Floor-Mounted Robotic Pedicle Screw Placement in Lumbar Spine Surgery: An Analysis of 1,050 Screws

Pratyush Shahi; Omri Maayan; Daniel Shinn; Sidhant Dalal; Junho Song; Kasra Araghi; Dimitra Melissaridou; Avani Vaishnav; Karim Shaf; Yuri Pompeu; Evan Sheha; James Dowdell; Sravisht Iyer; Sheeraz A. Qureshi

doi:10.14245/ns.2346070.035

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자료유형: 학술저널

저자정보: Pratyush Shahi (Hospital for Special Surgery) Omri Maayan (Hospital for Special Surgery) Daniel Shinn (Hospital for Special Surgery) Sidhant Dalal (Hospital for Special Surgery) Junho Song (Hospital for Special Surgery) Kasra Araghi (Hospital for Special Surgery) Dimitra Melissaridou (Hospital for Special Surgery) Avani Vaishnav (Hospital for Special Surgery) Karim Shaf (Hospital for Special Surgery) Yuri Pompeu (Hospital for Special Surgery) Evan Sheha (Hospital for Special Surgery) James Dowdell (Hospital for Special Surgery) Sravisht Iyer (Hospital for Special Surgery) Sheeraz A. Qureshi (Hospital for Special Surgery)

저널정보: 대한척추신경외과학회 Neurospine Neurospine 제20권 제2호

발행연도: 2023.6

수록면: 577 - 586 (10page)

DOI: 10.14245/ns.2346070.035

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Objective: To analyze the usage of floor-mounted robot in minimally invasive lumbar fusion. Methods: Patients who underwent minimally invasive lumbar fusion for degenerative pa thology using floor-mounted robot (ExcelsiusGPS) were included. Pedicle screw accuracy, proximal level violation rate, pedicle screw size, screw-related complications, and robot abandonment rate were analyzed. Results: Two hundred twenty-nine patients were included. Most surgeries were primary single-level fusion. Sixty-five percent of surgeries had intraoperative computed tomography (CT) workflow, 35% had preoperative CT workflow. Sixty-six percent were transforaminal lumbar interbody fusion, 16% were lateral, 8% were anterior, and 10% were a combined approach. A total of 1,050 screws were placed with robotic assistance (85% in prone posi tion, 15% in lateral position). Postoperative CT scan was available for 80 patients (419 screws). Overall pedicle screw accuracy rate was 96.4% (prone, 96.7%; lateral, 94.2%; primary, 96.7%; revision, 95.3%). Overall poor screw placement rate was 2.8% (prone, 2.7%; later al, 3.8%; primary, 2.7%; revision, 3.5%). Overall proximal facet and endplate violation rates were 0.4% and 0.9%. Average diameter and length of pedicle screws were 7.1 mm and 47.7 mm. Screw revision had to be done for 1 screw (0.1%). Use of the robot had to be abort ed in 2 cases (0.8%). Conclusion: Usage of floor-mounted robotics for the placement of lumbar pedicle screws leads to excellent accuracy, large screw size, and negligible screw-related complications. It does so for screw placement in prone/lateral position and primary/revision surgery alike with negligible robot abandonment rates.

#Robotics #Pedicle screw #Accuracy #Lumbar spine #Complications #Screw size

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