Roboticguided Placement of Cervical Pedicle Screws Feasibility and
Robotic-guided Placement of Cervical Pedicle Screws: Feasibility and Accuracy Isador H. Lieberman, MD, FRCSC, MBA Xiaobang Hu, Ph. D
ISADOR LIEBERMAN MD MBA FRCSC disclosures April 2018 Consulta nt Research Support Royalti es Stock Options Mazor Robotics X X Stryker Spine X Globus X Misonix X Safe Orthopaedics X Medtronic X SI Bone X AAOS; member CME Courses committee ISASS; member Public Policy committee SMISS; member Board of Directors SRS; member - Annual meeting & IMAST committee Editorial board; Spine, CSS, European Spine J Reviewer; JBJS, Spine Journal,
Introduction • It has been shown that pedicle screw instrumentation in the cervical spine has superior biomechanical pullout strength and stability. • However, due to the complex and variable anatomy of the cervical pedicles and the risk of catastrophic complications, cervical pedicle screw placement is not widely utilized.
Purpose • To review and report our experience with robotic guided cervical pedicle screw placement
Methods • Retrospective review • Consecutive patients who underwent cervical pedicle screw placement with robotic guidance • Post-operative CT scan available • Single surgeon
Methods • Fuse the preoperative CT (with the planned cervical pedicle screws) to the post-op CT. • Compare the planned vs. actual screw placements in both axial and sagittal planes, at the mid-point of the pedicle in a resolution of 0. 1 mm. • Medical charts: technical issues and intraoperative complications
Methods
Results • Four patients (3 female, 1 male) • Mean age: 59 years (range 51 -75) • Mean BMI: 23. 0 (range 17. 7 -27. 4) • 21 cervical pedicle screws - C 2: 4 screws - C 3: 2 screws - C 4: 4 screws - C 5: 3 screws - C 6: 4 screws - C 7: 4 screws
Results • No intra-operative complications related to the placement of cervical pedicle screws • Robotic guidance was successful in all 21 screws • Post-operative CT: 4 pedicle screw breaches
Results Deviation Axial plane Sagittal plane Left screw 1. 1 ± 0. 7 mm 1. 0 ± 0. 9 mm Right screw 1. 4 ± 1. 3 mm 1. 2 ± 0. 7 mm
Conclusion • Our study indicates that robotic guided cervical pedicle screw placement is feasible with clinically acceptable results.
Thank You
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