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Robot-Assisted Positioning for Percutaneous Endoscopic Interlaminar Discectomy.

Shuai Jiang1,2,3, Fei Xu1,2,3, Zhuofu Li1,2,3

  • 1Orthopaedic Department, Peking University Third Hospital, Beijing, China.

Orthopaedic Surgery
|January 15, 2025
PubMed
Summary

This study introduces a precise robot-assisted targeting method for percutaneous endoscopic interlaminar discectomy (PEID), significantly reducing pain and improving function. The method enhances surgical accuracy and patient outcomes in minimally invasive spine surgery.

Keywords:
accuracy and reliabilitylumbar disc herniationpercutaneous endoscopic Interlaminar discectomyrobot‐assisted positioningsimultaneous fluoroscopy calibration

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Area of Science:

  • Minimally Invasive Spine Surgery
  • Medical Robotics
  • Surgical Navigation

Background:

  • Percutaneous endoscopic interlaminar discectomy (PEID) benefits from advanced technologies like robotics and visual navigation to improve outcomes.
  • Robotic technology enhances surgical accuracy and reduces risks in minimally invasive procedures.

Purpose of the Study:

  • To introduce a precise and efficient robot-assisted targeting method for C-arm fluoroscopy-guided PEID.
  • To evaluate the accuracy and clinical efficacy of this novel robotic positioning system.

Main Methods:

  • Retrospective analysis of 107 patients with lumbar disc herniation (LDH) undergoing PEID.
  • Development of a specialized end-effector for simultaneous fluoroscopy calibration and robot-to-image registration.
  • Collection of surgical time, fluoroscopy exposure, and pre/postoperative JOA and VAS scores.

Main Results:

  • Robot-assisted positioning averaged 2.5 minutes with high accuracy (AP: 2.4±2.8mm, Lat: 3.1±3.7mm).
  • Significant reductions in postoperative VAS scores for back and leg pain compared to preoperative scores (p<0.05).
  • Significant improvements in postoperative JOA scores compared to preoperative scores (p<0.05).

Conclusions:

  • The proposed robot-assisted positioning method is accurate and reliable for clinical application in PEID.
  • This technique effectively reduces operation time and radiation exposure.
  • The system demonstrates significant improvements in patient pain scores and functional outcomes.