Yann Croissant1,2, Stephan Zangos2, Moritz H Albrecht2, Katrin Eichler2, Christof Schomerus3, Adam Spandorfer4, U Joseph Schoepf4, Thomas J Vogl2, Christoph Czerny5. 1. Department of Orthopedic and Trauma Surgery, St Josefs-Hospital Wiesbaden, Wiesbaden, Germany. 2. Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany. 3. Institute of Anatomy, Goethe University Frankfurt, Frankfurt am Main, Germany. 4. Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston SC, United States. 5. Department of Trauma Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany.
Abstract
Purpose: To assess the accuracy and time requirements of image-guided percutaneous K-wire insertion in the spine using an advanced robot assistance device for needle guidance and to demonstrate a radiation-free workflow for the physician. Material and methods: A planning CT-scan was acquired of a cadaver specimen and analyzed using a 3D-interventional software integrated in the robotic device. The optimal needle path was simulated and the needle holder of the robot was used for guidance during K-wire insertion. Twenty-four K-wires were inserted percutaneously in a transpedicular approach in the following vertebrae: thoracic (T) 2, 7-12 and lumbar (L) 1-5. A post-procedural CT scan was performed to analyze the accuracy of the K-wire insertion. Results: All procedures were carried out without any perforation of the pedicle wall. The mean duration of planning the intervention path was 2:54 ± 2:22 min, mean positioning time was 2:04 ± 0:42 min and the mean time for K-wire insertion was 2:13 ± 0:54 min. In total, the average intervention time was 7:10 ± 3:06 min per pedicle. Compared to the planning, the K-wire position showed a mean deviation of 0.5 mm in the vertical-axis and 1.2 mm in the horizontal-axis. The average intervention path length was 8.1 cm. Conclusion: Our findings show a high accuracy in robot-assisted K-wire insertion during spinal interventions without any exposure of the operator to radiation.
Purpose: To assess the accuracy and time requirements of image-guided percutaneous K-wire insertion in the spine using an advanced robot assistance device for needle guidance and to demonstrate a radiation-free workflow for the physician. Material and methods: A planning CT-scan was acquired of a cadaver specimen and analyzed using a 3D-interventional software integrated in the robotic device. The optimal needle path was simulated and the needle holder of the robot was used for guidance during K-wire insertion. Twenty-four K-wires were inserted percutaneously in a transpedicular approach in the following vertebrae: thoracic (T) 2, 7-12 and lumbar (L) 1-5. A post-procedural CT scan was performed to analyze the accuracy of the K-wire insertion. Results: All procedures were carried out without any perforation of the pedicle wall. The mean duration of planning the intervention path was 2:54 ± 2:22 min, mean positioning time was 2:04 ± 0:42 min and the mean time for K-wire insertion was 2:13 ± 0:54 min. In total, the average intervention time was 7:10 ± 3:06 min per pedicle. Compared to the planning, the K-wire position showed a mean deviation of 0.5 mm in the vertical-axis and 1.2 mm in the horizontal-axis. The average intervention path length was 8.1 cm. Conclusion: Our findings show a high accuracy in robot-assisted K-wire insertion during spinal interventions without any exposure of the operator to radiation.
Authors: Yannick Scharll; Alexander Mitteregger; Gregor Laimer; Christoph Schwabl; Peter Schullian; Reto Bale Journal: J Clin Med Date: 2022-06-28 Impact factor: 4.964