Evaluating robotic pedicle screw placement against conventional modalities: a systematic review and network meta-analysis

Naik, Anant; Smith, Audrey; Shaffer, Annabelle; Krist, David T.; Moawad, Christina M; MacInnis, Bailey; Teal, Kevin; Hassaneen, Wael; Arnold, Paul M.

doi:10.3171/2021.10.focus21509

Cited by 36 publications

(24 citation statements)

References 31 publications

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“…Meanwhile, another study by Devito et al did not publish the levels that were instrumented limiting the conclusions which can be drawn [ 11 ]. This study demonstrates that robot-assisted pedicle screws in the thoracolumbar spine during acute, traumatic surgery are both feasible and accurate which is in agreement with previous studies demonstrating the accuracy of robot-assisted pedicle screws [ 20 - 22 ]. However, a large, randomized trial should be performed to confirm or disprove the superiority of robot-assisted pedicle screw placement as compared to pedicle screws placed with other techniques in the thoracic spine during an acute, traumatic setting.…”

Section: Discussionsupporting

confidence: 91%

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Robot-Assisted Thoracolumbar Fixation After Acute Spinal Trauma: A Case Series

Villeneuve¹,

Lee²,

Cornwell³

et al. 2022

Cureus

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Background: Pedicle screw fixation has become the workhorse for the stabilization of the thoracolumbar spine. Since accurate pedicle screw placement is necessary for a successful surgery, three-dimensional navigation has become a mainstay for placing pedicle screws. However, the published studies have an overrepresentation of lumbar screws despite the prevalence of thoracic fractures. Furthermore, no roboticassisted pedicle screw study has focused solely on traumatic fractures. The goal of this study was to address whether (1) robot-assisted pedicle screw placement had comparable accuracy in the thoracic and thoracolumbar region and (2) robot-assisted spine surgery was feasible in an acute, traumatic setting.Methods: We performed 14 consecutive, thoracolumbar spinal stabilization procedures in which 126 pedicle screws were placed using the Globus ExcelsiusGPS® spine robot in an acute, traumatic setting. Operative times were measured, and the accuracy of pedicle screws was assessed with the Gertzbein and Robbins classification system by two board-certified neuroradiologists.Results: A total of 60-thoracic (T3-T11), the 24-thoracolumbar junction (T12-L1), 40-lumbar (L2-L5), and two-sacral pedicle screws were placed. Pedicle screw placement was accurate with a < 1% (1/126) pedicle breach rate. Thoracolumbar robotic spine surgery in an acute, traumatic setting was demonstrated to have a good safety profile with only one minor neurological deficit which was related to positioning. Furthermore, surgical times were inversely related to the case number.Conclusions: These results together suggest that robot-assisted spine surgery is accurate in the thoracic spine. Furthermore, placement of thoracolumbar screws in an acute trauma is non-inferior to other methods when based on accuracy.

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Section: Discussionsupporting

confidence: 91%

“…Another critique of this paper would be the blood loss. Previous work has demonstrated decreased blood loss for robot-assisted spinal surgery as opposed to freehand techniques [ 22 ]. However, our surgeries were performed in the acute phase and in the context of other injuries.…”

Section: Discussionmentioning

confidence: 99%

Robot-Assisted Thoracolumbar Fixation After Acute Spinal Trauma: A Case Series

Villeneuve¹,

Lee²,

Cornwell³

et al. 2022

Cureus

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“…Surgical robots are increasingly utilized to assist or replace surgeons in completing surgery operations [1][2][3]. Their high-precision operation capability and reliability are very attractive in surgeries [4,5]. In clinics, each surgeon needs to be trained for years so as to acquire qualifications.…”

Section: Introduction 1background and Significancementioning

confidence: 99%

Virtual and Real Bidirectional Driving System for the Synchronization of Manipulations in Robotic Joint Surgeries

Qin

Lin

et al. 2022

Machines

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Surgical robots are increasingly important in orthopedic surgeries to assist or replace surgeons in completing operations. During joint surgeries, the patient’s joint needs to be adjusted several times by the surgeon. Therefore, the virtual model, built on the preoperative medical images, cannot match the actual variation of the patient’s joint during the surgery. Conventional virtual reality techniques cannot fully satisfy the requirements of the joint surgeries. This paper proposes a real and virtual bidirectional driving method to synchronize the manipulations in both the real operation site and the virtual scene. The dynamic digital twin of the patient’s joint is obtained by decoupling the joint and dynamically updating its pose via the intraoperative measurements. During surgery, the surgeon can intuitively monitor the real-time position of the patient and the surgical tool through the system and can also manipulate the surgical robot in the virtual scene. In addition, the system can provide visual guidance to the surgeon when the patient’s joint is adjusted. A prototype system is developed for orthopedic surgeries. Proof-of-concept joint surgery demo is carried out to verify the effectiveness of the proposed method. Experimental results show that the proposed system can synchronize the manipulations in both the real operation site and the virtual scene, thus realizing the bidirectional driving.

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“…Robot-assisted spinal surgery has also been applied in clinical practice [ 8 ]. It has been confirmed to be superior to manual operations in terms of safety, accuracy, the amount of radiation to surgeons, and the learning curve [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Development and Clinical Trial of a New Orthopedic Surgical Robot for Positioning and Navigation

Chang

et al. 2022

JCM

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Robot-assisted orthopedic surgery has great application prospects, and the accuracy of the robot is the key to its overall performance. The aim of this study was to develop a new orthopedic surgical robot to assist in spinal surgeries and to compare its feasibility and accuracy with the existing orthopedic robot. A new type of high-precision orthopedic surgical robot (Tuoshou) was developed. A multicenter, randomized controlled trial was carried out to compare the Tuoshuo with the TiRobot (TINAVI Medical Technologies Co., Ltd., Beijing) to evaluate the accuracy and safety of their navigation and positioning. A total of 112 patients were randomized, and 108 patients completed the study. The position deviation of the Kirschner wire placement in the Tuoshuo group was smaller than that in the TiRobot group (p = 0.014). The Tuoshuo group was better than the TiRobot group in terms of the pedicle screw insertion accuracy (p = 0.016) and entry point deviation (p < 0.001). No differences were observed in endpoint deviation (p = 0.170), axial deviation (p = 0.170), sagittal deviation (p = 0.324), and spatial deviation (p = 0.299). There was no difference in security indicators. The new orthopedic surgical robot was highly accurate and optimized for clinical practice, making it suitable for clinical application.

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Evaluating robotic pedicle screw placement against conventional modalities: a systematic review and network meta-analysis

Cited by 36 publications

References 31 publications

Robot-Assisted Thoracolumbar Fixation After Acute Spinal Trauma: A Case Series

Robot-Assisted Thoracolumbar Fixation After Acute Spinal Trauma: A Case Series

Virtual and Real Bidirectional Driving System for the Synchronization of Manipulations in Robotic Joint Surgeries

Development and Clinical Trial of a New Orthopedic Surgical Robot for Positioning and Navigation

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