The Clinical Impact of Image Guidance and Robotics in Spinal Surgery: A Review of Safety, Accuracy, Efficiency, and Complication Reduction.

Autor:	Campbell DH; Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, Arizona., McDonald D; Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, Arizona., Araghi K; Arizona State University, Tempe, Arizona., Araghi T; Arizona State University, Tempe, Arizona., Chutkan N; Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, Arizona.; The CORE Institute, Phoenix, Arizona., Araghi A; The CORE Institute, Phoenix, Arizona.
Jazyk:	angličtina
Zdroj:	International journal of spine surgery [Int J Spine Surg] 2021 Oct; Vol. 15 (s2), pp. S10-S20. Date of Electronic Publication: 2021 Oct 04.
DOI:	10.14444/8136
Abstrakt:	Image guidance (IG) and robotic-assisted (RA) surgery are modern technological advancements that have provided novel ways to perform precise and accurate spinal surgery. These innovations supply real-time, three-dimensional imaging information to aid in instrumentation, decompression, and implant placement. Although nothing can replace the knowledge and expertise of an experienced spine surgeon, these platforms do have the potential to supplement the individual surgeon's capabilities. Specific advantages include more precise pedicle screw placement, minimally invasive surgery with less reliance on intraoperative fluoroscopy, and lower radiation exposure to the surgeon and staff. As these technologies have become more widely adopted over the years, novel uses such as tumor resection have been explored. Disadvantages include the cost of implementing IG and robotics platforms, the initial learning curve for both the surgeon and the staff, and increased patient radiation exposure in scoliosis surgery. Also, given the relatively recent transition of many procedures from inpatient settings to ambulatory surgery centers, access to current devices may be cost prohibitive and not as readily available at some centers. Regarding patient-related outcomes, much further research is warranted. The short-term benefits of minimally invasive surgery often bolster the perioperative and early postoperative outcomes in many retrospective studies on IG and RA surgery. Randomized controlled trials limiting such confounding factors are warranted to definitively show potential independent improvements in patient-related outcomes specifically attributable to IG and RA alone. Nonetheless, irrespective of these current unknowns, it is clear that these technologies have changed the field and the practice of spine surgery. Surgeons should be familiar with the potential benefits and tradeoffs of these platforms when considering adopting IG and robotics in their practices. (This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2021 ISASS.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu