Role of Robotics in Improving Surgical Outcome in Spinal Pathologies

Molliqaj, Granit; Paun, Luca; Nouri, Aria; Girod, Pierre-Pascal; Schaller, Karl; Tessitore, Enrico

doi:10.1016/j.wneu.2020.05.132

Cited by 7 publications

(3 citation statements)

References 41 publications

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“…More recent studies, such as those reported by Molliqaj et al [7], demonstrate the increase of accuracy with the use of comanipulation robotic devices, particularly for pedicle screw positioning in the thoracic spine. These results show the potential of using robotic systems considering the smaller size of the thoracic vertebrae pedicles compared to the lumbar vertebrae and therefore the increased accuracy offered by robotic devices.…”

Section: Contributions Of Roboticsmentioning

confidence: 88%

Comanipulation Robotic Platform for Spine Surgery With Exteroceptive Visual Coupling: Development and Experimentation

Koszulinski

Sandoval

Vendeuvre

et al. 2022

Journal of Medical Devices

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In this paper, a novel surgical robotic platform intended to assist surgeons in cervical spine surgery is presented. The purpose of this surgery is to treat cervical spine instabilities. The surgical procedure requires drilling into specific region of the vertebrae in order to attach spinal implants and ensure a normal spacing between each vertebra. In this context, the proposed robotic platform allows to control and restrict surgeon's movements to a specific drilling direction set by the surgeon. The current platform is composed of a collaborative robot with 7 DoF equipped with a drilling tool and directly comanipulated by the surgeon. A motion capture system, as an exteroceptive sensor device, provides the robot controller with the movement data of the vertebra to be drilled. Robot Operating System (ROS) framework is used to enable real-time communication between the collaborative robot and the visual exteroceptive device. In addition, an implemented compliance control program allows to enhance the safety aspect of the robotic platform. Indeed, the collaborative robot follow the patient's movements while constraining the tool movements to an optimal trajectory as well as a limited drilling depth selected by the surgeon. The robot's elbow movements are also restricted by exploiting the null-space in order to avoid collisions with other equipment or medical team members. Experimental drilling trials have been performed by an orthopedic surgeon to validate the usefulness and different functionalities of the developed robotic platform, and provide that a collaborative robot can comply with spine surgery procedure.

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Section: Contributions Of Roboticsmentioning

confidence: 88%

Comanipulation Robotic Platform for Spine Surgery With Exteroceptive Visual Coupling: Development and Experimentation

Koszulinski

Sandoval

Vendeuvre

et al. 2022

Journal of Medical Devices

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“…Overall, further randomized, controlled studies with the elimination of confounding factors such as differences in surgical approach would be highly benefitial. 78…”

Section: Complications Reductionmentioning

confidence: 99%

The Clinical Impact of Image Guidance and Robotics in Spinal Surgery: A Review of Safety, Accuracy, Efficiency, and Complication Reduction

et al. 2021

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Image guidance (IG) and robotic-assisted (RA) surgery are modern technological advancements that have provided novel ways to perform precise and accurate spinal surgery. These innovations supply real-time, three-dimensional imaging information to aid in instrumentation, decompression, and implant placement. Although nothing can replace the knowledge and expertise of an experienced spine surgeon, these platforms do have the potential to supplement the individual surgeon's capabilities. Specific advantages include more precise pedicle screw placement, minimally invasive surgery with less reliance on intraoperative fluoroscopy, and lower radiation exposure to the surgeon and staff. As these technologies have become more widely adopted over the years, novel uses such as tumor resection have been explored. Disadvantages include the cost of implementing IG and robotics platforms, the initial learning curve for both the surgeon and the staff, and increased patient radiation exposure in scoliosis surgery. Also, given the relatively recent transition of many procedures from inpatient settings to ambulatory surgery centers, access to current devices may be cost prohibitive and not as readily available at some centers. Regarding patient-related outcomes, much further research is warranted. The short-term benefits of minimally invasive surgery often bolster the perioperative and early postoperative outcomes in many retrospective studies on IG and RA surgery. Randomized controlled trials limiting such confounding factors are warranted to definitively show potential independent improvements in patient-related outcomes specifically attributable to IG and RA alone. Nonetheless, irrespective of these current unknowns, it is clear that these technologies have changed the field and the practice of spine surgery. Surgeons should be familiar with the potential benefits and tradeoffs of these platforms when considering adopting IG and robotics in their practices.

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“…Several robotic systems are available for spinal interventions, mostly for assistance in pedicle screw placement [19]. Recent literature reported that robot-assisted screw placement is at least non-inferior if not superior with respect to accuracy than conventional free-hand technique and potentially decreases [5,17,[20][21][22][23][24]. A recent paper byJosephetal.systematicallyreviewedapplicationsofrobotics in spinal surgery [18].…”

Section: Spinal Applicationsmentioning

confidence: 99%

Global adoption of robotic technology into neurosurgical practice and research

et al. 2020

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Recent technological advancements have led to the development and implementation of robotic surgery in several specialties, including neurosurgery. Our aim was to carry out a worldwide survey among neurosurgeons to assess the adoption of and attitude toward robotic technology in the neurosurgical operating room and to identify factors associated with use of robotic technology. The online survey was made up of nine or ten compulsory questions and was distributed via the European Association of the Neurosurgical Societies (EANS) and the Congress of Neurological Surgeons (CNS) in February and March 2018. From a total of 7280 neurosurgeons who were sent the survey, we received 406 answers, corresponding to a response rate of 5.6%, mostly from Europe and North America. Overall, 197 neurosurgeons (48.5%) reported having used robotic technology in clinical practice. The highest rates of adoption of robotics were observed for Europe (54%) and North America (51%). Apart from geographical region, only age under 30, female gender, and absence of a non-academic setting were significantly associated with clinical use of robotics. The Mazor family (32%) and ROSA (26%) robots were most commonly reported among robot users. Our study provides a worldwide overview of neurosurgical adoption of robotic technology. Almost half of the surveyed neurosurgeons reported having clinical experience with at least one robotic system. Ongoing and future trials should aim to clarify superiority or non-inferiority of neurosurgical robotic applications and balance these potential benefits with considerations on acquisition and maintenance costs.

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Role of Robotics in Improving Surgical Outcome in Spinal Pathologies

Cited by 7 publications

References 41 publications

Comanipulation Robotic Platform for Spine Surgery With Exteroceptive Visual Coupling: Development and Experimentation

Comanipulation Robotic Platform for Spine Surgery With Exteroceptive Visual Coupling: Development and Experimentation

The Clinical Impact of Image Guidance and Robotics in Spinal Surgery: A Review of Safety, Accuracy, Efficiency, and Complication Reduction

Global adoption of robotic technology into neurosurgical practice and research

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