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Pedicle screw insertion in spine: a randomized controlled study for robot-assisted spinal surgery

5 pagesPublished: June 13, 2017

Abstract

To introduce a new robot-assisted surgical system for spinal posterior fixation which called TiRobot, based on intraoperative three-dimensional images. TiRobot has three components: the planning and navigation system, optical tracking system and robotic arm system. By combining navigation and robot techniques, TiRobot can guide the screw trajectories for orthopedic surgeries.
In this randomized controlled study approved by the Ethics Committee, 40 patients were involved and all has been fully informed and sign the informed consent. 17 patients were treated by free-hand fluoroscopy-guided surgery, and 23 patients were treated by robot-assisted spinal surgery.
A total of 190 pedicle screws was implanted. The overall operation time were not different for both groups. None of the screws necessitated re-surgery for revised placement. In the robot-assisted group, assessment of pedicle screw accuracy showed that 102 of 102 screws (100%) were safely placed (<2 mm, category A+B). And mean deviation in entry point was 1.70 +/- 0.83mm, mean deviation in end point was 1.84 +/- 1.04mm. In the conventional freehand group, assessment of pedicle screw accuracy showed that 87 of 88 (98.9%) were safely placed (<2 mm, category A+B), 1 screw fall in category C, mean deviation in entry point was 3.73 +/- 2.28mm, mean deviation in end point was 4.11 +/- 2.31mm.
This randomized controlled study verified that robot-assisted pedicle screw placement with real-time navigation is a more accuracy and safer method, also revealed great clinical potential of robot-assisted surgery in the future.

Keyphrases: pedicle screw, randomized controlled study, robot assisted surgery, spine

In: Klaus Radermacher and Ferdinando Rodriguez Y Baena (editors). CAOS 2017. 17th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 1, pages 23--27

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