Related Experiment Video
Updated: Aug 5, 2026
06:24
A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
Published on: May 11, 2020
Accuracy of Robot-Assisted Pedicle Screw Placement: Two-Center Experience with Learning Curve Analysis
Ismail Zaed1,2, Carlo Brembilla3, Giuseppe De Gennaro Aquino3,4
1Department of Neurosurgery, Neurocenter of South Switzerland, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland.
Journal of Clinical Medicine
|July 28, 2026
Summary
Robot-assisted spinal instrumentation using ExcelsiusGPS demonstrated high accuracy (98.7%) in pedicle screw placement during its initial implementation. Early cases showed a slight increase in non-acceptable screws, but overall accuracy remained excellent across two centers.
Area of Science:
- Spinal Surgery
- Robotics in Medicine
- Surgical Navigation
Background:
- Accurate pedicle screw placement is critical for spinal instrumentation success.
- Robotic navigation systems aim to enhance safety, reproducibility, and standardization in spinal surgery.
- The ExcelsiusGPS platform represents a technological advancement in robot-assisted spinal procedures.
Purpose of the Study:
- To evaluate the accuracy of robot-assisted pedicle screw placement using the ExcelsiusGPS platform.
- To analyze the learning curve associated with the initial implementation of this robotic system at two surgical centers.
- To assess the impact of robotic navigation on workflow efficiency and screw placement accuracy.
Main Methods:
- Retrospective review of consecutive patients undergoing robot-assisted spinal instrumentation over one year.
- Assessment of pedicle screw accuracy using the intraoperative Gertzbein-Robbins Scale (GRS).
- Exclusion of S1 screws and oncological cases from primary analysis; robotic workflow time was measured.
Main Results:
- 98.7% of 455 non-S1 screws achieved clinically acceptable placement (GRS A+B).
- Perfect intrapedicular placement (GRS A) was achieved in 90.3% of screws.
- Clinically non-acceptable screws (GRS C-E) were infrequent (1.3%), concentrated in early cases, with no GRS D observed.
Conclusions:
- The ExcelsiusGPS platform facilitates accurate and reproducible pedicle screw placement in spinal instrumentation.
- Early implementation at two centers showed high accuracy, with non-acceptable screw placement primarily in the initial cases.
- Robotic workflow metrics were comparable across centers, supporting the system's efficiency and reliability.
