Impact of landmark crater creation on improving accuracy of pedicle screw insertion in robot-assisted scoliosis surgery

Purpose This study evaluated the impact of the Landmark Crater (LC) method on pedicle perforation rates in robot-guided surgery for pediatric scoliosis for each pedicle diameter. Methods Seventy-six scoliosis patients underwent robot-assisted posterior spinal fusion. The cohort consisted of 19 male...

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Bibliographic Details
Published in:European spine journal 2024-12, Vol.33 (12), p.4730-4739
Main Authors: Oba, Hiroki, Ikegami, Shota, Uehara, Masashi, Hatakenaka, Terue, Miyaoka, Yoshinari, Kurogochi, Daisuke, Fukuzawa, Takuma, Sasao, Shinji, Shigenobu, Keisuke, Makiyama, Fumiaki, Koseki, Michihiko, Neo, Masashi, Takahashi, Jun
Format: Article
Language:English
Subjects:
Adolescent
Child
Female
Humans
Male
Medicine
Medicine & Public Health
Neurosurgery
Original Article
Patients
Pediatrics
Pedicle Screws
Retrospective Studies
Robotic surgery
Robotic Surgical Procedures - methods
Robots
Scoliosis
Scoliosis - diagnostic imaging
Scoliosis - surgery
Spinal Fusion - instrumentation
Spinal Fusion - methods
Surgery
Surgical Orthopedics
Young Adult
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Summary:Purpose This study evaluated the impact of the Landmark Crater (LC) method on pedicle perforation rates in robot-guided surgery for pediatric scoliosis for each pedicle diameter. Methods Seventy-six scoliosis patients underwent robot-assisted posterior spinal fusion. The cohort consisted of 19 male and 57 female patients, with a mean ± standard deviation age of 17.5 ± 7.7 years and a preoperative Cobb angle of 57.0 ± 18.5°. The LC method is a method in which craters that serves as a landmark are created in advance at the planned PS insertion site of all pedicles within the intraoperative CT imaging area. The patients were divided into the LC group, in which PS insertion was performed using the LC method, and the control group using the conventional PS insertion method. Overall and pedicle perforation rates for each pedicle outer diameter were compared between the groups by Fisher’s exact test. Results The LC group exhibited a significantly lower pedicle major perforation rate than did the control group (2.7% vs. 6.2%, P  = 0.001). The perforation rates in pedicles with a pedicle outer diameter > 6 mm, 4–6 mm, 2–4 mm, and
ISSN:0940-6719
1432-0932
1432-0932
DOI:10.1007/s00586-024-08506-0