scholarly journals Placement of percutaneous pedicle screws without imaging guidance

2006 ◽  
Vol 20 (3) ◽  
pp. 1-6 ◽  
Author(s):  
Ciaran J. Powers ◽  
Vinod K. Podichetty ◽  
Robert E. Isaacs
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Pedicle Screw ◽  
Spine Surgery ◽  
Spinal Canal ◽  
Pedicle Screws ◽  
Degenerative Disease ◽  
Imaging Guidance ◽  
Intraoperative Fluoroscopy ◽  
Minimally Invasive Spine

✓ Pedicle screw (PS) instrumentation provides an exceptionally rigid construct to promote fusion in cases of spinal trauma and degenerative disease. Although the safety of traditional open techniques for PS placement has been well documented, there are no large series in the literature in which the safety of percutaneously placed PSs has been examined. Because the advantages of minimally invasive spine surgery are becoming more widely recognized, especially in regard to the lessening of morbidity caused by pain and blood loss, there will be a greater demand for spine surgeons to place PSs percutaneously. During a 2-year period, the authors placed 287 PSs percutaneously with the aid of intraoperative fluoroscopy. Only one of these screws was later found to have breached the spinal canal, yielding a breach rate of 0.35% for percutaneously placed PSs (one of 287).

scholarly journals Robotic Guided Minimally Invasive Spine Surgery

2021 ◽  
Author(s):  
Ram Kiran Alluri ◽  
Ahilan Sivaganesan ◽  
Avani S. Vaishnav ◽  
Sheeraz A. Qureshi
Keyword(s):  
Minimally Invasive ◽  
Pedicle Screw ◽  
Spine Surgery ◽  
Clinical Applications ◽  
Minimally Invasive Spine Surgery ◽  
Robotic Systems ◽  
Evidence Based ◽  
Future Directions ◽  
Novel Technology ◽  
Minimally Invasive Spine

Minimally invasive spine surgery (MISS) continues to evolve, and the advent of robotic spine technology may play a role in further facilitating MISS techniques, increasing safety, and improving patient outcomes. In this chapter we review early limitations of spinal robotic systems and go over currently available spinal robotic systems. We then summarize the evidence-based advantages of robotic spine surgery, with an emphasis on pedicle screw placement. Additionally, we review some common and expanded clinical applications of robotic spine technology to facilitate MISS. The chapter concludes with a discussion regarding the current limitations and future directions of this relatively novel technology as it applies to MISS.

scholarly journals Minimally invasive spine technology and minimally invasive spine surgery: a historical review

2009 ◽  
Vol 27 (3) ◽  
pp. E9 ◽  
Author(s):  
Jeffrey H. Oppenheimer ◽  
Igor DeCastro ◽  
Dennis E. McDonnell
Keyword(s):  
Minimally Invasive ◽  
Spine Surgery ◽  
New Technologies ◽  
Spinal Instrumentation ◽  
Pedicle Screws ◽  
Historical Review ◽  
Outpatient Basis ◽  
Minimal Access ◽  
Hybrid Procedures ◽  
Minimally Invasive Spine

The trend of using smaller operative corridors is seen in various surgical specialties. Neurosurgery has also recently embraced minimal access spine technique, and it has rapidly evolved over the past 2 decades. There has been a progression from needle access, small incisions with adaptation of the microscope, and automated percutaneous procedures to endoscopically and laparoscopically assisted procedures. More recently, new muscle-sparing technology has come into use with tubular access. This has now been adapted to the percutaneous placement of spinal instrumentation, including intervertebral spacers, rods, pedicle screws, facet screws, nucleus replacement devices, and artificial discs. New technologies involving hybrid procedures for the treatment of complex spine trauma are now on the horizon. Surgical corridors have been developed utilizing the interspinous space for X-STOP placement to treat lumbar stenosis in a minimally invasive fashion. The direct lateral retroperitoneal corridor has allowed for minimally invasive access to the anterior spine. In this report the authors present a chronological, historical perspective of minimal access spine technique and minimally invasive technologies in the lumbar, thoracic, and cervical spine from 1967 through 2009. Due to a low rate of complications, minimal soft tissue trauma, and reduced blood loss, more spine procedures are being performed in this manner. Spine surgery now entails shorter hospital stays and often is carried out on an outpatient basis. With education, training, and further research, more of our traditional open surgical management will be augmented or replaced by these technologies and approaches in the future.

Navigated Spinal Robotics in Minimally Invasive Spine Surgery, With Preoperative and Intraoperative Workflows: 2-Dimensional Operative Video

2020 ◽  
Vol 19 (4) ◽  
pp. E422-E422
Author(s):  
Martin H Pham ◽  
Joseph A Osorio ◽  
Ronald A Lehman
Keyword(s):  
Minimally Invasive ◽  
Ct Scan ◽  
Spine Surgery ◽  
Degenerative Spondylolisthesis ◽  
Spinal Instrumentation ◽  
Pedicle Screws ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Minimally Invasive Spine Surgery ◽  
Patient Consent ◽  
Minimally Invasive Spine

Abstract The use of robotic guidance for spinal instrumentation has become promising for its ability to offer the advantages of precision, accuracy, and reproducibility. However, the utilization and adoption of robotic platforms for spine surgery remain limited, especially in comparison to other surgical fields. We present here a case of a 52-yr-old man with a grade 1 L4-5 degenerative spondylolisthesis causing severe claudication and radiculopathy who subsequently underwent a minimally invasive L4-5 transforaminal lumbar interbody fusion with navigated spinal robotic assistance (Mazor X Stealth Edition, Mazor Robotics Ltd, Caesarea, Israel). This platform allows for planning and registration via (1) a preoperative thin-cut computed tomography (CT) scan, or (2) an intraoperative CT “scan-and-plan” method. We show here the preoperative CT method that we use in the majority of our patients. To our knowledge, this is the first video demonstrating the preoperative software and intraoperative surgical registration and instrument workflow of navigated spinal robotic guidance using the Mazor X Stealth Edition for the insertion of pedicle screws in a minimally invasive spine surgery procedure. There is no identifying information in this video. Patient consent was obtained for the surgical procedure and for publishing of the material included in the video.

scholarly journals Does the accuracy of pedicle screw placement differ between the attending surgeon and resident in navigated robotic-assisted minimally invasive spine surgery?

