/or visceral/other injuries. RA is gaining the attention of spine surgeons to optimize the placement of TL PSs, and to do this more safely/effectively versus utilizing stereotactic navigation alone, or predominantly free hand (FH) techniques. However, little attention is being focused on whether a significant number of these TL RA instrumented fusions are necessary. Methods: RA spine surgery has been developed to improve the safety, efficacy, and accuracy of minimally invasive TL versus open FH PS placement. Results: Theoretical benefits of RA spine surgery include; enhanced accuracy of screw placement, fewer complications, less radiation exposure, smaller incisions, to minimize blood loss, reduce infection rates, shorten operative times, reduce postoperative recovery periods, and shorten lengths of stay. Cons of RA include; increased cost, increased morbidity with steep learning curves, robotic failures of registration, more soft tissue injuries, lateral skiving of drill guides, displacement of robotic arms impacting accurate PS placement, higher reoperation rates, and potential loss of accuracy with motion versus FH techniques. Notably, insufficient attention has been focused on the necessity for performing many of these TL PS instrumented fusions in the first place. Conclusion: RA spinal surgery is still in its infancy, and comparison of RA versus FH techniques for TL PS placement demonstrates several potential pros, but also multiple cons. Further, more attention must be focused on whether many of these TL PS instrumented procedures are even warranted.

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Robotic Tissue Manipulation and Resection in Spine Surgery

Cited by 11 publications

References 50 publications

The current state of navigation in robotic spine surgery

The current state of navigation in robotic spine surgery

Robot-assisted laminectomy in spinal surgery: a systematic review

Perspective on robotic spine surgery: Who’s doing the thinking?

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