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KMID : 1145220230200031028
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Neurospine
2023 Volume.20 No. 3 p.1028 ~ p.1039
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Three-Dimensional Quantitative Assessment of Pedicle Screw Accuracy in Clinical Utilization of a New Robotic System in Spine Surgery: A Multicenter Study
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Ha Byeong-Jin
Lee Jong-Min
Yoon Seon-Jin
Kim Byung-Kwan
Lee Jun-Seok
Lee Su-Hun
Ryu Seung-Jae
Cha Yong-Yeob
Hwang Sung-Teac
Woo Dong-Gi
Lee Chang-Kyu
Shin Dong-Ah
Ha Yoon
Yu Qiu
Zhihua Yu
Son Dong-Wuk
Yi Seong
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Abstract
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Objective : The objective of this study was to evaluate the accuracy of pedicle screw placement in patients undergoing percutaneous pedicle screw fixation with robotic guidance, using a newly developed 3-dimensional quantitative measurement system. The study also aimed to assess the clinical feasibility of the robotic system in the field of spinal surgery.
Methods : A total of 113 patients underwent pedicle screw insertion using the CUVIS-spine pedicle screw guide system (CUREXO Inc.). Intraoperative O-arm images were obtained, and screw insertion pathways were planned accordingly. Image registration was performed using paired-point registration and iterative closest point methods. The accuracy of the robotic-guided pedicle screw insertion was assessed using 3-dimensional offset calculation and the Gertzbein-Robbins system (GRS).
Results : A total of 448 screws were inserted in the 113 patients. The image registration success rate was 95.16%. The average error of entry offset was 2.86 mm, target offset was 2.48 mm, depth offset was 1.99 mm, and angular offset was 3.07°. According to the GRS grading system, 88.39% of the screws were classified as grade A, 9.60% as grade B, 1.56% as grade C, 0.22% as grade D, and 0.22% as grade E. Clinically acceptable screws (GRS grade A or B) accounted for 97.54% of the total, with no reported neurologic complications.
Conclusion : Our study demonstrated that pedicle screw insertion using the novel robot-assisted navigation method is both accurate and safe. Further prospective studies are necessary to explore the potential benefits of this robot-assisted technique in comparison to conventional approaches.
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KEYWORD
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Robot-assisted spine surgery, Pedicle screws, Dimensional measurement accuracy
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