Spine surgical robotics: review of the current application and disadvantages for future perspectives

Huang, Junshen; Li, Yuxi; Huang, Lin

doi:10.1007/s11701-019-00983-6

Cited by 32 publications

(19 citation statements)

References 34 publications

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“…However, some studies have shown that pedicle screw placement using navigation systems with robotics has no advantage in terms of accuracy; therefore, there is still controversy in terms of accuracy and safety 18,19 . On the other hand, the general evaluation is that the accuracy and safety of pedicle screw placement using navigation systems with robotics are superior to that of conventional or freehand techniques 20–25 . Even if the superiority and safety of the navigation and robotic systems using intraoperative O‐arm‐based images or CT images are secured, in view of the cost aspect, with O‐arms being expensive, and the current status of dissemination, if the navigation system using the C‐arm already owned by hospitals is available, it is thought that more hospitals will be able to apply efficient and reliable surgical methods at a low cost.…”

Section: Discussionmentioning

confidence: 99%

“…18,19 On the other hand, the general evaluation is that the accuracy and safety of pedicle screw placement using navigation systems with robotics are superior to that of conventional or freehand techniques. [20][21][22][23][24][25] Even if the superiority and safety of the navigation and robotic systems using reported that breached pedicles were observed in 37 of the 161 screws, of which 31 were breaching less than 2 mm (clinically acceptable) when performed using a navigation system with a preoperative C-arm image in 41 consecutive patients. 26 Most studies evaluated the accuracy of screw insertion using the GRS grade, but when we evaluated the accuracy of screw insertion using GRS grade in our preclinical animal study, it might seem that our insertions were less accurate than in other studies conducted on human patients.…”

Section: Discussionmentioning

confidence: 99%

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Novel C‐arm based planning spine surgery robot proved in a porcine model and quantitative accuracy assessment methodology

Kim

Jeon

et al. 2020

Robotics Computer Surgery

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Background We assessed pedicle screw accuracy utilizing a novel navigation‐based spine surgery robotic system by comparing planned pathways with placed pathways in a porcine model. Methods We placed three mini screws per vertebra for accuracy evaluation and used a reference frame for registration in four pigs (46 screws in 23 vertebrae). We planned screw paths and performed screw insertion under robot guidance. Using C‐arm and CT images, we evaluated accuracy by comparing the 3D distance of the placed screw head/tip from the planned screw head/tip and 3D angular offset. Results Mean registration deviation between the preoperative 3D space (C‐arm) and postoperative CT scans was 0.475 ± 0.119 mm. The average offset from preoperative plan to final placement was 4.8 ± 2.0 mm from the head (tail), 5.3 ± 2.3 mm from the tip and 3.9 ± 2.4 degrees of angulation. Conclusions Our spine surgery robot showed good accuracy in executing an intended planned trajectory and screw path. This faster and more accurate robotic system will be applied in future studies, first in cadavers and subsequently in the clinical field.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Novel C‐arm based planning spine surgery robot proved in a porcine model and quantitative accuracy assessment methodology

Kim

Jeon

et al. 2020

Robotics Computer Surgery

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“…In recent years, computer-assisted navigation and robotic techniques (e.g., Renaissance, ROSA, and TIANJI) have been introduced to spinal surgery, which has stepped to a new stage [ 7 – 10 ]. Studies have showed that robot-assisted spine surgery could improve the accuracy of screw placement and reduce radiation exposure [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Robot-assisted orthopedic surgery in the treatment of adult degenerative scoliosis: a preliminary clinical report

Chen

Feng

et al. 2020

J Orthop Surg Res

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Study design A single-institution, retrospective cohort study. Objective To compare the accuracy and short-term clinical outcomes of pedicle screw placement between robot-assisted (RA) and freehand (FH) technique in the treatment of adult degenerative scoliosis (ADS). Methods From February 2018 to October 2019, 97 adult patients with degenerative scoliosis admitted to our department were retrospectively reviewed. Thirty-one patients received robot-assisted pedicle screw placement (RA group), and 66 patients underwent freehand pedicle screw placement (FH group). Patient demographics and short-term clinical outcomes were recorded and compared between two groups. Gertzbein-Robbins grading system was adopted to evaluate the accuracy of pedicle screw placement by means of postoperative CT scan. Short-term clinical outcomes consist of operative time, intraoperative blood loss, length of hospital stay (LOS), radiological parameters, Scoliosis Research Society-22 (SRS-22) scores before the operation, 6 months after operation, adverse events, and revisions. Results The accuracy of screw placement was higher than that of the FH group (clinically acceptable 98.7% vs. 92.2%; P < 0.001). Intraoperative blood loss of the RA group was less than those in the FH group (499 vs. 573 ml; P < 0.001). Operative time (283.1 vs. 291.9 min; P = 0.31) and length of stay (12.8 vs. 13.7 days; P = 0.36) were compared between RA and FH groups. In terms of radiological parameters, both of groups were improved postoperatively. The SRS-22 scores at 6 months after operation from both groups were better than those before operation. For surgery-related complication, one case had pressure sores in the RA group while two cases developed dural tears in the FH group. No revision was required in both groups. Conclusion Combined with other surgical correction modalities, robot-assisted pedicle screw fixation is an effective and safe method of treating degenerative scoliosis. Due to its satisfactory surgical outcomes such as higher accuracy and less trauma, it provides a good alternative for clinical practice. Level of evidence 3.

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“…Existing user interface software can be cumbersome and unintuitive, especially to older learners. [41][42][43] However, many studies have shown that as the number of procedures performed increases, accuracy of pedicle screw placement with robots improves and operating time decreases. 44,45 Success rates usually improve after 30 procedures, with less frequent conversion to nonrobotic techniques.…”

Section: What the Future Holdsmentioning

confidence: 99%

Robotic Spine Surgery: Current State in Minimally Invasive Surgery

Vo¹,

Jiang²,

Azad

et al. 2020

Global Spine Journal

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Study Design: Narrative review. Objectives: Robotic systems in spinal surgery may offer potential benefits for both patients and surgeons. In this article, the authors explore the future prospects and current limitations of robotic systems in minimally invasive spine surgery. Methods: We describe recent developments in robotic spine surgery and minimally invasive spine surgery. Institutional review board approval was not needed. Results: Although robotic application in spine surgery has been gradual, the past decade has seen the arrival of several novel robotic systems for spinal procedures, suggesting the evolution of technology capable of augmenting surgical ability. Conclusion: Spine surgery is well positioned to benefit from robotic assistance and automation. Paired with enhanced navigation technologies, robotic systems have tremendous potential to supplement the skills of spine surgeons, improving patient safety and outcomes while limiting complications and costs.

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Spine surgical robotics: review of the current application and disadvantages for future perspectives

Cited by 32 publications

References 34 publications

Novel C‐arm based planning spine surgery robot proved in a porcine model and quantitative accuracy assessment methodology

Novel C‐arm based planning spine surgery robot proved in a porcine model and quantitative accuracy assessment methodology

Robot-assisted orthopedic surgery in the treatment of adult degenerative scoliosis: a preliminary clinical report

Robotic Spine Surgery: Current State in Minimally Invasive Surgery

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