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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

Limitations of current robot-assisted pedicle screw insertion systems.

Caitlyn Wandvik¹, Madeline E Greil², Samantha Colby²

¹1Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City; and.

Neurosurgical Focus

|December 1, 2024

Summary

Robot-assisted spine surgery shows promise but faces limitations. A review of 100 cases identified issues like registration errors and patient anatomy impacting screw placement accuracy and safety.

Keywords:

pedicle screw placement robot-assisted surgery spine surgery

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Area of Science:

Neurosurgery
Robotics
Medical Technology

Background:

Robot systems enhance accuracy and efficiency in spine surgery.
Preoperative planning and real-time feedback mitigate human error.
Limitations in current robot-assisted spine surgery persist.

Purpose of the Study:

Analyze limitations in robot-assisted pedicle screw placement.
Evaluate screw accuracy and identify reasons for complications.
Review literature on robot-assisted spine surgery limitations.

Main Methods:

Retrospective review of 100 robot-assisted pedicle screw placements.
Intraoperative CT scans assessed for screw accuracy.
Malpositioned screws, near misses, and abandoned attempts analyzed.

Main Results:

20 screw-related complications in 100 cases.
14 near misses, 1 neurological injury, 5 abandoned attempts.
Identified limitations: registration errors, spine movement, patient habitus, artifacts, poor bone differentiation, skiving, soft-tissue interference, physical constraints.

Conclusions:

Robot-assisted spine surgery has limitations, particularly in mobile segments and near critical structures.
Technical nuances are crucial for navigating these limitations.
Standardized metrics and ongoing innovation are needed to improve efficacy.