Related Experiment Video
Updated: Sep 12, 2025
A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
Published on: May 11, 2020
Intraoperative-CT-navigated percutaneous posterior positioning of pedicle screws in the cervical spine
Holger Stadthalter1, Michael Kreinest2, Paul Alfred Grützner2
1Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Department of Trauma and Orthopaedic Surgery, Krankenhausstr. 12, 91054, Erlangen, Germany.
Introduction:
This study was conducted to evaluate reliability and precision of a novel intraoperative computed tomography(iCT)-based navigated procedure to minimally invasive positioning of cervical pedicle screws.
Methods:
Ten cases were included. Pedicle screws were positioned percutaneously with iCT-based navigation between C3-C7 (Airo mobile CT scanner, Brainlab, Munich, Germany). In the control CT scan screws were assessed regarding affection of the pedicle cortices and neuroforamina. Image quality was evaluated with a subjective Likert-Scale (0-5) and a semi-objective Assessability score (0-4).
Results:
40 screws were placed. Average subjective image quality was 3.57 ± 1.0, average assessability score was 3.59 ± 0.73.23 screws (58 %) were positioned centered in the pedicle. 4 screws perforated the medial wall by more than 2 mm [2.7-2.9]. 9 screws were positioned laterally by more than 2 mm [2.5-4.9]. No postoperative neurological deficits were observed.
Conclusion:
Even in shallow anatomic structures, iCT-navigated visualization of instruments and implants allows for minimally invasive surgery.
