Related Experiment Video
Updated: Jun 14, 2025
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A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
Published on: May 11, 2020
8.8K
Pedicle Screw Placement With Augmented Reality Versus Robotic-Assisted Surgery
Franziska C S Altorfer1, Michael J Kelly1, Fedan Avrumova1
1Department of Spine Surgery, Hospital for Special Surgery, New York, NY.
Spine
|September 4, 2024
Summary
Robotic-assisted navigation (RAN) and augmented reality (AR) both offer high accuracy for lumbosacral pedicle screw placement. RAN demonstrated a significantly higher rate of optimal Grade-A screw placement compared to AR.
Area of Science:
- Spine surgery
- Surgical navigation technologies
- Orthopedic instrumentation
Background:
- Robotic-assisted navigation (RAN) and augmented reality (AR) show improved accuracy over free-hand techniques for lumbar pedicle screw placement.
- Direct comparative studies on RAN and AR accuracy for pedicle screw placement are lacking.
Purpose of the Study:
- To compare the accuracy of lumbosacral pedicle screw placement between Robotic-assisted navigation (RAN) and augmented reality (AR).
Main Methods:
- Prospective analysis of 212 patients undergoing lumbosacral (L1-S1) pedicle screw placement using either RAN or AR.
- Screw accuracy was evaluated by two independent reviewers using intraoperative 3D fluoroscopic scans and the Gertzbein and Robbins scale.
Main Results:
- A total of 1,211 pedicle screws were placed (827 with RAN, 384 with AR).
- Overall accuracy (Grades A and B) was high for both techniques (99.6% for RAN, 98.7% for AR).
- Robotic-assisted navigation (RAN) achieved a significantly higher rate of optimal Grade-A screw placements (95.2%) compared to augmented reality (AR) (89.8%) (P=0.001).
Conclusions:
- Both RAN and AR are reliable and accurate technologies for lumbosacral pedicle screw placement.
- RAN demonstrated superior accuracy in achieving optimal (Grade-A) pedicle screw placement compared to AR.
