Farah Kaissar1, Meyer Mikael2, Prost Solene3, Albader Faisal2, Dufour Henry2, Blondel Benjamin3, Fuentes Stephane2. 1. Neurosurgery Department, La Timone university hospital, APHM, Marseille, France; Spine Unit, La Timone university hospital, APHM, Marseille, France. Electronic address: kaissar.farah@gmail.com. 2. Neurosurgery Department, La Timone university hospital, APHM, Marseille, France; Spine Unit, La Timone university hospital, APHM, Marseille, France. 3. Department of orthopedic surgery, La Timone university hospital, APHM, Marseille, France; Spine Unit, La Timone university hospital, APHM, Marseille, France.
Abstract
BACKGROUND: Accurate screw placement remains very challenging especially in the cervical spine. OBJECTIVE: We present our first experience of minimally invasive posterior cervical and upper thoracic pedicle screw fixation in the lower cervical spine. METHODS: This is a case-series of patients, undergoing a posterior percutaneous pedicle fixation using Cirq® Robotic Assistance coupled to the AIRO® intraoperative computed tomography (iCT)-Scan and BrainLab® (Brainlab AG Olof-Palme-Straße 9 81829 Munich Germany) navigation system. Routine computed tomography was performed on postoperative day 2 to evaluate pedicle screw placement. The effective dose was calculated. RESULTS: Between February 2020 and December 2020, 7 patients (4 men and 3 women) were included. The mean age was 58,8 years (29-75 years). Fixation was performed with cannulated PASS OCT® Reconstruction System (MEDICREA®). Overall, 28 screws were placed within cervical and upper thoracic pedicles. According to the Neo and Heary classification 85,7% were rated as acceptable and 14,3 as poor. Radiation dose received by the patient was 9,1 mSv (range 7,7-10,6 mSv). Radiation dose received by the surgical staff was 0 mSv. Postoperative course was excellent. CONCLUSION: Posterior miniopen fixation using Cirq® Robotic Assistance coupled with iCT navigation system is a major innovation that can improve pedicle screw positioning's accuracy with acceptable patient radiation and reduced surgical team exposure.
BACKGROUND: Accurate screw placement remains very challenging especially in the cervical spine. OBJECTIVE: We present our first experience of minimally invasive posterior cervical and upper thoracic pedicle screw fixation in the lower cervical spine. METHODS: This is a case-series of patients, undergoing a posterior percutaneous pedicle fixation using Cirq® Robotic Assistance coupled to the AIRO® intraoperative computed tomography (iCT)-Scan and BrainLab® (Brainlab AG Olof-Palme-Straße 9 81829 Munich Germany) navigation system. Routine computed tomography was performed on postoperative day 2 to evaluate pedicle screw placement. The effective dose was calculated. RESULTS: Between February 2020 and December 2020, 7 patients (4 men and 3 women) were included. The mean age was 58,8 years (29-75 years). Fixation was performed with cannulated PASS OCT® Reconstruction System (MEDICREA®). Overall, 28 screws were placed within cervical and upper thoracic pedicles. According to the Neo and Heary classification 85,7% were rated as acceptable and 14,3 as poor. Radiation dose received by the patient was 9,1 mSv (range 7,7-10,6 mSv). Radiation dose received by the surgical staff was 0 mSv. Postoperative course was excellent. CONCLUSION: Posterior miniopen fixation using Cirq® Robotic Assistance coupled with iCT navigation system is a major innovation that can improve pedicle screw positioning's accuracy with acceptable patient radiation and reduced surgical team exposure.