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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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Robot assisted navigated drilling for percutaneous pedicle screw placement: A preliminary animal study</title><author><name sortKey="Wang, Hongwei" sort="Wang, Hongwei" uniqKey="Wang H" first="Hongwei" last="Wang">Hongwei Wang</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Orthopedics, General Hospital of Shenyang Military Area Command of Chinese PLA, Liaoning, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Orthopedics, General Hospital of Shenyang Military Area Command of Chinese PLA, Liaoning</wicri:regionArea><wicri:noRegion>Liaoning</wicri:noRegion></affiliation></author><author><name sortKey="Zhou, Yue" sort="Zhou, Yue" uniqKey="Zhou Y" first="Yue" last="Zhou">Yue Zhou</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Orthopedics, Xinqiao Hospital, The Third Military Medical University, Chongqing 400037, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Orthopedics, Xinqiao Hospital, The Third Military Medical University, Chongqing 400037</wicri:regionArea><wicri:noRegion>Chongqing 400037</wicri:noRegion></affiliation></author><author><name sortKey="Liu, Jun" sort="Liu, Jun" uniqKey="Liu J" first="Jun" last="Liu">Jun Liu</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Orthopedics, General Hospital of Shenyang Military Area Command of Chinese PLA, Liaoning, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Orthopedics, General Hospital of Shenyang Military Area Command of Chinese PLA, Liaoning</wicri:regionArea><wicri:noRegion>Liaoning</wicri:noRegion></affiliation></author><author><name sortKey="Han, Jianda" sort="Han, Jianda" uniqKey="Han J" first="Jianda" last="Han">Jianda Han</name><affiliation wicri:level="1"><nlm:aff id="aff3">Department of Electronics, State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Science, Shenyang, Liaoning 110016, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Electronics, State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Science, Shenyang, Liaoning 110016</wicri:regionArea><wicri:noRegion>Liaoning 110016</wicri:noRegion></affiliation></author><author><name sortKey="Xiang, Liangbi" sort="Xiang, Liangbi" uniqKey="Xiang L" first="Liangbi" last="Xiang">Liangbi Xiang</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Orthopedics, General Hospital of Shenyang Military Area Command of Chinese PLA, Liaoning, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Orthopedics, General Hospital of Shenyang Military Area Command of Chinese PLA, Liaoning</wicri:regionArea><wicri:noRegion>Liaoning</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26229168</idno><idno type="pmc">4510801</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4510801</idno><idno type="RBID">PMC:4510801</idno><idno type="doi">10.4103/0019-5413.159670</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000231</idno><idno type="wicri:Area/Pmc/Curation">000231</idno><idno type="wicri:Area/Pmc/Checkpoint">000377</idno><idno type="wicri:Area/Ncbi/Merge">003B27</idno><idno type="wicri:Area/Ncbi/Curation">003B27</idno><idno type="wicri:Area/Ncbi/Checkpoint">003B27</idno><idno type="wicri:doubleKey">0019-5413:2015:Wang H:robot:assisted:navigated</idno><idno type="wicri:Area/Main/Merge">000618</idno><idno type="wicri:Area/Main/Curation">000618</idno><idno type="wicri:Area/Main/Exploration">000618</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Robot assisted navigated drilling for percutaneous pedicle screw placement: A preliminary animal study</title><author><name sortKey="Wang, Hongwei" sort="Wang, Hongwei" uniqKey="Wang H" first="Hongwei" last="Wang">Hongwei Wang</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Orthopedics, General Hospital of Shenyang Military Area Command of Chinese PLA, Liaoning, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Orthopedics, General Hospital of Shenyang Military Area Command of Chinese PLA, Liaoning</wicri:regionArea><wicri:noRegion>Liaoning</wicri:noRegion></affiliation></author><author><name sortKey="Zhou, Yue" sort="Zhou, Yue" uniqKey="Zhou Y" first="Yue" last="Zhou">Yue Zhou</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Orthopedics, Xinqiao Hospital, The Third Military Medical University, Chongqing 400037, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Orthopedics, Xinqiao Hospital, The Third Military Medical University, Chongqing 400037</wicri:regionArea><wicri:noRegion>Chongqing 400037</wicri:noRegion></affiliation></author><author><name sortKey="Liu, Jun" sort="Liu, Jun" uniqKey="Liu J" first="Jun" last="Liu">Jun Liu</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Orthopedics, General Hospital of Shenyang Military Area Command of Chinese PLA, Liaoning, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Orthopedics, General Hospital of Shenyang Military Area Command of Chinese PLA, Liaoning</wicri:regionArea><wicri:noRegion>Liaoning</wicri:noRegion></affiliation></author><author><name sortKey="Han, Jianda" sort="Han, Jianda" uniqKey="Han J" first="Jianda" last="Han">Jianda Han</name><affiliation wicri:level="1"><nlm:aff id="aff3">Department of Electronics, State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Science, Shenyang, Liaoning 110016, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Electronics, State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Science, Shenyang, Liaoning 110016</wicri:regionArea><wicri:noRegion>Liaoning 110016</wicri:noRegion></affiliation></author><author><name sortKey="Xiang, Liangbi" sort="Xiang, Liangbi" uniqKey="Xiang L" first="Liangbi" last="Xiang">Liangbi Xiang</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Orthopedics, General Hospital of Shenyang Military Area Command of Chinese PLA, Liaoning, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Orthopedics, General Hospital of Shenyang Military Area Command of Chinese PLA, Liaoning</wicri:regionArea><wicri:noRegion>Liaoning</wicri:noRegion></affiliation></author></analytic><series><title level="j">Indian Journal of Orthopaedics</title><idno type="ISSN">0019-5413</idno><idno type="eISSN">1998-3727</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><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><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Foley, Kt" uniqKey="Foley K">KT Foley</name></author><author><name sortKey="Gupta, Sk" uniqKey="Gupta S">SK Gupta</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Knop, C" uniqKey="Knop C">C Knop</name></author><author><name sortKey="Fabian, Hf" uniqKey="Fabian H">HF Fabian</name></author><author><name sortKey="Bastian, L" uniqKey="Bastian L">L Bastian</name></author><author><name sortKey="Blauth, M" uniqKey="Blauth M">M Blauth</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Alanay, A" uniqKey="Alanay A">A Alanay</name></author><author><name sortKey="Acaroglu, E" uniqKey="Acaroglu E">E Acaroglu</name></author><author><name sortKey="Yazici, M" 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