Percutaneous Placement of Pedicle Screws in the Lumbar Spine Using a Bone Mounted Miniature Robotic System First : Experiences and Accuracy of Screw Placement

A prospective analysis. The idea of this study was to evaluate a new miniature robotic system providing passive guidance for pedicle screw placement at the lumbar spine. Special focus was laid on the postoperative accuracy of screw placement. Recent technical developments lead to a minimization of p...

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Bibliographic Details
Published in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 2009-02, Vol.34 (4), p.392-399
Main Authors: PECHLIVANIS, Loannis, KIRIYANTHAN, George, ENGELHARDT, Martin, SCHOLZ, Martin, LÜCKE, Sebastian, HARDERS, Albrecht, SCHMIEDER, Kirsten, PHILLIPS, Frank M
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Bone Screws
Cerebrospinal fluid. Meninges. Spinal cord
Diseases of the osteoarticular system
Diseases of the spine
Equipment Design
Female
Humans
Imaging, Three-Dimensional
Lumbar Vertebrae - diagnostic imaging
Lumbar Vertebrae - surgery
Male
Medical sciences
Middle Aged
Miniaturization
Nervous system (semeiology, syndromes)
Neurology
Pilot Projects
Prospective Studies
Robotics
Spinal Fusion - instrumentation
Surgery, Computer-Assisted - instrumentation
Tomography, X-Ray Computed
Treatment Outcome
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Summary:A prospective analysis. The idea of this study was to evaluate a new miniature robotic system providing passive guidance for pedicle screw placement at the lumbar spine. Special focus was laid on the postoperative accuracy of screw placement. Recent technical developments lead to a minimization of pedicle screw fixation techniques. However, the use of navigational techniques is still under controversy. Patients selected for a minimal invasive posterior lumbar interbody fusion received a spiral computer tomographic scan before surgery. The miniature hexapod robot was mounted to the spinous process and the system moves to the exact entry point according to the trajectory of the surgeon's preoperative plan. After minimal invasive screw placement all patients received routinely a postoperative spiral computer tomographic scan. Screws placed exactly within the pedicle were evaluated as group A, screws deviating or =2 mm to or =4 mm to
ISSN:0362-2436
1528-1159
DOI:10.1097/BRS.0b013e318191ed32