Feasibility and accuracy of a robotic guidance system for navigated spine surgery in a hybrid operating room: a cadaver study.
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Authors
Burström, GustavBalicki, Marcin
Patriciu, Alexandru
Kyne, Sean
Popovic, Aleksandra
Holthuizen, Ronald
Homan, Robert
Skulason, Halldor
Persson, Oscar
Edström, Erik
Elmi-Terander, Adrian
Issue Date
2020-05-05
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Burström G, Balicki M, Patriciu A, et al. Feasibility and accuracy of a robotic guidance system for navigated spine surgery in a hybrid operating room: a cadaver study. Sci Rep. 2020;10(1):7522. Published 2020 May 5. doi:10.1038/s41598-020-64462-xAbstract
The combination of navigation and robotics in spine surgery has the potential to accurately identify and maintain bone entry position and planned trajectory. The goal of this study was to examine the feasibility, accuracy and efficacy of a new robot-guided system for semi-automated, minimally invasive, pedicle screw placement. A custom robotic arm was integrated into a hybrid operating room (OR) equipped with an augmented reality surgical navigation system (ARSN). The robot was mounted on the OR-table and used to assist in placing Jamshidi needles in 113 pedicles in four cadavers. The ARSN system was used for planning screw paths and directing the robot. The robot arm autonomously aligned with the planned screw trajectory, and the surgeon inserted the Jamshidi needle into the pedicle. Accuracy measurements were performed on verification cone beam computed tomographies with the planned paths superimposed. To provide a clinical grading according to the Gertzbein scale, pedicle screw diameters were simulated on the placed Jamshidi needles. A technical accuracy at bone entry point of 0.48 ± 0.44 mm and 0.68 ± 0.58 mm was achieved in the axial and sagittal views, respectively. The corresponding angular errors were 0.94 ± 0.83° and 0.87 ± 0.82°. The accuracy was statistically superior (p < 0.001) to ARSN without robotic assistance. Simulated pedicle screw grading resulted in a clinical accuracy of 100%. This study demonstrates that the use of a semi-automated surgical robot for pedicle screw placement provides an accuracy well above what is clinically acceptable.Description
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https://www.nature.com/articles/s41598-020-64462-xhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7200720/
ae974a485f413a2113503eed53cd6c53
10.1038/s41598-020-64462-x
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