Stereotactic Navigation for Placement of Pedicle Screws in the Thoracic Spine

Robot-assisted spine surgery: feasibility study through a prospective case-matched analysis

“…Two investigators studied the postoperative CT scans of the spine with coronal and sagittal image reconstruction to evaluate each implantation according to the classification of Gertzbein and Robbins [7] and a modified classification of Youkilis [8] (Fig. 4).…”

“…However, the 15 studies on the lumbar spine included in this meta-analysis used different criteria to assess implant accuracy with some including pedicle breaches up to 4 mm among their implants defined as accurately placed. Clearly if we consider only intrapedicular implants (respectively group A or 1 of Gertzbein and Robbins [7] and Youkilis [8] classifications), as correctly positioned, these rates sharply reduce and can reach 60 % for the lumbar spine [9]. Today, no technique or device exists that is able to guarantee 100 % accuracy in implant placement.…”

A new 3-dimensional method for measuring precision in surgical navigation and methods to optimize navigation accuracy

“…With the advent of computerassisted systems, preoperative CT scans can be used intraoperatively to navigate pedicle screw placement. Several studies have reported misplacement rates ranging from 4.5 to 8.5 % using such systems [23][24][25][26]. Youkilis et al [26] reported their experience using computer navigation in 224 pedicle screws, with only 19 (8.5 %) cortical breaches.…”

Towards accurate, robust and practical ultrasound-CT registration of vertebrae for image-guided spine surgery

“…The use of IGS systems in spine surgeries has greatly increased the accuracy of screw implantations and reduced their rate of failure [7][8][9][10][11][12]. The resulting benefits are numerous, including lower surgical risk, increased possibility of performing more complex instrumentation, decreased postoperative complications, more confidence in the surgical procedures, and better postoperative function.…”

“…A number of intraoperative imaging modalities exist and have been implemented for IGS application [16], such as C-arm fluoroscopy [12,17,18], intraoperative CT [4], and intraoperative magnetic resonance imaging [19]. However, these systems are limited due to either occupational radiation exposure [20], prohibitive cost, or stringent requirements for operating conditions and access to the patient.…”