Pedicle screw placement accuracy of bone-mounted miniature robot system

Abstract

This article describes factors affecting the accuracy of transpedicle screw placements performed with the Renaissance robot-guided system and reviews the relevant literature. Between January 2013 and January 2015, Renaissance robot-guided spinal surgery was performed in 125 patients at Kaohsiung Medical University Hospital in Kaohsiung, Taiwan. The surgeries included 662 transpedicle screw implants and 49 Kirschner wire (K-wire) reimplants performed by intraoperative repositioning. The lead author evaluated the accuracy of all K-wire insertions and classified their accuracy into 3 categories relative to the preoperative plan for transpedicle screw placement. For cases in which screws required repositioning after the registration step, factors affecting pedicle screw placement were determined according to the consensus of 3 experienced spinal surgeons. According to the scheme developed by Kuo et al (PLoS One 2016;11:e0153235), the K-wire placement accuracies before and after repositioning were respectively classified as follows: 76.1% and 77.6% in type I; 12.2% and 17.7% in type IIa; 4.3% and 4.5% in type IIb; 6.4% and 0% in type IIIa; and 1% and 1% in type IIIb. The percentage of screws requiring repositioning due to drilling error was 85.7% (42/49). Comparisons of preoperative and postoperative function showed significantly improved accuracy. This study showed that inaccurate pedicle screw placement mainly results from errors in preoperative planning, mounting, registration, drilling, and robot assembly. Pedicle screw placement using a bone-mounted miniature robot system requires meticulous preoperative planning to minimize these errors.

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

“…The previous studies demonstrated that the malfunction and registration failure rate of the spinal robot system was 1%, and 85.7% adverse events were related to the misoperation of surgeons. 31,32 In this way, except for keep promoting the robot system, the practice of operation skill and manipulation of the robot system are also critical to the success of robot-assisted surgery. 33 These clinical case series also explored the new pattern of "one-to-many" remote surgery.…”

Radiological and Clinical Differences between Tinavi Orthopedic Robot and O-Arm Navigation System in Thoracolumbar Screw Implantation for Reconstruction of Spinal Stability

“…At present, a variety of surgical robot systems have been used in the field of spinal surgery, including SpineAssist/Renaissance, SPINEBOT, VectorBot, and ROSA, among which the SpineAssist/Renaissance system developed in Israel is the best known. Although the SpineAssist/Renaissance spinal robot has a high accuracy of pedicle screw placement [ 11 – 14 ], there is still misplacement of guide wires and screws with this device [ 15 , 16 ]. In addition, SpineAssist/Renaissance has some defects, including complex operation and lack of real-time image monitoring [ 17 ].…”

Minimally invasive versus conventional fixation of tracer in robot-assisted pedicle screw insertion surgery: a randomized control trial

“…Pedicle screw fixation plays an important role in reconstruction procedures for spinal stability. Given the complex morphology and variability of the pedicle, screws penetrating it may injure surrounding tissues, thus resulting in severe complications in conventional spine surgery procedures, especially those involving freehand pedicle screw insertion [1][2][3][4][5]. To improve the rate of successful screw placement and reduce the complications, a robotic system for spinal surgery has been recently developed.…”