scholarly journals Known-component 3D-2D registration for image guidance and quality assurance in spine surgery pedicle screw placement

2015 ◽  
Author(s):  
A. Uneri ◽  
J. W. Stayman ◽  
T. De Silva ◽  
A. S. Wang ◽  
G. Kleinszig ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Pedicle Screw ◽  
Spine Surgery ◽  
Image Guidance ◽  
Screw Placement ◽  
Pedicle Screw Placement

scholarly journals Known-component 3D–2D registration for quality assurance of spine surgery pedicle screw placement

2015 ◽  
Vol 60 (20) ◽  
pp. 8007-8024 ◽  
Author(s):  
A Uneri ◽  
T De Silva ◽  
J W Stayman ◽  
G Kleinszig ◽  
S Vogt ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Pedicle Screw ◽  
Spine Surgery ◽  
Screw Placement ◽  
Pedicle Screw Placement

scholarly journals Overview of Robotic Technology in Spine Surgery

2021 ◽  
pp. 155633162110266
Author(s):  
Ram K. Alluri ◽  
Fedan Avrumova ◽  
Ahilan Sivaganesan ◽  
Avani S. Vaishnav ◽  
Darren R. Lebl ◽  
...  
Keyword(s):  
Economic Impact ◽  
Pedicle Screw ◽  
Clinical Outcomes ◽  
Spine Surgery ◽  
Screw Placement ◽  
Complication Rates ◽  
Robotic Technology ◽  
Pedicle Screw Placement ◽  
The Past ◽  
Compare And Contrast

As robotics in spine surgery has progressed over the past 2 decades, studies have shown mixed results on its clinical outcomes and economic impact. In this review, we highlight the evolution of robotic technology over the past 30 years, discussing early limitations and failures. We provide an overview of the history and evolution of currently available spinal robotic platforms and compare and contrast the available features of each. We conclude by summarizing the literature on robotic instrumentation accuracy in pedicle screw placement and clinical outcomes such as complication rates and briefly discuss the future of robotic spine surgery.

The accuracy of pedicle screw placement using intraoperative image guidance systems

2014 ◽  
Vol 20 (2) ◽  
pp. 196-203 ◽  
Author(s):  
Alexander Mason ◽  
Renee Paulsen ◽  
Jason M. Babuska ◽  
Sharad Rajpal ◽  
Sigita Burneikiene ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Image Guidance ◽  
Pedicle Screws ◽  
Screw Placement ◽  
Data Sets ◽  
Pedicle Screw Placement ◽  
Fluoroscopic Image ◽  
Fluoroscopic Navigation ◽  
Guidance Systems ◽  
Accuracy Rates

Object Several retrospective studies have demonstrated higher accuracy rates and increased safety for navigated pedicle screw placement than for free-hand techniques; however, the accuracy differences between navigation systems has not been extensively studied. In some instances, 3D fluoroscopic navigation methods have been reported to not be more accurate than 2D navigation methods for pedicle screw placement. The authors of this study endeavored to identify if 3D fluoroscopic navigation methods resulted in a higher placement accuracy of pedicle screws. Methods A systematic analysis was conducted to examine pedicle screw insertion accuracy based on the use of 2D, 3D, and conventional fluoroscopic image guidance systems. A PubMed and MEDLINE database search was conducted to review the published literature that focused on the accuracy of pedicle screw placement using intraoperative, real-time fluoroscopic image guidance in spine fusion surgeries. The pedicle screw accuracy rates were segregated according to spinal level because each spinal region has individual anatomical and morphological variations. Descriptive statistics were used to compare the pedicle screw insertion accuracy rate differences among the navigation methods. Results A total of 30 studies were included in the analysis. The data were abstracted and analyzed for the following groups: 12 data sets that used conventional fluoroscopy, 8 data sets that used 2D fluoroscopic navigation, and 20 data sets that used 3D fluoroscopic navigation. These studies included 1973 patients in whom 9310 pedicle screws were inserted. With conventional fluoroscopy, 2532 of 3719 screws were inserted accurately (68.1% accuracy); with 2D fluoroscopic navigation, 1031 of 1223 screws were inserted accurately (84.3% accuracy); and with 3D fluoroscopic navigation, 4170 of 4368 screws were inserted accurately (95.5% accuracy). The accuracy rates when 3D was compared with 2D fluoroscopic navigation were also consistently higher throughout all individual spinal levels. Conclusions Three-dimensional fluoroscopic image guidance systems demonstrated a significantly higher pedicle screw placement accuracy than conventional fluoroscopy or 2D fluoroscopic image guidance methods.

