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Updated: May 28, 2026
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A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
Published on: May 11, 2020
Implementation of Intraoperative Cone-Beam CT (Loop-X) in an Established Robotic-Assisted Pedicle Screw Program: An
Julien N Jost1, Kristina Catalano1, Jaqueline Lattmann1
1Department of Neurosurgery, Cantonal Hospital Aarau, 5001 Aarau, Switzerland.
Journal of Clinical Medicine
|May 27, 2026
Summary
The introduction of Loop-X intraoperative cone-beam CT (iCBCT) for robotic-assisted pedicle screw placement did not significantly impact operating room time, blood loss, or length of stay. This study found no association between Loop-X implementation and perioperative efficiency or short-term safety outcomes.
Area of Science:
- Spinal Surgery
- Robotic Surgery
- Medical Imaging
Background:
- Reliable intraoperative imaging is crucial for robotic-assisted (RA) pedicle screw placement.
- Mobile intraoperative cone-beam CT (iCBCT) systems like Loop-X are being integrated into RA workflows.
- Limited data exist on the implementation impact of these new imaging systems.
Purpose of the Study:
- To evaluate the association between Loop-X iCBCT implementation and perioperative efficiency (OR time, EBL, LOS) in RA pedicle screw placement.
- To assess the impact of Loop-X on short-term safety, specifically 30-day complications.
- To determine if surgeon experience modifies the association between Loop-X and outcomes.
Main Methods:
- Retrospective epoch-based cohort study of 146 patients undergoing RA pedicle screw placement.
- Comparison between 3D C-arm navigation (3D-BV) and Loop-X iCBCT.
- Multivariable regression models adjusted for patient and procedural covariates.
- Analysis included operating room time, estimated blood loss, length of stay, and 30-day complications (Clavien-Dindo grade III+).
Main Results:
- Loop-X implementation was not independently associated with significant changes in operating room time, estimated blood loss, or length of stay after adjustment.
- No significant interaction was detected between Loop-X implementation and surgeon experience.
- Major complications occurred in 11.0% of cases and were not associated with Loop-X implementation (OR 0.41, 95% CI 0.10-1.74).
- Patient factors and procedural complexity were primary determinants of outcomes.
Conclusions:
- Implementation of Loop-X iCBCT in RA pedicle screw programs was not associated with adverse effects on perioperative efficiency or short-term safety in this cohort.
- Findings support the feasibility of Loop-X in clinical practice.
- The study does not establish superiority, equivalence, or specific imaging-related effects of Loop-X compared to traditional methods.
