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A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
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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.
Journal of Neurosurgical Sciences
|May 5, 2016
Summary
Real-time spinal navigation using 3D fluoroscopic images significantly reduces screw misplacement compared to traditional fluoroscopy. This advanced navigation facilitates complex spinal surgeries and expands the use of minimally invasive percutaneous techniques.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Medical Imaging
Background:
- Retrospective study comparing real-time spinal navigation with 3D fluoroscopic images versus standard fluoroscopy.
- Investigating the impact of navigation technology on surgical indications and clinical practice in spinal surgery.
Purpose of the Study:
- To assess the advantages of real-time spinal navigation (O-arm® and StealthStation®) over fluoroscopy.
- To determine if 3D fluoroscopic navigation affects surgical indications and clinical practice.
Main Methods:
- Analysis of 421 patients undergoing image-guided spinal surgery from January 2009 to December 2013.
- Two groups: Group 1 (fluoroscopic control), Group 2 (real-time 3D fluoroscopic navigation).
- Postoperative CT scans used to verify screw placement in all vertebral osteosynthesis cases.
Main Results:
- Screw misplacement rates were 5.8% in Group 1 and 1.5% in Group 2 (Odds Ratio 4.2, P<0.0001).
- Increased utilization of percutaneous procedures observed in Group 2.
- Longer duration noted for open osteosynthesis in Group 2.
Conclusions:
- 3D fluoroscopic navigation significantly reduces screw misplacement in spinal surgery.
- This technology aids osteosynthesis in challenging vertebral segments.
- Enables wider application of percutaneous techniques when appropriate.
