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Related Experiment Video

Updated: Aug 1, 2025

A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
06:24

A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement

Published on: May 11, 2020

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Robotic-navigated assistance in spine surgery.

Frederik Abel1, Fedan Avrumova1, Samuel N Goldman1

  • 1Department of Spine Surgery, Hospital for Special Surgery, New York, New York, USA.

The Bone & Joint Journal
|April 30, 2023
PubMed
Summary

Robotic-navigated assistance (RNA) for spinal surgery demonstrates high accuracy in pedicle screw placement for degenerative spine disorders. This advanced technique shows reliability and a low complication rate in adult patients.

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Medical Robotics

Background:

  • Degenerative disorders of the thoracic and lumbar spines are common, often requiring surgical intervention.
  • Accurate pedicle screw placement is critical for successful spinal fusion and minimizing complications.
  • Robotic-navigated assistance (RNA) is an emerging technology in spinal surgery.

Purpose of the Study:

  • To evaluate the accuracy of pedicle screw placement using robotic-navigated assistance (RNA).
  • To assess intraoperative factors, radiation exposure, and complication rates in adult patients undergoing RNA spinal surgery.
  • To analyze the reliability and learning curve associated with the Mazor X Stealth system.

Main Methods:

  • Prospective review of 196 adult patients undergoing RNA spinal surgery (Mazor X Stealth system) between June 2019 and March 2022.
  • Analysis of 1,123 pedicle screws implanted, with 1,001 placed robotically.
  • Accuracy assessment using intraoperative 3D fluoroscopy, with Gertzbein and Robbins grading.

Main Results:

  • 94% of robotically placed screws achieved Gertzbein and Robbins grade A accuracy (median deviation 0.8 mm).
  • A low rate of skive events (1.8%) and no adverse clinical sequelae within 90-day follow-up.
  • Mean fluoroscopic exposure per screw was 4.9 seconds.

Conclusions:

  • Robotic-navigated assistance (RNA) is highly accurate and reliable for pedicle screw placement in adult spinal surgery.
  • RNA demonstrates a low complication rate and manageable radiation exposure after a learning period.
  • Further improvements in accuracy may be achieved by understanding patient anatomy and real-time risk factors.