TY - JOUR
T1 - Clinical acceptance and accuracy assessment of spinal implants guided with spineassist surgical robot
T2 - Retrospective study
AU - Devito, Dennis P.
AU - Kaplan, Leon
AU - Dietl, Rupert
AU - Pfeiffer, Michael
AU - Horne, Dale
AU - Silberstein, Boris
AU - Hardenbrook, Mitchell
AU - Kiriyanthan, George
AU - Barzilay, Yair
AU - Bruskin, Alexander
AU - Sackerer, Dieter
AU - Alexandrovsky, Vitali
AU - Stüer, Carsten
AU - Burger, Ralf
AU - Maeurer, Johannes
AU - Gordon, Donald G.
AU - Schoenmayr, Robert
AU - Friedlander, Alon
AU - Knoller, Nachshon
AU - Schmieder, Kirsten
AU - Pechlivanis, Ioannis
AU - Kim, In Se
AU - Meyer, Bernhard
AU - Shoham, Moshe
PY - 2010/11/15
Y1 - 2010/11/15
N2 - Study Design. Retrospective, multicenter study of robotically-guided spinal implant insertions. Clinical acceptance of the implants was assessed by intraoperative radiograph, and when available, postoperative computed tomography (CT) scans were used to determine placement accuracy. Objective. To verify the clinical acceptance and accuracy of robotically-guided spinal implants and compare to those of unguided free-hand procedures. Summary Of Background Data. SpineAssist surgical robot has been used to guide implants and guide-wires to predefined locations in the spine. SpineAssist which, to the best of the authors' knowledge, is currently the sole robot providing surgical assistance in positioning tools in the spine, guided over 840 cases in 14 hospitals, between June 2005 and June 2009. Methods. Clinical acceptance of 3271 pedicle screws and guide-wires inserted in 635 reported cases was assessed by intraoperative fluoroscopy, where placement accuracy of 646 pedicle screws inserted in 139 patients was measured using postoperative CT scans. RESULTS.: Screw placements were found to be clinically acceptable in 98% of the cases when intraoperatively assessed by fluoroscopic images. Measurements derived from postoperative CT scans demonstrated that 98.3% of the screws fell within the safe zone, where 89.3% were completely within the pedicle and 9% breached the pedicle by up to 2 mm. The remaining 1.4% of the screws breached between 2 and 4 mm, while only 2 screws (0.3%) deviated by more than 4 mm from the pedicle wall. Neurologic deficits were observed in 4 cases yet, following revisions, no permanent nerve damage was encountered, in contrast to the 0.6% to 5% of neurologic damage reported in the literature. Conclusion. SpineAssist offers enhanced performance in spinal surgery when compared to free-hand surgeries, by increasing placement accuracy and reducing neurologic risks. In addition, 49% of the cases reported herein used a percutaneous approach, highlighting the contribution of SpineAssist in procedures without anatomic landmarks.
AB - Study Design. Retrospective, multicenter study of robotically-guided spinal implant insertions. Clinical acceptance of the implants was assessed by intraoperative radiograph, and when available, postoperative computed tomography (CT) scans were used to determine placement accuracy. Objective. To verify the clinical acceptance and accuracy of robotically-guided spinal implants and compare to those of unguided free-hand procedures. Summary Of Background Data. SpineAssist surgical robot has been used to guide implants and guide-wires to predefined locations in the spine. SpineAssist which, to the best of the authors' knowledge, is currently the sole robot providing surgical assistance in positioning tools in the spine, guided over 840 cases in 14 hospitals, between June 2005 and June 2009. Methods. Clinical acceptance of 3271 pedicle screws and guide-wires inserted in 635 reported cases was assessed by intraoperative fluoroscopy, where placement accuracy of 646 pedicle screws inserted in 139 patients was measured using postoperative CT scans. RESULTS.: Screw placements were found to be clinically acceptable in 98% of the cases when intraoperatively assessed by fluoroscopic images. Measurements derived from postoperative CT scans demonstrated that 98.3% of the screws fell within the safe zone, where 89.3% were completely within the pedicle and 9% breached the pedicle by up to 2 mm. The remaining 1.4% of the screws breached between 2 and 4 mm, while only 2 screws (0.3%) deviated by more than 4 mm from the pedicle wall. Neurologic deficits were observed in 4 cases yet, following revisions, no permanent nerve damage was encountered, in contrast to the 0.6% to 5% of neurologic damage reported in the literature. Conclusion. SpineAssist offers enhanced performance in spinal surgery when compared to free-hand surgeries, by increasing placement accuracy and reducing neurologic risks. In addition, 49% of the cases reported herein used a percutaneous approach, highlighting the contribution of SpineAssist in procedures without anatomic landmarks.
KW - computer-assisted surgery
KW - minimally invasive
KW - pedicle screws
KW - robotic-assisted surgery
UR - http://www.scopus.com/inward/record.url?scp=78649412164&partnerID=8YFLogxK
U2 - 10.1097/BRS.0b013e3181d323ab
DO - 10.1097/BRS.0b013e3181d323ab
M3 - Article
AN - SCOPUS:78649412164
SN - 0362-2436
VL - 35
SP - 2109
EP - 2115
JO - Spine
JF - Spine
IS - 24
ER -