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Updated: May 7, 2026
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A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
Published on: May 11, 2020
Routine spinal navigation for thoraco-lumbar pedicle screw insertion using the O-arm three-dimensional imaging system
Ji Min Ling1, Shree Kumar Dinesh1, Boon Chuan Pang1
1Department of Neurosurgery, National Neuroscience Institute, Singapore 11 Jalan Tan Tock Seng, Sinagpore 308433, Singapore.
Summary
O-arm navigation provides high accuracy for thoraco-lumbar pedicle screw insertion, with 95.3% of screws placed without breach. Operative times were comparable to traditional fluoroscopy, demonstrating its efficacy in spinal surgery.
Area of Science:
- Orthopedic Surgery
- Neurosurgery
- Medical Imaging
Background:
- Image-guided navigation enhances surgical precision.
- Intra-operative 3D imaging is crucial for accurate spinal procedures.
Purpose of the Study:
- To evaluate the accuracy of thoraco-lumbar pedicle screw insertion using O-arm 3D imaging.
- To compare operative times between O-arm navigation and fluoroscopy.
Main Methods:
- Retrospective review of 467 pedicle screws in 92 patients undergoing O-arm guided surgery.
- Assessment of pedicle breach using Gertzbein classification.
- Comparison of operative time with a matched fluoroscopy control group.
Main Results:
- 95.3% of screws had no pedicle breach (Gertzbein grade 0).
- Minor breaches (grades 1 and 2) occurred in 4.7% of screws, with grade 2 screws revised.
- No neurovascular injuries were reported.
- Operative times were not significantly different between O-arm and fluoroscopy groups (5.25 vs. 4.75 hours).
Conclusions:
- O-arm based stereotactic navigation ensures high accuracy for thoraco-lumbar pedicle screw placement.
- The O-arm system is a safe and effective tool for image-guided spinal surgery.
- Intra-operative 3D imaging does not significantly increase operative time compared to fluoroscopy.
