Chao Wang1, Hao Zhang1, Lu Zhang2, Meng Kong1, Kai Zhu1, Chuan-Li Zhou1, Xue-Xiao Ma1. 1. Department of Spine Surgery, the Affiliated Hospital of Qingdao University, Qingdao, China. 2. Department of Medical Research Center, the Affiliated Hospital of Qingdao University, Qingdao, China.
Abstract
BACKGROUND: Whether the accuracy of robot-assisted spinal screw placement is significantly higher than that of freehand and the source of robotic deviation remain unclear. METHODS: Clinical data of 105 patients who underwent robot-assisted spinal surgery was collected and screw accuracy was evaluated by computed tomography according to the modified Gertzbein-Robbins classification. Patients were grouped by percutaneous and open surgery. Intergroup comparisons of clinical and screw accuracy parameters were performed. Reasons for deviation were determined. Thirty-one patients with lumbar spondylolisthesis undergoing open robot-assisted surgery and the same number of patients treated by open freehand surgery were compared for screw accuracy. RESULTS: Screw accuracy was not significantly different between the percutaneous and open groups in both intra- and postoperative evaluations. Tool skiving was identified as the main cause of deviation. The proportion of malpositioned screws (grade B+C+D) was significantly higher in the freehand group than in the robot-assisted group. However, remarkably malpositioned (grade C+D) screws showed no significant differences between the groups. No revision surgery was necessary. CONCLUSIONS: Robot-assisted spinal instrumentation manifests high accuracy and low incidence of nerve injury. Tool skiving is a major cause of implant deviation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
BACKGROUND: Whether the accuracy of robot-assisted spinal screw placement is significantly higher than that of freehand and the source of robotic deviation remain unclear. METHODS: Clinical data of 105 patients who underwent robot-assisted spinal surgery was collected and screw accuracy was evaluated by computed tomography according to the modified Gertzbein-Robbins classification. Patients were grouped by percutaneous and open surgery. Intergroup comparisons of clinical and screw accuracy parameters were performed. Reasons for deviation were determined. Thirty-one patients with lumbar spondylolisthesis undergoing open robot-assisted surgery and the same number of patients treated by open freehand surgery were compared for screw accuracy. RESULTS: Screw accuracy was not significantly different between the percutaneous and open groups in both intra- and postoperative evaluations. Tool skiving was identified as the main cause of deviation. The proportion of malpositioned screws (grade B+C+D) was significantly higher in the freehand group than in the robot-assisted group. However, remarkably malpositioned (grade C+D) screws showed no significant differences between the groups. No revision surgery was necessary. CONCLUSIONS: Robot-assisted spinal instrumentation manifests high accuracy and low incidence of nerve injury. Tool skiving is a major cause of implant deviation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.