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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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Autores principales: Li, Zongze, Chen, Jianting, Zhu, Qing-An, Zheng, Shaoli, Zhong, Zhaoming, Yang, Jincheng, Yang, Dehong, Jiang, Hui, Jiang, Wangsheng, Zhu, Yongjian, Sun, Donghui, Huang, Wei, Chen, Jiarui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Chinese Speaking Orthopaedic Society 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6939109/
https://www.ncbi.nlm.nih.gov/pubmed/31908936
http://dx.doi.org/10.1016/j.jot.2019.09.002
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author Li, Zongze
Chen, Jianting
Zhu, Qing-An
Zheng, Shaoli
Zhong, Zhaoming
Yang, Jincheng
Yang, Dehong
Jiang, Hui
Jiang, Wangsheng
Zhu, Yongjian
Sun, Donghui
Huang, Wei
Chen, Jiarui
author_facet Li, Zongze
Chen, Jianting
Zhu, Qing-An
Zheng, Shaoli
Zhong, Zhaoming
Yang, Jincheng
Yang, Dehong
Jiang, Hui
Jiang, Wangsheng
Zhu, Yongjian
Sun, Donghui
Huang, Wei
Chen, Jiarui
author_sort Li, Zongze
collection PubMed
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.
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spelling pubmed-69391092020-01-06 A preliminary study of a novel robotic system for pedicle screw fixation: A randomised controlled trial Li, Zongze Chen, Jianting Zhu, Qing-An Zheng, Shaoli Zhong, Zhaoming Yang, Jincheng Yang, Dehong Jiang, Hui Jiang, Wangsheng Zhu, Yongjian Sun, Donghui Huang, Wei Chen, Jiarui J Orthop Translat Original Article 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. Chinese Speaking Orthopaedic Society 2019-09-16 /pmc/articles/PMC6939109/ /pubmed/31908936 http://dx.doi.org/10.1016/j.jot.2019.09.002 Text en © 2019 Published by Elsevier (Singapore) Pte Ltd on behalf of Chinese Speaking Orthopaedic Society. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Li, Zongze
Chen, Jianting
Zhu, Qing-An
Zheng, Shaoli
Zhong, Zhaoming
Yang, Jincheng
Yang, Dehong
Jiang, Hui
Jiang, Wangsheng
Zhu, Yongjian
Sun, Donghui
Huang, Wei
Chen, Jiarui
A preliminary study of a novel robotic system for pedicle screw fixation: A randomised controlled trial
title 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_short 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
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6939109/
https://www.ncbi.nlm.nih.gov/pubmed/31908936
http://dx.doi.org/10.1016/j.jot.2019.09.002
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