Guideline for Thoracolumbar Pedicle Screw Placement Assisted by Orthopaedic Surgical Robot

Abstract

The pedicle screw placement procedure is the most commonly used technique for spinal fixation and can provide reliable three‐column stabilization. Accurate screw placement is necessary in clinical practice. To avoid screw malposition, which may decrease the stiffness of the screw‐rod construct or increase the likelihood of neural and vascular injuries, the surgeons must fully understand the regional anatomy. Deformities, such as scoliosis, kyphosis or congenital anomalies, may complicate the application of the pedicle screw placement technique and increase the chance of screw encroachments. Incidences of pedicle screw malposition vary in different districts and hospitals and with surgeons and techniques. Today, the minimally invasive spinal surgery is well developed. However, the narrow corridors and limited views for surgeons increase the difficulty of pedicle screw placement and the possibility of screw encroachment. Evidenced by previous studies, robotic surgery can provide accurate screw placement, especially in settings of spinal deformities, anatomical anomalies, and minimally invasive procedures. Based on the consensus of consultant specialists, the literature review and our local experiences, this guideline introduces the robotic system and describes the workflow of robot‐assisted procedures and the precautions to take during procedures. This guideline aims to outline a standardized method for robotic surgery for thoracolumbar pedicle screw placement.

Comparison of Superior‐Level Facet Joint Violations Between Robot‐Assisted Percutaneous Pedicle Screw Placement and Conventional Open Fluoroscopic‐Guided Pedicle Screw Placement

“…Robot‐assisted TLIF procedures were performed using the TiRobot system (TINAVI Medical Technologies, Beijing, China). The patient tracker was percutaneously anchored at the spinal process.…”

Telerobotic Spinal Surgery Based on 5G Network: The First 12 Cases

“…Except for pedicle screw placement, the previous article also reported the application of robot technology in the guidance procedure of percutaneous transforaminal endoscopy and vertebroplasty surgery, anterior odontoid screw fixation, posterior C1-2 transarticular screw fixation, cortical trajectory for pedicle fixation, and translaminar lag screw fixation. [2][3][4][5][6][7][8][9][10][11][12] More complicated telerobotic cases would be performed based on the 5G network in the future. Not only spinal surgery could benefit from this high-speed network, but also other surgeries like cardiac surgery, urinary surgery, and hepatobiliary surgery.…”

“…The operation was performed according to the guideline for thoracolumbar pedicle screw placement assisted by orthopaedic surgical robot. 5 After anesthesia, the patient was prone on the Jackson table. The patient tracker was placed at the spinous process of 1 to 2 vertebrae cranial to the operative segments.…”

“…3 After several years of development, testing, and research, the TiRobot system has been proved to be reliable and efficacious in full-length spinal surgery. [4][5][6][7][8][9][10][11][12] Remote surgery is based on the mutual telecommunication of medical information. Medical information, such as image, audio, and video, are digitized and transmitted via cable or wireless telecommunication networks.…”

Optimization of virtual and real registration technology based on augmented reality in a surgical navigation system

“…Computerassisted orthopaedic surgery is a related field of orthopaedic technology development. However, robot-assisted orthopaedic surgery can achieve the accuracy, precision and safety that computer-assisted orthopaedic surgery lacks [21][22][23].…”