Accuracy of Robot-Assisted Percutaneous Pedicle Screw Placement for Treatment of Lumbar Spondylolisthesis: A Comparative Cohort Study

Autor: Yuan Tuo, Jia-Nan Zhang, Fang Tian, Shichang Liu, Dingjun Hao, Tuanjiang Liu, Peng Liu, Lei Chu, Jun-Song Yang, Baorong He
Rok vydání: 2019
Předmět:
Adult
Male
musculoskeletal diseases
China
medicine.medical_specialty
Facet (geometry)
Percutaneous
030204 cardiovascular system & hematology
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Robotic Surgical Procedures
Clinical Research
Pedicle Screws
Retrospective analysis
Humans
Minimally Invasive Surgical Procedures
Medicine
Pedicle screw
Lumbar spondylolisthesis
Aged
Retrospective Studies
Lumbar Vertebrae
business.industry
Lumbosacral Region
Retrospective cohort study
Robotics
General Medicine
Minimally invasive spine surgery
Middle Aged
equipment and supplies
musculoskeletal system
Spine
Orthopedic Fixation Devices
Surgery
Spinal Fusion
Treatment Outcome
surgical procedures
operative
Surgery
Computer-Assisted
030220 oncology & carcinogenesis
Female
Spondylolisthesis
business
Cohort study
Zdroj: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
ISSN: 1643-3750
DOI: 10.12659/msm.913124
Popis: BACKGROUND With the in-depth development of minimally invasive spine surgery in recent years, robot- and computer-assisted technologies have been increasingly used and successfully applied to spinal surgery. MATERIAL AND METHODS We performed a retrospective analysis of 60 patients with grade I or II lumbar spondylolisthesis who underwent minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) from January 2017 to December 2017. A robot-assisted surgical system was used in 30 patients for pedicle screw placement. The other 30 patients underwent fluoroscopy-guided percutaneous pedicle screw placement. RESULTS There were 130 screws placed under fluoroscopic guidance, with 26.2% penetration of the pedicle wall. There were 130 screws placed in robotic-assisted surgery, with 6.2% penetration of the pedicle wall. Severe screw deviation (Neo grade III) was identified in 4 screws in the fluoroscopy-guided group, while no severe deviation was noted in the robot-assisted group. In the fluoroscopic group, 15.6% of screws penetrated the superior articular process, and 2.1% screws had severe complications (Babu grade III). However, only 5.1% of screws in the robot-assisted group had severe complications. The mean screw insertion angle was significantly greater in the robot-assisted group than in the fluoroscopy-guided group (23.8±6.1° vs. 18.4±7.2°, P=0.017). CONCLUSIONS Compared to fluoroscopy-guided percutaneous pedicle screw placement, robot-assisted percutaneous pedicle screw placement has the following advantages: greater accuracy, lower incidences of screw penetration of the pedicle wall and invasion of the facet joints, and better screw insertion angle. Combined with MIS-TLIF, robot-assisted percutaneous pedicle screw placement is an effective minimally invasive treatment for lumbar spondylolisthesis.
Databáze: OpenAIRE
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