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Updated: Jan 13, 2026
A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
Published on: May 11, 2020
A Novel Radiation-Free Navigation Method for Robotic Pedicle Screw Placement Using Three-Dimensional Printed Guide
Yi Bao1, Ce Bian2, Hao-Tian Luo3
1Graduate School of Kunming Medical University, Kunming, YunNan, China; Department of Orthopedics, the First People's Hospital of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan Province, China; The Key Laboratory of Digital Orthopedics of Yunnan Province, Kunming, Yunnan Province, China; Intelligent Orthopedic Medical Technology Research Center, Kunming University of Science and Technology, Kunming, China.
This study demonstrates that 3D-printed navigation guides allow for accurate, radiation-free robot-assisted thoracic pedicle screw placement. This technique improves surgical efficiency and offers a safe alternative to traditional image-guided procedures.
Area of Science:
- Orthopedic Surgery
- Robotics in Medicine
- Spinal Surgery
Background:
- Robot-assisted surgery enhances precision but increases radiation exposure.
- Concerns exist regarding radiation safety for staff and patients in spinal procedures.
- Novel methods are needed to maintain accuracy while reducing radiation.
Purpose of the Study:
- To evaluate the clinical accuracy of thoracic pedicle screw placement using 3D-printed navigation guides for robotic registration.
- To determine if equivalent precision can be achieved without intraoperative imaging.
- To assess the safety and efficiency of a radiation-free robotic approach.
Main Methods:
- Patient-specific 3D-printed navigation guides were designed using reverse-engineering principles.
- A robotic system (XGK-6508A) recognized the guides for automatic pin insertion.
- 168 thoracic pedicle screws were implanted in human cadavers; accuracy was assessed postoperatively via CT using Gertzbein-Robbins scale, deviation distance, and angle.
Main Results:
- 98% of screws achieved acceptable accuracy (85% Grade A, 13% Grade B on Gertzbein-Robbins scale).
- Mean deviation distances were minimal (e.g., 0.4 mm sagittal entry, 0.3 mm axial entry).
- Mean deviation angles were low (e.g., 3.2° sagittal, 2.4° axial); implantation time significantly decreased with experience.
Conclusions:
- 3D-printed navigation guides facilitate accurate and radiation-free robot-assisted thoracic pedicle screw placement.
- The technique offers a safe and efficient alternative to conventional image-guided spinal surgery.
- Experience significantly improves surgical efficiency, highlighting the method's practical advantages.
