A preliminary study of a novel robotic system for pedicle screw fixation: A randomised controlled trial
Background and objective: Existing orthopaedic robotic systems are almost restricted to provide guidance for trajectory direction. In the present study, a novel spinal robotic system with automatic drilling power was introduced. The aim of this study is to evaluate the feasibility and safety in pedi...
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Format: | Article |
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Elsevier
2020-01-01
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Series: | Journal of Orthopaedic Translation |
Online Access: | http://www.sciencedirect.com/science/article/pii/S2214031X19302062 |
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Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Zongze Li Jianting Chen Qing-An Zhu Shaoli Zheng Zhaoming Zhong Jincheng Yang Dehong Yang Hui Jiang Wangsheng Jiang Yongjian Zhu Donghui Sun Wei Huang Jiarui Chen |
spellingShingle |
Zongze Li Jianting Chen Qing-An Zhu Shaoli Zheng Zhaoming Zhong Jincheng Yang Dehong Yang Hui Jiang Wangsheng Jiang Yongjian Zhu Donghui Sun Wei Huang Jiarui Chen A preliminary study of a novel robotic system for pedicle screw fixation: A randomised controlled trial Journal of Orthopaedic Translation |
author_facet |
Zongze Li Jianting Chen Qing-An Zhu Shaoli Zheng Zhaoming Zhong Jincheng Yang Dehong Yang Hui Jiang Wangsheng Jiang Yongjian Zhu Donghui Sun Wei Huang Jiarui Chen |
author_sort |
Zongze Li |
title |
A preliminary study of a novel robotic system for pedicle screw fixation: A randomised controlled trial |
title_short |
A preliminary study of a novel robotic system for pedicle screw fixation: A randomised controlled trial |
title_full |
A preliminary study of a novel robotic system for pedicle screw fixation: A randomised controlled trial |
title_fullStr |
A preliminary study of a novel robotic system for pedicle screw fixation: A randomised controlled trial |
title_full_unstemmed |
A preliminary study of a novel robotic system for pedicle screw fixation: A randomised controlled trial |
title_sort |
preliminary study of a novel robotic system for pedicle screw fixation: a randomised controlled trial |
publisher |
Elsevier |
series |
Journal of Orthopaedic Translation |
issn |
2214-031X |
publishDate |
2020-01-01 |
description |
Background and objective: Existing orthopaedic robotic systems are almost restricted to provide guidance for trajectory direction. In the present study, a novel spinal robotic system with automatic drilling power was introduced. The aim of this study is to evaluate the feasibility and safety in pedicle screw insertion of posterior lumbar interbody fusion assisted by this novel robotic system. Methods and materials: A randomised controlled trial was conducted for 17 participants who were required posterior lumbar interbody fusion process. Seven (3 M/4 F) were randomly assigned to the robot-assisted group (RA group), and the other ten (4 M/6 F) were assigned to the conventional technique group (FH group). A novel robotic system was used in the RA group. All measurements were based on postoperative computed tomography (CT) data. Accuracy of screw insertion was determined using the Gertzbein and Robbins Scale. Precision was measured by the entry point deviation distance and the trajectory rotation. Other variables included operation time, radiation time, length of stay, and screw-related complications. Result: A total of 82 pedicle screws were placed in the 17 participants. In the RA group, 90.6% of screws placed were Grade A, and 9.4% were Grade B. In the FH group, 78.0% of screws were Grade A, 20.0% were Grade B, and 2.0% were Grade C. No statistical difference was found in the operation time, radiation time per case, and length of stay between both groups. The radiation time per screw is significantly lower in the RA group. No screw-related complications or revision occurred in the present study. Conclusion: The outcome of screw accuracy of this robotic system was comparable with that of experienced surgeons, and no screw-related complication was found in the RA group during hospitalisation. In addition, radiation time per screw in the robotic group was significantly lower than that in the conventional group, which shows the potential to reduce radiation exposure of pedicle screw fixation assisted by this robotic system. Translational potential: Our study shows that pedicle screw fixation assisted by “Orthbot” system is accurate and safe. It is concluded that this novel robotic system offers a new option for internal implantation in spine surgery. Keywords: Robotic system, Pedicle screw fixation, Posterior lumbar interbody fusion, Preoperative planning, Accurcay |
url |
http://www.sciencedirect.com/science/article/pii/S2214031X19302062 |
work_keys_str_mv |
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1724891101120167936 |
spelling |
doaj-ff200e3904ac4047a6f13ed1de6e949f2020-11-25T02:16:29ZengElsevierJournal of Orthopaedic Translation2214-031X2020-01-01207379A preliminary study of a novel robotic system for pedicle screw fixation: A randomised controlled trialZongze Li0Jianting Chen1Qing-An Zhu2Shaoli Zheng3Zhaoming Zhong4Jincheng Yang5Dehong Yang6Hui Jiang7Wangsheng Jiang8Yongjian Zhu9Donghui Sun10Wei Huang11Jiarui Chen12Department of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China; Corresponding author. Department of Spinal Surgery, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou 510515, Guangdong, China.Department of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaXinjunte Smart Medical Equipment Co.Ltd, Shenzhen, ChinaXinjunte Smart Medical Equipment Co.Ltd, Shenzhen, ChinaXinjunte Smart Medical Equipment Co.Ltd, Shenzhen, ChinaBackground and objective: Existing orthopaedic robotic systems are almost restricted to provide guidance for trajectory direction. In the present study, a novel spinal robotic system with automatic drilling power was introduced. The aim of this study is to evaluate the feasibility and safety in pedicle screw insertion of posterior lumbar interbody fusion assisted by this novel robotic system. Methods and materials: A randomised controlled trial was conducted for 17 participants who were required posterior lumbar interbody fusion process. Seven (3 M/4 F) were randomly assigned to the robot-assisted group (RA group), and the other ten (4 M/6 F) were assigned to the conventional technique group (FH group). A novel robotic system was used in the RA group. All measurements were based on postoperative computed tomography (CT) data. Accuracy of screw insertion was determined using the Gertzbein and Robbins Scale. Precision was measured by the entry point deviation distance and the trajectory rotation. Other variables included operation time, radiation time, length of stay, and screw-related complications. Result: A total of 82 pedicle screws were placed in the 17 participants. In the RA group, 90.6% of screws placed were Grade A, and 9.4% were Grade B. In the FH group, 78.0% of screws were Grade A, 20.0% were Grade B, and 2.0% were Grade C. No statistical difference was found in the operation time, radiation time per case, and length of stay between both groups. The radiation time per screw is significantly lower in the RA group. No screw-related complications or revision occurred in the present study. Conclusion: The outcome of screw accuracy of this robotic system was comparable with that of experienced surgeons, and no screw-related complication was found in the RA group during hospitalisation. In addition, radiation time per screw in the robotic group was significantly lower than that in the conventional group, which shows the potential to reduce radiation exposure of pedicle screw fixation assisted by this robotic system. Translational potential: Our study shows that pedicle screw fixation assisted by “Orthbot” system is accurate and safe. It is concluded that this novel robotic system offers a new option for internal implantation in spine surgery. Keywords: Robotic system, Pedicle screw fixation, Posterior lumbar interbody fusion, Preoperative planning, Accurcayhttp://www.sciencedirect.com/science/article/pii/S2214031X19302062 |