Abstract
With increasing numbers of patients requiring spine surgery, there has been an emphasis on technological advances designed to enhance surgical outcomes and improve patient safety. In particular, the number of elective spinal fusion surgeries in the USA continues to increase. Instrumentation of the spine with pedicle screws is frequently used for indications including deformity and instability. With neurovascular structures near the pedicle, accurate screw placement is of paramount importance to ensure good outcomes. Reported complications related to pedicle screw malposition range from 1% to 54% (Molliqaj et al., Neurosurg Focus 42(5):E14, 2017). Currently, there are several techniques described for inserting pedicle screws, including freehand manual insertion based on anatomic landmarks and fluoroscopy, manual insertion with navigation assistance systems, and robotic-assisted methods.
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References
Ahern DP, Gibbons D, Schroeder GD, Vaccaro AR, Butler JS (2020) Image-guidance, robotics, and the future of spine surgery. Clin Spine Surg 33(5):179–184. https://doi.org/10.1097/BSD.00000000000000809. PMID: 31425306
Chen AF, Kazarian GS, Jessop GW, Makhdom A (2018) Robotic technology in orthopaedic surgery. J Bone Joint Surg Am 100(22):1984–1992. https://doi.org/10.2106/JBJS.17.01397
D’Souza M, Gendreau J, Feng A, Kim L, Ho A, Veeravagu A (2019) Robotic-assisted spine surgery: history, efficacy, cost, and future trends. Robot Surg Res Rev 6:9–23. https://doi.org/10.2147/RSRR.S190720
Galetta MS, Leider JD, Divi SN, Goyal DKC, Schroeder GD (2019) Robotics in spinal surgery. Ann Transl Med 7:S165. https://doi.org/10.21037/atm.2019.07.93
Ganz JC (2011) Gamma knife neurosurgery: principles of Sterotaxy, vol XXII. Springer, Vienna.
Hayda RA, Hsu RY, DePasse JM, Gil JA (2018) Radiation exposure and health risks for orthopaedic surgeons. J Am Acad Orthop Surg 26(8):268–277. https://doi.org/10.5435/JAAOS-D-16-00342
Hu X, Ohnmeiss DD, Lieberman IH (2014) What is the learning curve for robotic-assisted pedicle screw placement in spine surgery? Clin Orthop Relat Res 472:1839. https://doi.org/10.1007/s11999-013-3291-1
Huntsman KT, Ahrendtsen LA, Riggleman JR, Ledonio CG (2020) Robotic-assisted navigated minimally invasive pedicle screw placement in the first 100 cases at a single institution. J Robot Surg 14(1):199–203. https://doi.org/10.1007/s11701-019-00959-6
Jacofsky DJ, Allen M (2016) Robotics in Arthroplasty: a comprehensive review. J Arthroplast 31(10):2353–2363. https://doi.org/10.1016/j.arth.2016.05.026
Kim HJ, Jung WI, Chang BS, Lee CK, Kang KT, Yeom JS (2017) A prospective, randomized, controlled trial of robot-assisted vs freehand pedicle screw fixation in spine surgery. Int J Med Robot 13(3). https://doi.org/10.1002/rcs.1779
Kochanski RB, Lombardi JM, Laratta JL, Lehman RA, O’Toole JE (2019) Image-guided navigation and robotics in spine surgery. Neurosurgery 84:1179. https://doi.org/10.1093/neuros/nyy630
Li H-M, Zhang R-J, Shen C-L (2020) Accuracy of pedicle screw placement and clinical outcomes of robot-assisted technique versus conventional freehand technique in spine surgery from nine randomized controlled trials. Spine 45:E111. https://doi.org/10.1097/brs.0000000000003193
Lippross S, Jünemann K-P, Osmonov D, Peh S, Alkatout I, Finn J, Egberts J-H, Seekamp A (2020) Robot assisted spinal surgery – a technical report on the use of DaVinci in orthopaedics. J Orthop 19:50–53. https://doi.org/10.1016/j.jor.2019.11.045
Lonjon N, Chan-Seng E, Costalat V, Bonnafoux B, Vassal M, Boetto J (2016) Robot-assisted spine surgery: feasibility study through a prospective case-matched analysis. Eur Spine J 25(3):947–955. https://doi.org/10.1007/s00586-015-3758-8
Malham GM, Wells-Quinn T (2019) What should my hospital buy next?-guidelines for the acquisition and application of imaging, navigation, and robotics for spine surgery. J Spine Surg 5(1):155–165. https://doi.org/10.21037/jss.2019.02.04
Molliqaj G, Schatlo B, Alaid A, Solomiichuk V, Rohde V, Schaller K, Tessitore E (2017) Accuracy of robot-guided versus freehand fluoroscopy-assisted pedicle screw insertion in thoracolumbar spinal surgery. Neurosurg Focus 42(5):E14. https://doi.org/10.3171/2017.3.FOCUS179
Perez-Cruet MJ, Welsh RJ, Hussain NS, Begun EM, Lin J, Park P (2012) Use of the da Vinci minimally invasive robotic system for resection of a complicated paraspinal schwannoma with thoracic extension: case report. Neurosurgery 71(1 Suppl Operative):209–214. https://doi.org/10.1227/NEU.0b013e31826112d8
Shoham M, Lieberman IH, Benzel EC, Togawa D, Zehavi E, Zilberstein B, Roffman M, Bruskin A, Fridlander A, Joskowicz L, Brink-Danan S, Knoller N (2007) Robotic assisted spinal surgery–from concept to clinical practice. Comput Aided Surg 12(2):105–115. https://doi.org/10.3109/10929080701243981
Siddiqui MI, Wallace DJ, Salazar LM, Vardiman AB (2019) Robot-assisted pedicle screw placement: learning curve experience. World Neurosurg 130:e417. https://doi.org/10.1016/j.wneu.2019.06.107
Solomiichuk V, Fleischhammer J, Molliqaj G, Warda J, Alaid A, von Eckardstein K, Schaller K, Tessitore E, Rohde V, Schatlo B (2017) Robotic versus fluoroscopy-guided pedicle screw insertion for metastatic spinal disease: a matched-cohort comparison. Neurosurg Focus 42(5):E13. https://doi.org/10.3171/2017.3.FOCUS1710
Theodore N, Ahmed AK (2018) The history of robotics in spine surgery. Spine 43:S23. https://doi.org/10.1097/BRS.0000000000002553
Urakov TM, Chang KH, Burks SS, Wang MY (2017) Initial academic experience and learning curve with robotic spine instrumentation. Neurosurg Focus 42(5):E4. https://doi.org/10.3171/2017.2.FOCUS175
Acknowledgments
The authors would like to thank Allegheny Health Network’s Department of Orthopaedic Spine Surgery, the Allegheny Health Network Neuroscience Institute, Robert Pezzin, and all those who contributed to this review.
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Holmberg, K.J., Altman, D.T., Cheng, B.C., Sauber, T.J. (2020). Robotic Technology. In: Cheng, B. (eds) Handbook of Spine Technology. Springer, Cham. https://doi.org/10.1007/978-3-319-33037-2_138-1
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DOI: https://doi.org/10.1007/978-3-319-33037-2_138-1
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