Methods to determine pedicle screw placement accuracy in spine surgery: a systematic review

2015 ◽  
Vol 24 (5) ◽  
pp. 990-1004 ◽  
Author(s):  
Ahmed A. Aoude ◽  
Maryse Fortin ◽  
Rainer Figueiredo ◽  
Peter Jarzem ◽  
Jean Ouellet ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pedicle Screw ◽  
Spine Surgery ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Placement Accuracy

Accuracy of upper thoracic pedicle screw placement using three-dimensional image guidance

2009 ◽  
Vol 9 (10) ◽  
pp. 817-821 ◽  
Author(s):  
Jonathan M. Bledsoe ◽  
Doug Fenton ◽  
Jeremy L. Fogelson ◽  
Eric W. Nottmeier
Keyword(s):  
Pedicle Screw ◽  
Image Guidance ◽  
Three Dimensional ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Dimensional Image ◽  
Thoracic Pedicle Screw ◽  
Upper Thoracic

A comparison of two techniques in image-guided thoracic pedicle screw placement: a retrospective study of 37 patients and 277 pedicle screws

2007 ◽  
Vol 7 (4) ◽  
pp. 393-398 ◽  
Author(s):  
Gregory P. Lekovic ◽  
Eric A. Potts ◽  
Dean G. Karahalios ◽  
Graham Hall
Keyword(s):  
Pedicle Screw ◽  
Image Guidance ◽  
Vascular Complications ◽  
Pedicle Screws ◽  
Guidance System ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
3D Navigation ◽  
Thoracic Pedicle Screw ◽  
Computed Tomography Scanning

Object The goal of this study was to compare the accuracy of thoracic pedicle screw placement aided by two different image-guidance modalities. Methods The charts of 40 consecutive patients who had undergone stabilization of the thoracic spine between January 2003 and January 2005 were retrospectively reviewed. Three patients were excluded from the study because, on the basis of preoperative findings, small pedicle diameter precluded the use of pedicle screws. Thus, a total of 37 patients had 277 screws placed with the aid of either virtual fluoroscopy or isocentric C-arm 3D navigation. The indications for surgery included trauma, degenerative disease, and tumor, and were similar in both groups. All 37 patients underwent postoperative computed tomography scanning, and an independent reviewer graded all screws based on axial, sagittal, and coronal projections for a full determination of the placement of the screw in the pedicle. Results The rate of unintended perforations was found to depend on pedicle diameter (p < 0.0001). There were no statistical differences between groups with regard to rate or grade of cortical perforations. Overall, the rate and grade of perforations was low, and there were no neurological or vascular complications. Conclusions The authors have shown that either image-guidance system may be used with a high degree of accuracy and safety. Because both systems were found to be comparably safe and accurate, the choice of image-guidance modality may be determined by the level of surgeon comfort and/or availability of the system.

scholarly journals Sublaminar bands in oncological spine surgery: illustrative cases

2021 ◽  
Vol 1 (21) ◽  
Author(s):  
Godard C. W. de Ruiter ◽  
Valerio Pipola ◽  
Cristiana Griffoni ◽  
Alessandro Gasbarrini
Keyword(s):  
Pedicle Screw ◽  
Spine Surgery ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Pathological Fractures ◽  
Additional Tool ◽  
Beneficial Effects ◽  
Potential Applications ◽  
Hybrid Construct ◽  
Sublaminar Bands

