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A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
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Trajectory tracking made simple: validating a low-cost IMU pedicle screw guide.

Swaminathan Ganesh1, Suresh Devasahayam2, Baylis Vivek Joseph3

  • 1Department of Neurological Sciences, Christian Medical College & Hospital, Vellore, India.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|April 1, 2026
PubMed
Summary
This summary is machine-generated.

A low-cost inertial measurement unit (IMU) guide accurately tracked pedicle screw trajectories in saw bone models. This system shows promise for improving spinal stabilization surgery accuracy and reducing costs.

Keywords:
IMU navigationInertial measurement unitLumbar spinePedicle screwTrajectory accuracy

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Area of Science:

  • Spinal Surgery
  • Biomedical Engineering
  • Surgical Navigation

Background:

  • Pedicle screw fixation is crucial for spinal stabilization.
  • Freehand screw placement has limitations, including a significant learning curve and potential for breaches (1.7-6.2%).
  • Current navigation and template systems enhance precision but are expensive, limiting accessibility.

Purpose of the Study:

  • To validate a cost-effective inertial measurement unit (IMU)-based guide for real-time pedicle screw trajectory tracking.
  • To assess the accuracy of IMU guidance in achieving precise screw placement in simulated spinal models.
  • To evaluate the potential of this low-cost system as an alternative to existing navigation technologies.

Main Methods:

  • A prospective experimental study utilized five lumbosacral saw bone models (60 screws).
  • Computed tomography (CT) was used for pre-procedural planning of screw trajectories.
  • A custom IMU assembly (MPU-925x™, Arduino Uno) provided real-time axial orientation during screw insertion at the superior facet-transverse process (SF-TP) junction.
  • Post-insertion CT scans evaluated achieved angles and cortical breaches.

Main Results:

  • Ninety percent (54/60) of pedicle screws achieved excellent containment, with overall fidelity at 96.7% (58/60).
  • The mean angular offset between planned and achieved trajectories was 2.23° ± 6.5°, with 83.3% (50/60) of screws within 10° of the target.
  • Cortical breaches occurred in 10% (6/60) of screws, with only 3.3% (2/60) considered significant (> 2 mm).

Conclusions:

  • The IMU-guided system demonstrated high pedicle screw containment and trajectory fidelity in simulated bone models.
  • This low-cost orientation-tracking system shows potential for improving surgical accuracy in spinal stabilization.
  • Further evaluation in cadaveric studies is recommended to confirm the efficacy of this IMU-based guidance system.