Accuracy and Clinical Outcomes of Fluoroscopy-Guided and Robotic-Assisted Percutaneous Pedicle Screw Fixation Performed by a Single Surgeon at a Single Center
10.21182/jmisst.2024.01172
- Author:
Jong Hyeok LEE
1
;
Dong Wuk SON
;
Bu Kwang OH
;
Jun Seok LEE
;
Su Hun LEE
;
Young Ha KIM
;
Soon Ki SUNG
;
Sang Weon LEE
;
Geun Sung SONG
;
Chang Hyeun KIM
;
Chi Hyung LEE
;
Seong YI
Author Information
1. Department of Neurosurgery, Pusan National University Yangsan Hospital, Busan, Korea
- Publication Type:Original Article
- From:
Journal of Minimally Invasive Spine Surgery and Technique
2024;9(1):61-68
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objective:Fluoroscopy-guided percutaneous pedicle screw fixation (FGPSF) and its further development, robot-assisted percutaneous pedicle screw fixation (RAPSF), are minimally invasive spinal surgery (MISS) techniques. FGPSF is a standard technique at our hospital, and RAPSF incorporating artificial intelligence has been performed at our hospital since October 2021. This study compared these 2 techniques and analyzed their differences, accuracy, and clinical outcomes based on our experiences.
Methods:This study conducted a detailed analysis of screw accuracy and the clinical outcomes of 2 MISS techniques, FGPSF, and RAPSF. Screw accuracy was evaluated using the Gertzbein and Robbins scale, categorizing placements into grades A–E, with grades A and B considered clinically acceptable. Accuracy was assessed using postoperative computed tomography images for FGPSF and intraoperative O-arm scan images for RAPSF. Clinical outcomes were compared by examining parameters, such as hospitalization duration, C-reactive protein (CRP) normalization period, estimated blood loss (EBL), and preoperative/postoperative visual analogue scale (VAS) scores. Screw-related complications were reviewed. Independent image evaluations by nonparticipating spine specialists ensured objective and reliable assessments.
Results:Both FGPSF and RAPSF demonstrated high rates of clinically acceptable screw placement, with minimal breaches that required no repositioning. The clinically acceptable rates of FGPSF and RAPSF were similar (99.17% and 99.19%, respectively). Both groups also demonstrated similar clinical outcomes. The CRP normalization period, EBL, and ΔVAS (preoperative—postoperative) scores revealed no statistically significant differences between FGPSF and RAPSF. Neither group experienced screw-related complications; however, the RAPSF group exhibited a statistically significant shorter hospital stay than the FGPSF group.
Conclusion:This study compared the accuracy and clinical outcomes of FGPSF and RAPSF. Both methods demonstrated no significant differences in accuracy or clinical outcomes. Spine surgeons selected between the 2 methods based on individual patient needs, and additional research is required to fully understand the practical advantages of each technique in the clinical field.
