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Two-dimensional C-arm robotic navigation system (i-Navi) in spine surgery: a pilot study

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Pedicle screws placement is very common procedure in spinal surgery. Robotic assisted surgery has been widely used in this operation. We assessed the accuracy of thoracolumbar spine trans-pedicle screws (TPS) implantation utilizing a noval robotic navigation system (i-Navi robotic navigation system) by planning with two-dimensional (2-D) C-arm.

Methods

This study was approved by the Institutional Review Board of the Cathay General Hospital on June 21, 2018 (IRB number: CGH-P 106,092), and written informed consents were obtained from all the patients. There are 18 patients were enrolled in the study. All the patients received the posterior fusion with TPS insertion under the assistant of our robotic navigation system.

Results

There are 18 patients were included into our study, there are 2 patients were quitted from the study due to the equipment setup was not complete. Other 16 patients completed the entire procedure successfully. There is total 88 pedicle screws were inserted through i-Navi robotic navigation system. There are 79 of 88 screws were graded A, and 9 screws were graded B; no screws were graded C or D. No vascular or nerve injuries were noted after the operations.

Conclusion

We present our i-Navi robotic navigation system, by planning with 2-D C-arm imaging and pre-operative CT scans. According to the results of study, we think it can provide a reliable and easy tool to perform the TPS in thoracic lumbar spine surgery.

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Abbreviations

2-D:

Two-dimensional

3-D:

Three-dimensional

AP:

Anteroposterior

CAS:

Computer assisted surgery

CAN:

Computer assisted navigation surgery

CT:

Computer tomography

DRF:

Dynamic reference frame

DRR:

Digitally reconstructed radiograph

FDA:

Food and drug administration

HIVD:

Herniated intervertebral disc

IRB:

Institutional review board

LA:

Lateral

MIS:

Minimally invasive spinal surgery

MRI:

Magnetic resonance imaging

TPS:

Trans-pedicle screws

VAS:

Visual analogue scale

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Funding

This study was funded by grants from the Ministry of Science and Technology of Taiwan (107-2314-B-281-003-MY2). We would like to thank all of the patients who participated in this study.

Author information

Authors and Affiliations

  1. Division of Neurosurgery, Department of Surgery, Cathay General Hospital, Taipei City, 106, Taiwan

    Zhao-Quan Liu, Cheng-Ta Hsieh & Chih-Ju Chang

  2. Division of Neurosurgery, Department of Surgery, Sijhih Cathay General Hospital, New Taipei City, 221, Taiwan

    Zhao-Quan Liu, Cheng-Ta Hsieh & Chih-Ju Chang

  3. School of Medicine, National Tsing Hua University, Hsinchu, 300044, Taiwan

    Cheng-Ta Hsieh & Chih-Ju Chang

  4. Department of Medicine, School of Medicine, Fu Jen Catholic University, New Taipei City, 242, Taiwan

    Cheng-Ta Hsieh & Chih-Ju Chang

  5. Department of Mechanical Engineering, National Central University, Taoyuan County, Taiwan

    Wei-En Hsu & Ching-Shiow Tseng

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  1. Zhao-Quan Liu
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Correspondence to Chih-Ju Chang.

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Liu, ZQ., Hsieh, CT., Hsu, WE. et al. Two-dimensional C-arm robotic navigation system (i-Navi) in spine surgery: a pilot study. Int J CARS 17, 2281–2290 (2022). https://doi.org/10.1007/s11548-022-02751-8

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  • DOI: https://doi.org/10.1007/s11548-022-02751-8

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