Robot assisted navigated drilling for percutaneous pedicle screw placement: A preliminary animal study
Identifieur interne : 000618 ( Main/Exploration ); précédent : 000617; suivant : 000619Robot assisted navigated drilling for percutaneous pedicle screw placement: A preliminary animal study
Auteurs : Hongwei Wang [République populaire de Chine] ; Yue Zhou [République populaire de Chine] ; Jun Liu [République populaire de Chine] ; Jianda Han [République populaire de Chine] ; Liangbi Xiang [République populaire de Chine]Source :
- Indian Journal of Orthopaedics [ 0019-5413 ] ; 2015.
Abstract
There is much more radiation exposure to the surgeons during minimally invasive pedicle screws placement. In order to ease the surgeon's hand-eye coordination and to reduce the iatrogenic radiation injury to the surgeons, a robot assisted percutaneous pedicle screw placement is useful. This study assesses the feasibility and clinical value of robot assisted navigated drilling for pedicle screw placement and the results thus achieved formed the basis for the development of a new robot for pedicle screw fixation surgery.
Preoperative computed tomography (CT) of eight bovine lumbar spines (L1–L5) in axial plane were captured for each vertebra, the entry points and trajectories of the screws were preoperatively planned. On the basis of preoperative CT scans and intraoperative fluoroscopy, we aligned the robot drill to the desired entry point and trajectory, as dictated by the surgeon's preoperative plan. Eight bovine lumbar spines were inserted 80 K-wires using the spine robot system. The time for system registration and pedicle drilling, fluoroscopy times were measured and recorded. Postoperative CT scans were used to assess the position of the K-wires.
Assisted by spine robot system, the average time for system registration was (343.4 ± 18.4) s, the average time for procedure of drilling one pedicle screw trajectory was (89.5 ± 6.1) s, times of fluoroscopy for drilling one pedicle screw were (2.9 ± 0.8) times. Overall, 12 (15.0%) of the 80 K-wires violated the pedicle wall. Four screws (5.0%) were medial to the pedicle and 8 (10.5%) were lateral. The number of K-wires wholly within the pedicle were 68 (85%).
The preliminary study supports the view that computer assisted pedicle screw fixation using spinal robot is feasible and the robot can decrease the intraoperative fluoroscopy time during the minimally invasive pedicle screw fixation surgery. As spine robotic surgery is still in its infancy, further research in this field is worthwhile especially the accuracy of spine robot system should be improved.
Url:
DOI: 10.4103/0019-5413.159670
PubMed: 26229168
PubMed Central: 4510801
Affiliations:
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<author><name sortKey="Zhou, Yue" sort="Zhou, Yue" uniqKey="Zhou Y" first="Yue" last="Zhou">Yue Zhou</name>
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<front><div type="abstract" xml:lang="en"><sec id="st1"><title>Background:</title>
<p>There is much more radiation exposure to the surgeons during minimally invasive pedicle screws placement. In order to ease the surgeon's hand-eye coordination and to reduce the iatrogenic radiation injury to the surgeons, a robot assisted percutaneous pedicle screw placement is useful. This study assesses the feasibility and clinical value of robot assisted navigated drilling for pedicle screw placement and the results thus achieved formed the basis for the development of a new robot for pedicle screw fixation surgery.</p>
</sec>
<sec id="st2"><title>Materials and Methods:</title>
<p>Preoperative computed tomography (CT) of eight bovine lumbar spines (L1–L5) in axial plane were captured for each vertebra, the entry points and trajectories of the screws were preoperatively planned. On the basis of preoperative CT scans and intraoperative fluoroscopy, we aligned the robot drill to the desired entry point and trajectory, as dictated by the surgeon's preoperative plan. Eight bovine lumbar spines were inserted 80 K-wires using the spine robot system. The time for system registration and pedicle drilling, fluoroscopy times were measured and recorded. Postoperative CT scans were used to assess the position of the K-wires.</p>
</sec>
<sec id="st3"><title>Results:</title>
<p>Assisted by spine robot system, the average time for system registration was (343.4 ± 18.4) s, the average time for procedure of drilling one pedicle screw trajectory was (89.5 ± 6.1) s, times of fluoroscopy for drilling one pedicle screw were (2.9 ± 0.8) times. Overall, 12 (15.0%) of the 80 K-wires violated the pedicle wall. Four screws (5.0%) were medial to the pedicle and 8 (10.5%) were lateral. The number of K-wires wholly within the pedicle were 68 (85%).</p>
</sec>
<sec id="st4"><title>Conclusions:</title>
<p>The preliminary study supports the view that computer assisted pedicle screw fixation using spinal robot is feasible and the robot can decrease the intraoperative fluoroscopy time during the minimally invasive pedicle screw fixation surgery. As spine robotic surgery is still in its infancy, further research in this field is worthwhile especially the accuracy of spine robot system should be improved.</p>
</sec>
</div>
</front>
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<author><name sortKey="Winscher, Jc" uniqKey="Winscher J">JC Winscher</name>
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<author><name sortKey="Padberg, Am" uniqKey="Padberg A">AM Padberg</name>
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<author><name sortKey="Bridwell, Kh" uniqKey="Bridwell K">KH Bridwell</name>
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<author><name sortKey="Lenke, Lg" uniqKey="Lenke L">LG Lenke</name>
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<author><name sortKey="Dobbs, Mb" uniqKey="Dobbs M">MB Dobbs</name>
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<author><name sortKey="Brodke, Ds" uniqKey="Brodke D">DS Brodke</name>
</author>
<author><name sortKey="Norvell, Dc" uniqKey="Norvell D">DC Norvell</name>
</author>
<author><name sortKey="Dettori, Jr" uniqKey="Dettori J">JR Dettori</name>
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<affiliations><list><country><li>République populaire de Chine</li>
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<tree><country name="République populaire de Chine"><noRegion><name sortKey="Wang, Hongwei" sort="Wang, Hongwei" uniqKey="Wang H" first="Hongwei" last="Wang">Hongwei Wang</name>
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<name sortKey="Han, Jianda" sort="Han, Jianda" uniqKey="Han J" first="Jianda" last="Han">Jianda Han</name>
<name sortKey="Liu, Jun" sort="Liu, Jun" uniqKey="Liu J" first="Jun" last="Liu">Jun Liu</name>
<name sortKey="Xiang, Liangbi" sort="Xiang, Liangbi" uniqKey="Xiang L" first="Liangbi" last="Xiang">Liangbi Xiang</name>
<name sortKey="Zhou, Yue" sort="Zhou, Yue" uniqKey="Zhou Y" first="Yue" last="Zhou">Yue Zhou</name>
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