Robotics Coupled With Navigation for Pediatric Spine Surgery: Initial Intraoperative Experience With 162 Cases

Area of Science:

• Spine Surgery
• Pediatric Orthopedics
• Robotics in Medicine

Background:

• Pedicle screw placement is crucial in pediatric spine deformity surgery.
• Ensuring accuracy and minimizing complications during screw insertion is paramount.

Purpose of the Study:

• To assess the intraoperative efficacy, accuracy, and complication rates of pedicle screw placement using robotic-assisted navigation (RAN).
• To evaluate the learning curve and procedural modifications for optimizing RAN in pediatric spine surgery.

Main Methods:

• Retrospective review of pediatric spine deformity surgeries utilizing RAN (2019-2021).
• Analysis of patient demographics, perioperative metrics, screw accuracy (Gertzbein and Robbins classification), and technical difficulties.
• Statistical analysis of procedural changes and their impact on screw malposition.

Main Results:

• 99.6% of 1467 attempted screws were successfully placed.
• 100% of screws evaluated by CT scans showed complete containment (Grade A).
• Adoption of a high-speed navigated drill and robotic pilot hole drilling reduced screw malposition and loss of registration.

Conclusions:

• Robotic-assisted navigation (RAN) is a safe and accurate method for pedicle screw placement in pediatric spine surgery.
• RAN contributes to improved screw accuracy and a reduced complication profile in spinal deformity correction.