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Internal fixation in upper cervical spinal surgery: a randomized controlled study

5 pagesPublished: July 12, 2018

Abstract

Internal fixation in upper cervical spine (C1 and C2) is a big challenge. There is a large anatomical variation, and the upper cervical region is adjacent to important organs such as spinal cords, oblongata, vertebral artery, nerve roots and other important structures, misplacement of internal fixation might lead not only to an instability of the screws, but also to neurological, vascular, and visceral injuries.
TianJi Robot was used in this study to compare the internal fixation safety and accuracy between using the navigation based robotic system and free-hand. In this randomized controlled study 51 patients were involved.
129 screws were smoothly implanted without intraoperative complications. In the robot-assisted surgery group, the analysis of the screw showed that 58 of 59 screws (98.3%) were safely placed (<2 mm), and the mean deviation between the planned trajectory and the actual path is 1.14 +/- 0.09mm. In the free-hand fluoroscopy-guided surgery and navigation assisted surgery group, assessment of screw accuracy showed that 66 of 70 screws (94.3%) were safely placed (<2 mm), and the mean deviation between the planned trajectory and the actual path is 1.48 +/- 0.14mm. There was no statistical difference in Gertzbein-Robbins classification distribution between these two groups (P value = 0.551), however, the discrepancies between the actual path and planned trajectory in this two groups have statistical difference (P value = 0.047).
The TianJi Robot has demonstrated its safety and accuracy in upper cervical spinal surgery upon free-hand technic and the navigation technic, which will have expanded applications in spinal surgery.

Keyphrases: Navigation, robot, screw, spine, upper cervical

In: Wenbo Zhan and Ferdinando Rodriguez Y Baena (editors). CAOS 2018. The 18th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 2, pages 51--55

Links:
BibTeX entry
@inproceedings{CAOS2018:Internal_fixation_in_upper,
  author    = {Mingxing Fan and Yajun Liu and Wei Tian},
  title     = {Internal fixation in upper cervical spinal surgery: a randomized controlled study},
  booktitle = {CAOS 2018. The 18th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Wenbo Zhan and Ferdinando Rodriguez Y Baena},
  series    = {EPiC Series in Health Sciences},
  volume    = {2},
  pages     = {51--55},
  year      = {2018},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {https://easychair.org/publications/paper/7Llw},
  doi       = {10.29007/63j9}}
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