What should my hospital buy next?—Guidelines for the acquisition and application of imaging, navigation, and robotics for spine surgery

Malham, Gregory M.; Wells-Quinn, Thomas A.

doi:10.21037/jss.2019.02.04

Cited by 95 publications

(84 citation statements)

References 16 publications

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“…The original Mazor robotic system (SpineAssist) was approved by the FDA in 2004, and is the most extensively studied system to date. 5,13,14 The next-generation Mazor 49 $700 000-$800 000 (MR); $1 500 000 (MX) $700 000 $1 000 000-$1 500 000…”

Section: Computer-assisted Navigation Systems For Spinal Surgerymentioning

confidence: 99%

Robotic Spine Surgery: Current State in Minimally Invasive Surgery

Vo¹,

Jiang²,

Azad

et al. 2020

Global Spine Journal

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Study Design: Narrative review. Objectives: Robotic systems in spinal surgery may offer potential benefits for both patients and surgeons. In this article, the authors explore the future prospects and current limitations of robotic systems in minimally invasive spine surgery. Methods: We describe recent developments in robotic spine surgery and minimally invasive spine surgery. Institutional review board approval was not needed. Results: Although robotic application in spine surgery has been gradual, the past decade has seen the arrival of several novel robotic systems for spinal procedures, suggesting the evolution of technology capable of augmenting surgical ability. Conclusion: Spine surgery is well positioned to benefit from robotic assistance and automation. Paired with enhanced navigation technologies, robotic systems have tremendous potential to supplement the skills of spine surgeons, improving patient safety and outcomes while limiting complications and costs.

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Section: Computer-assisted Navigation Systems For Spinal Surgerymentioning

confidence: 99%

Robotic Spine Surgery: Current State in Minimally Invasive Surgery

Vo¹,

Jiang²,

Azad

et al. 2020

Global Spine Journal

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“…Images of lesion points in patients during and before surgery can be obtained using many ways, and different ways had different effects on the operation. In most cases, preoperative images of the patient were obtained by CT or MRI [50,51]. However, images of the patient's focal point during an operation can be obtained using different ways.…”

Section: Preoperative or Intraoperative Imagingmentioning

confidence: 99%

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

et al. 2020

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Background: The traditional navigation interface was intended only for two-dimensional observation by doctors; thus, this interface does not display the total spatial information for the lesion area. Surgical navigation systems have become essential tools that enable for doctors to accurately and safely perform complex operations. The image navigation interface is separated from the operating area, and the doctor needs to switch the field of vision between the screen and the patient's lesion area. In this paper, augmented reality (AR) technology was applied to spinal surgery to provide more intuitive information to surgeons. The accuracy of virtual and real registration was improved via research on AR technology. During the operation, the doctor could observe the AR image and the true shape of the internal spine through the skin. Methods: To improve the accuracy of virtual and real registration, a virtual and real registration technique based on an improved identification method and robotassisted method was proposed. The experimental method was optimized by using the improved identification method. X-ray images were used to verify the effectiveness of the puncture performed by the robot. Results: The final experimental results show that the average accuracy of the virtual and real registration based on the general identification method was 9.73 ± 0.46 mm (range 8.90-10.23 mm). The average accuracy of the virtual and real registration based on the improved identification method was 3.54 ± 0.13 mm (range 3.36-3.73 mm). Compared with the virtual and real registration based on the general identification method, the accuracy was improved by approximately 65%. The highest accuracy of the virtual and real registration based on the robot-assisted method was 2.39 mm. The accuracy was improved by approximately 28.5% based on the improved identification method. Conclusion: The experimental results show that the two optimized methods are highly very effective. The proposed AR navigation system has high accuracy and stability. This system may have value in future spinal surgeries.

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“…Mazor Robotics' second-generation robot and successor to SpineAssist is the Renaissance Guidance System. The Renaissance is a miniature robotic platform that acts as a mechanical guidance unit that can be mounted directly to the patient via bone-anchored attachments to the spine or pelvis or the operating table (Malham and Wells-Quinn 2019). A three-dimensional marker is attached to the platform before the intraoperative CT scan is performed using an intraoperative CT with the patient prone on the operating table.…”

Section: Mazor: the Renaissance Guidance Systemmentioning

confidence: 99%

“…The Renaissance Guidance System has been used in approximately 30,000 cases since its release and is still widely used today. According to recent reports, the Renaissance reportedly costs approximately $700,000-$900,000 with disposable costs of up to $1000 per case (Malham and Wells-Quinn 2019).…”

Section: Mazor: the Renaissance Guidance Systemmentioning

confidence: 99%

“…Radiation exposure among spine surgeons varies considerably and assessing radiation exposure in spine surgery can be challenging due to a lack of standardized reporting. For instance, some studies report radiation exposure in time (seconds) per screw, whereas others report total radiation generated throughout a case using an entirely different scale or measurement (Malham and Wells-Quinn 2019). As such, implementing new technologies such as robotic surgical systems that can potentially decrease the risk of this occupational hazard in spine surgery would likely be beneficial to OR staff.…”

Section: Benefits: Decreased Radiation Exposurementioning

confidence: 99%

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Robotic Technology

Holmberg

Altman

Cheng

et al. 2020

Handbook of Spine Technology

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With increasing numbers of patients requiring spine surgery, there has been an emphasis on technological advances designed to enhance surgical outcomes and improve patient safety. In particular, the number of elective spinal fusion surgeries in the USA continues to increase. Instrumentation of the spine with pedicle screws is frequently used for indications including deformity and instability. With neurovascular structures near the pedicle, accurate screw placement is of paramount importance to ensure good outcomes. Reported complications related to pedicle screw malposition range from 1% to 54% (Molliqaj et al., Neurosurg Focus 42(5): E14, 2017). Currently, there are several techniques described for inserting pedicle screws, including freehand manual insertion based on anatomic landmarks and fluoroscopy, manual insertion with navigation assistance systems, and robotic-assisted methods.

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What should my hospital buy next?—Guidelines for the acquisition and application of imaging, navigation, and robotics for spine surgery

Cited by 95 publications

References 16 publications

Robotic Spine Surgery: Current State in Minimally Invasive Surgery

Robotic Spine Surgery: Current State in Minimally Invasive Surgery

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

Robotic Technology

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