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Updated: Mar 21, 2026
A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
Published on: May 11, 2020
Real-time navigation in spinal surgery: what has changed in surgical practice?
Paolo Roccucci1, Stefano Peron2, Matteo Minotti1
1Department of Neurosurgery, Legnano Civil Hospital, Legnano, Milan, Italy.
Background:
The authors have carried out a retrospective study to assess the advantages of real-time spinal navigation with 3D-fluoro images (O-arm® and StealthStation® navigation systems, Medtronic, Minneapolis, MN, USA) versus fluoroscopy in spinal surgery. The aim of the study is to ascertain whether this technology has affected surgical indications and clinical practice.
Methods:
From January 2009 to December 2013, 421 patients underwent image-guided spinal surgery procedures in our department. They were divided into two main groups: group 1: operated on with C-arm fluoroscopic control; group 2: operated on with real-time navigation with 3D-fluoro images. All patients with vertebral osteosynthesis underwent a postoperative CT scan to check the final position of the screws.
Results:
The screw misplacement proved to be 5.8% in group 1 and 1.5% in group 2. The odds ratio was 4.2 (95% confidence interval 2.3-7.5) with statistical significance (P<0.0001). The results clearly show an increased number of percutaneous procedures in group 2, as well as longer open osteosynthesis.
Conclusions:
Navigation with 3D-fluoro images reduces screw misplacement, facilitates osteosynthesis in the most difficult vertebral segments and allows broader use of percutaneous techniques, when indicated.