BACKGROUND Sublaminar bands have been used in addition to pedicle screw placement in the correction of idiopathic scoliosis forming a so-called hybrid construct. OBSERVATIONS In this article, the authors present several cases that demonstrate the potential applications of sublaminar bands in oncological spine surgery. The potential applications are divided into three categories: (1) as an additional tool in salvage procedures, (2) to correct kyphosis in pathological fractures, and (3) for bone graft anchoring to the spine. LESSONS The cases presented in this article demonstrate the potential beneficial effects of the sublaminar bands in addition to pedicle screw placement.

scholarly journals Cost-Effectiveness of Image-Guided Spine Surgery

2010 ◽  
Vol 4 (1) ◽  
pp. 228-233 ◽  
Author(s):  
Robert Green Watkins ◽  
Akash Gupta ◽  
Robert Green Watkins
Keyword(s):  
Pedicle Screw ◽  
Spine Surgery ◽  
Image Guidance ◽  
Pedicle Screws ◽  
Cost Savings ◽  
Cost Effective ◽  
Guidance System ◽  
Screw Placement ◽  
Image Guided ◽  
Time Required

Objective: To determine if image-guided spine surgery is cost effective. Methods: A prospective case series of the first 100 patients undergoing thoracolumbar pedicle screw instrumentation under image-guidance was compared to a retrospective control group of the last 100 patients who underwent screw placement prior to the use of image-guidance. The image-guidance system was NaviVision (Vector Vision-BrainLAB) and Arcadis Orbic (Siemens). Results: The rate of revision surgery was reduced from 3% to 0% with the use of image guidance (p=0.08). The cost savings of image guidance for the placement of pedicle screws was $71,286 per 100 cases. Time required for pedicle screw placement with image guidance was 20 minutes for 2 screws, 29 minutes for 4 screws, 38 minutes for 6 screws, and 50 min for 8 screws. Cost savings for the time required for placement of pedicle screws with image guidance can be estimated by subtracting the time required with currently used techniques without image guidance from the above averages, then multiplying by $93 per minute. The approximate costs of the navigation system is $475,000 ( $225,000 for Vector Vision-BrainLAB and $250,000 for Arcadis Orbic-Siemens). Conclusion: Image guidance for the placement of pedicle screws may be cost effective in spine practices with heavy volume, that perform surgery in difficult cases, and that require long surgical times for the placement of pedicle screws.

scholarly journals Feasibility and accuracy of a robotic guidance system for navigated spine surgery in a hybrid operating room: a cadaver study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Gustav Burström ◽  
Marcin Balicki ◽  
Alexandru Patriciu ◽  
Sean Kyne ◽  
Aleksandra Popovic ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Operating Room ◽  
Spine Surgery ◽  
Surgical Navigation ◽  
Guidance System ◽  
Screw Placement ◽  
Robot Arm ◽  
Hybrid Operating Room ◽  
Pedicle Screw Placement ◽  
Technical Accuracy

AbstractThe combination of navigation and robotics in spine surgery has the potential to accurately identify and maintain bone entry position and planned trajectory. The goal of this study was to examine the feasibility, accuracy and efficacy of a new robot-guided system for semi-automated, minimally invasive, pedicle screw placement. A custom robotic arm was integrated into a hybrid operating room (OR) equipped with an augmented reality surgical navigation system (ARSN). The robot was mounted on the OR-table and used to assist in placing Jamshidi needles in 113 pedicles in four cadavers. The ARSN system was used for planning screw paths and directing the robot. The robot arm autonomously aligned with the planned screw trajectory, and the surgeon inserted the Jamshidi needle into the pedicle. Accuracy measurements were performed on verification cone beam computed tomographies with the planned paths superimposed. To provide a clinical grading according to the Gertzbein scale, pedicle screw diameters were simulated on the placed Jamshidi needles. A technical accuracy at bone entry point of 0.48 ± 0.44 mm and 0.68 ± 0.58 mm was achieved in the axial and sagittal views, respectively. The corresponding angular errors were 0.94 ± 0.83° and 0.87 ± 0.82°. The accuracy was statistically superior (p < 0.001) to ARSN without robotic assistance. Simulated pedicle screw grading resulted in a clinical accuracy of 100%. This study demonstrates that the use of a semi-automated surgical robot for pedicle screw placement provides an accuracy well above what is clinically acceptable.

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