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Leveling Equipment

Leveling Equipment

As leveling involves measuring vertical distances relative to a horizontal line of sight, it requires a graduated rod, called a level rod, for vertical measurements and an instrument called a level for a horizontal sight line. A level includes a high-powered telescope with a mechanism for leveling to ensure the line of sight is horizontal when the bubble in the spirit level is centered. Leveling rods, made of wood, metal, or fiberglass, are graduated in feet or meters and commonly used in two-...

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Related Experiment Video

Updated: Jun 21, 2026

A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement

A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement

Published on: May 11, 2020

Prospective Comparison of Two Robotically Navigated Pedicle Screw Instrumentation Techniques.

Fedan Avrumova¹, Frederik Abel², William D Zelenty¹

¹Department of Spine Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.

Journal of Robotic Surgery

|August 22, 2023

Summary

The navigated, high-speed drill (HSD) technique significantly improved screw accuracy and reduced surgical time in robotically navigated posterior spine fusion compared to manual anti-skive instrumentation (ASC). HSD also decreased screw malpositioning and radiation exposure.

Keywords:

Accuracy Fusion Pedicle Robotic-navigated assistance Skive

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Published on: January 6, 2023

Area of Science:

Spine Surgery
Robotics in Medicine
Surgical Navigation

Background:

Robotically navigated spinal instrumentation aims to enhance surgical precision.
Manual anti-skive instrumentation (ASC) and navigated high-speed drill (HSD) are two techniques used in robotically navigated posterior fusion surgery.
Comparing the accuracy and efficiency of these techniques is crucial for optimizing surgical outcomes.

Purpose of the Study:

To compare screw accuracy and the incidence of skive between ASC and HSD techniques in robotically navigated posterior spine fusion.
To evaluate the operative time and radiation exposure associated with each technique.

Main Methods:

A comparative study involving 116 patients undergoing robotically navigated posterior fusion surgery over 3 years.
Patients were divided into two groups: ASC (n=53) and HSD (n=63).
Screw accuracy and skive were analyzed using preoperative CT and intraoperative 3D fluoroscopy, with a total of 590 planned screws analyzed.

Main Results:

The HSD technique achieved a higher successful screw insertion rate (96.3%) compared to ASC (82.8%) (p < 0.05).
Skive events were significantly lower with HSD (1.4%) versus ASC (6.2%) (p < 0.05).
HSD demonstrated superior accuracy in axial and sagittal planes, reduced time per screw (1.9 min vs. 3.2 min), and lower radiation exposure.

Conclusions:

The navigated, high-speed drill (HSD) technique offers significant improvements in screw accuracy, operative time, and radiation exposure compared to manual anti-skive instrumentation (ASC) in robotically navigated posterior spine fusion.
HSD represents an iterative improvement in robotic navigation platforms, potentially reducing the need for revision surgeries due to malpositioned screws.
No adverse clinical effects were observed with either technique.