Cargando…

Posterior atlantoaxial internal fixation using Harms technique assisted by 3D-based navigation robot for treatment of atlantoaxial instability

BACKGROUND: To evaluate the accuracy of screw placement using the TiRobot surgical robot in the Harms procedure and to assess the clinical outcomes of this technique. METHODS: This retrospective study included 21 patients with atlantoaxial instability treated by posterior atlantoaxial internal fixat...

Descripción completa

Detalles Bibliográficos
Autores principales: Lang, Zhao, Han, Xiaoguang, Fan, Mingxing, Liu, Yajun, He, Da, Tian, Wei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9636711/
https://www.ncbi.nlm.nih.gov/pubmed/36333797
http://dx.doi.org/10.1186/s12893-022-01826-2
_version_ 1784825010632785920
author Lang, Zhao
Han, Xiaoguang
Fan, Mingxing
Liu, Yajun
He, Da
Tian, Wei
author_facet Lang, Zhao
Han, Xiaoguang
Fan, Mingxing
Liu, Yajun
He, Da
Tian, Wei
author_sort Lang, Zhao
collection PubMed
description BACKGROUND: To evaluate the accuracy of screw placement using the TiRobot surgical robot in the Harms procedure and to assess the clinical outcomes of this technique. METHODS: This retrospective study included 21 patients with atlantoaxial instability treated by posterior atlantoaxial internal fixation (Harms procedure) using the TiRobot surgical robot between March 2016 and June 2021. The precision of screw placement, perioperative parameters and clinical outcomes were recorded. Screw placement was assessed based on intraoperative guiding pin accuracy measurements on intraoperative C-arm cone-beam computed tomography (CT) images using overlay technology and the incidence of screw encroachment identified on CT images. RESULTS: Among the 21 patients, the mean age was 44.8 years, and the causes of atlantoaxial instability were os odontoideum (n = 11), rheumatoid arthritis (n = 2), unknown pathogenesis (n = 3), and type II odontoid fracture (n = 5). A total of 82 screws were inserted with robotic assistance. From intraoperative guiding pin accuracy measurements, the average translational and angular deviations were 1.52 ± 0.35 mm (range 1.14–2.25 mm) and 2.25° ± 0.45° (range 1.73°–3.20º), respectively. Screw placement was graded as A for 80.5% of screws, B for 15.9%, and C for 3.7%. No complications related to screw misplacement were observed. After the 1-year follow-up, all patients with a neurological deficit experienced neurological improvement based on Nurick Myelopathy Scale scores, and all patients with preoperative neck pain reported improvement based on Visual Analog Scale scores. CONCLUSIONS: Posterior atlantoaxial internal fixation using the Harms technique assisted by a 3D-based navigation robot is safe, accurate, and effective for treating atlantoaxial instability.
format Online
Article
Text
id pubmed-9636711
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-96367112022-11-06 Posterior atlantoaxial internal fixation using Harms technique assisted by 3D-based navigation robot for treatment of atlantoaxial instability Lang, Zhao Han, Xiaoguang Fan, Mingxing Liu, Yajun He, Da Tian, Wei BMC Surg Research BACKGROUND: To evaluate the accuracy of screw placement using the TiRobot surgical robot in the Harms procedure and to assess the clinical outcomes of this technique. METHODS: This retrospective study included 21 patients with atlantoaxial instability treated by posterior atlantoaxial internal fixation (Harms procedure) using the TiRobot surgical robot between March 2016 and June 2021. The precision of screw placement, perioperative parameters and clinical outcomes were recorded. Screw placement was assessed based on intraoperative guiding pin accuracy measurements on intraoperative C-arm cone-beam computed tomography (CT) images using overlay technology and the incidence of screw encroachment identified on CT images. RESULTS: Among the 21 patients, the mean age was 44.8 years, and the causes of atlantoaxial instability were os odontoideum (n = 11), rheumatoid arthritis (n = 2), unknown pathogenesis (n = 3), and type II odontoid fracture (n = 5). A total of 82 screws were inserted with robotic assistance. From intraoperative guiding pin accuracy measurements, the average translational and angular deviations were 1.52 ± 0.35 mm (range 1.14–2.25 mm) and 2.25° ± 0.45° (range 1.73°–3.20º), respectively. Screw placement was graded as A for 80.5% of screws, B for 15.9%, and C for 3.7%. No complications related to screw misplacement were observed. After the 1-year follow-up, all patients with a neurological deficit experienced neurological improvement based on Nurick Myelopathy Scale scores, and all patients with preoperative neck pain reported improvement based on Visual Analog Scale scores. CONCLUSIONS: Posterior atlantoaxial internal fixation using the Harms technique assisted by a 3D-based navigation robot is safe, accurate, and effective for treating atlantoaxial instability. BioMed Central 2022-11-04 /pmc/articles/PMC9636711/ /pubmed/36333797 http://dx.doi.org/10.1186/s12893-022-01826-2 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Lang, Zhao
Han, Xiaoguang
Fan, Mingxing
Liu, Yajun
He, Da
Tian, Wei
Posterior atlantoaxial internal fixation using Harms technique assisted by 3D-based navigation robot for treatment of atlantoaxial instability
title Posterior atlantoaxial internal fixation using Harms technique assisted by 3D-based navigation robot for treatment of atlantoaxial instability
title_full Posterior atlantoaxial internal fixation using Harms technique assisted by 3D-based navigation robot for treatment of atlantoaxial instability
title_fullStr Posterior atlantoaxial internal fixation using Harms technique assisted by 3D-based navigation robot for treatment of atlantoaxial instability
title_full_unstemmed Posterior atlantoaxial internal fixation using Harms technique assisted by 3D-based navigation robot for treatment of atlantoaxial instability
title_short Posterior atlantoaxial internal fixation using Harms technique assisted by 3D-based navigation robot for treatment of atlantoaxial instability
title_sort posterior atlantoaxial internal fixation using harms technique assisted by 3d-based navigation robot for treatment of atlantoaxial instability
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9636711/
https://www.ncbi.nlm.nih.gov/pubmed/36333797
http://dx.doi.org/10.1186/s12893-022-01826-2
work_keys_str_mv AT langzhao posterioratlantoaxialinternalfixationusingharmstechniqueassistedby3dbasednavigationrobotfortreatmentofatlantoaxialinstability
AT hanxiaoguang posterioratlantoaxialinternalfixationusingharmstechniqueassistedby3dbasednavigationrobotfortreatmentofatlantoaxialinstability
AT fanmingxing posterioratlantoaxialinternalfixationusingharmstechniqueassistedby3dbasednavigationrobotfortreatmentofatlantoaxialinstability
AT liuyajun posterioratlantoaxialinternalfixationusingharmstechniqueassistedby3dbasednavigationrobotfortreatmentofatlantoaxialinstability
AT heda posterioratlantoaxialinternalfixationusingharmstechniqueassistedby3dbasednavigationrobotfortreatmentofatlantoaxialinstability
AT tianwei posterioratlantoaxialinternalfixationusingharmstechniqueassistedby3dbasednavigationrobotfortreatmentofatlantoaxialinstability