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Published on: January 6, 2023
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The positional consistency between guidewire and cannulated or solid screw in robot-assisted spinal internal fixation
Jingwei Zhao1,2, Yunxian Zhang3, Mingxing Fan4,5
1Department of Spine Surgery, Beijing Jishuitan Hospital, Capital Medical University, 31 Xinjiekou East Street, Xicheng District, Beijing, 100035, China. kivist@163.com.
Journal of Orthopaedic Surgery and Research
|January 4, 2024
Summary
Robot-assisted spinal surgery shows guidewire-screw consistency varies. Cannulated screws offer better accuracy than solid screws, despite potential trajectory alterations in pedicle screw fixation.
Area of Science:
- Spinal Surgery
- Robotics in Medicine
- Orthopedic Implants
Background:
- Investigating positional consistency between guidewires and screws in spinal internal fixation.
- Assessing accuracy in robot-assisted thoracic or lumbar pedicle screw placement.
Purpose of the Study:
- To evaluate guidewire-screw positional consistency in robot-assisted spinal surgery.
- To compare the accuracy of cannulated versus solid pedicle screws.
Main Methods:
- 64 patients underwent robot-assisted pedicle screw fixation using the Tirobot.
- Guidewire and screw accuracy assessed via CT scans using Gertzbein and Robbins scale.
- Positional consistency evaluated using a grading system based on distance and angulation.
Main Results:
- 97.5% guidewires and 94.1% screws achieved Grade A accuracy.
- Guidewire-screw consistency: 85% Grade A for cannulated screws, 69.8% for solid screws.
- Solid screws showed significantly worse positional accuracy and consistency than cannulated screws.
Conclusions:
- Pedicle screws can alter trajectory from guidewire path.
- Cannulated screws demonstrate superior positional accuracy and consistency compared to solid screws.
- Pedicle cortical bone positively influences screw guidance for both types.