2019 ◽  
Vol 14 (4) ◽  
pp. 567-572 ◽  
Author(s):  
Arnold B. Vardiman ◽  
David J. Wallace ◽  
Grant A. Booher ◽  
Neil R. Crawford ◽  
Jessica R. Riggleman ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Pedicle Screw ◽  
Spine Surgery ◽  
Pedicle Screws ◽  
Screw Placement ◽  
Robotic Assistance ◽  
Pedicle Screw Placement ◽  
Robot Assisted ◽  
Left And Right ◽  
Spine Surgeon

Abstract Robotic assistance with integrated navigation is an area of high interest for improving the accuracy of minimally invasive pedicle screw placement. This study analyzes the accuracy of pedicle screw placement between an attending spine surgeon and a resident by comparing the left and right sides of the first 101 consecutive cases using navigated robotic assistance in a private practice clinical setting. A retrospective, Institutional Review Board-exempt review of the first 106 navigated robot-assisted spine surgery cases was performed. One attending spine surgeon and one resident performed pedicle screw placement consistently on either the left or right side (researchers were blinded). A CT-based Gertzbein and Robbins system (GRS) was used to classify pedicle screw accuracy, with grade A or B considered accurate. There were 630 consecutive lumbosacral pedicle screws placed. Thirty screws (5 patients) were placed without the robot due to surgeon discretion. Of the 600 pedicle screws inserted by navigated robotic guidance (101 patients), only 1.5% (9/600) were repositioned intraoperatively. Based on the GRS CT-based grading of pedicle breach, 98.67% (296/300) of left-side screws were graded A or B, 1.3% (4/300) were graded C, and 0% (0/300) were graded D. For the right-side screws, 97.67% (293/300) were graded A or B, 1.67% (5/300) were graded C, and 0.66% (2/300) were graded D. This study demonstrated a high level of accuracy (based on GRS) with no significant differences between the left- and right-side pedicle screw placements (98.67% vs. 97.67%, respectively) in the clinical use of navigated, robot-assisted surgery.

scholarly journals Two Different Minimally Invasive Approaches for Management of Thoracolumbar Fractures

2021 ◽  
Author(s):  
Chenghao Yu ◽  
Fan Ding ◽  
Xiaosong Wu ◽  
Zhengyun Ye ◽  
Bing Hu
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Pedicle Screw ◽  
Guide Wire ◽  
Pedicle Screws ◽  
Operation Time ◽  
Thoracolumbar Fractures ◽  
Percutaneous Approach ◽  
Significant Difference ◽  
Paraspinal Approach

Abstract Objective To compare the clinical effect and safety of pedicle screw fixation via percutaneous approach and Wiltse paraspinal approach for thoracolumbar fractures without neurological deficit.Methods 98 cases who suffered from single level thoracolumbar fracture without nerve injury were treated by pedicle screws fixation via either percutaneous approach (percutaneous group) and Wiltse paraspinal approach(paraspinal group). Perioperative indexes, imaging parameters and functional and symptom results of the two groups were recorded and compared. Results All patients were followed for more than 12 months, and the incision length and postoperative hospital stay in the percutaneous group were significantly shorter than those in the paraspinal group (P<0.05), intraoperative blood loss was less than that of the paraspinal group (P<0.05), operative and postoperative costs and the number of fluoroscopy were significantly higher than those of the paraspinal group (P<0.05). There was no significant difference in operative time between the two groups (P > 0.05). The anterior edge height percentage of the injured vertebrae and kyphosis Cobb Angle were significantly improved 1 week and 1 year postoperatively in each group (P<0.05), there was no statistical difference between the two groups (P<0.05). As for Visual Analog Scale (VAS) scores, in each group there were continuous decreases 3 days, 6 months, and 1 year postoperatively (P<0.05); There were no statistically significant differences between the two groups before operation, 6 months and 1 year postoperatively (P<0.05), but a significant difference 3 days postoperatively (P<0.05). In terms of Oswestry disability index (ODI), in each group there was continuous decreases 6 months and 1 year postoperatively (P<0.05); and there was no significant difference between the two groups (P<0.05).There was no significant difference in the accuracy of implant between the two groups (P<0.05). In the percutaneous group, there were 2 cases of incision fat liquefaction, 1 case of guidewire fracture and 1 case of the anterior wall of the vertebra penetrated by guide wire rupture. 1 diabetic case of superficial incision infection and 2 cases of skin edge necrosis were found in the paraspinal group.Conclusion In the treatment of thoracolumbar fractures without neurological defect, pedicle screw fixations via Wiltse paraspinal and percutaneous approach both can obtain minimally invasive and reliable effect, but the percutaneous approach bring smaller trauma, less blood loss, longer operation time, more fluroscopy, higher surgery and postoperative costs, with its own unique complications especially in early learning curve.

Sign in / Sign up

Export Citation Format

Share Document