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Minimally invasive multiple-rod constructs with robotics planning in adult spinal deformity surgery: a case series

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Abstract

Purpose

Multiple-rod constructs (MRCs) are often used in deformity correction for increased stability and rigidity. There are currently no reports showing minimally invasive placement of MRCs in adult deformity surgery and its technical feasibility through preoperative software planning.

Methods

Data were collected retrospectively from medical records of six consecutive patients who underwent minimally invasive MRCs with robotics planning by a single surgeon at an academic center between March–August 2020.

Results

A total of six patients (4 females, mean age 69.7 years) underwent minimally invasive long-segment (6 +) posterior fixation with multiple rods (3 +) using the Mazor X Stealth Edition robotics platform. Average follow-up was 14.3 months. All patients underwent oblique lumbar interbody fusion (OLIF) as a first stage, followed by second stage posterior fixation in the same day. The mean number of levels posteriorly instrumented was 8.8. One patient underwent 3 rod fixation (1 iliac, 2 S2AI) and 5 patients underwent quad rod fixation (2 iliac, 2 S2AI). The mean time to secure all rods was 8 min 36 s. Mean improvement in spinopelvic parameters was -4.9 cm sagittal vertical axis, 18.0° lumbar lordosis, and -10.7° pelvic tilt with an average pelvic incidence of 62.5°. Estimated blood loss (EBL) was 100–250 cc with no blood transfusions, and all but one patient ambulated on postoperative day 1 or 2.

Conclusion

Spinal robotics brings us into a new era of minimally invasive construct design. To our knowledge, this is the first description of the technical feasibility of MRCs in minimally invasive adult spinal deformity surgery.

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Acknowledgements

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Authors and Affiliations

  1. Department of Neurosurgery, UC San Diego Health, University of California San Diego School of Medicine, 9300 Campus Point Drive, MC7893, La Jolla, San Diego, CA, 92037, USA

    Martin H. Pham, Vrajesh J. Shah, Luis Daniel Diaz-Aguilar & Joseph A. Osorio

  2. Department of Orthopedic Surgery, The Daniel and Jane Och Spine Hospital at NewYork-Presbyterian, Columbia University College of Physicians and Surgeons, New York, NY, USA

    Ronald A. Lehman

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  1. Martin H. Pham
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  2. Vrajesh J. Shah
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  4. Joseph A. Osorio
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Contributions

Dr. Pham reports consultant fees with Medtronic. Mr. Shah reports no disclosures. Dr. Diaz-Aguilar reports no disclosures. Dr. Osorio reports consultant fees with Medtronic, Depuy-Synthes, and Alpha Tec. Dr. Lehman reports consultant fees with Medtronic; speaking and/or teaching arrangements with Medtronic, DePuy, Stryker; grants from the Department of Defense, Defense Medical Research Development Program.

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Correspondence to Martin H. Pham.

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Conflict of interest

M.H. reports consultant fees with Medtronic. V.S. reports no disclosures. D.D. reports no disclosures. R.L. reports consultant fees with Medtronic; speaking and/or teaching arrangements with Medtronic, DePuy, Stryker; grants from the Department of Defense, Defense Medical Research Development Program. J.O. reports consultant fees with Medtronic, DePuy and Alpha Tec.

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Pham, M.H., Shah, V.J., Diaz-Aguilar, L.D. et al. Minimally invasive multiple-rod constructs with robotics planning in adult spinal deformity surgery: a case series. Eur Spine J 31, 95–103 (2022). https://doi.org/10.1007/s00586-021-06980-4

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  • DOI: https://doi.org/10.1007/s00586-021-06980-4

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