Robot-assisted cervical pedicle screw fixation
10.3760/cma.j.cn121113-20230725-00046
- VernacularTitle:骨科机器人辅助颈椎椎弓根螺钉内固定
- Author:
Da HE
1
;
Zhao LANG
Author Information
1. 首都医科大学附属北京积水潭医院（国家骨科医学中心）脊柱外科，北京 100035
- Keywords:
Cervical vertebrae;
Robotic surgical procedures;
Pedicle screws;
Education, medical, continuing
- From:
Chinese Journal of Orthopaedics
2024;44(15):1056-1060
- CountryChina
- Language:Chinese
-
Abstract:
The cervical pedicle screw fixation system is distinguished for its biomechanical stability, playing an essential role in corrective and fusion surgeries of the cervical spine. Nevertheless, the complex anatomy of the cervical region increases surgical risks, primarily the potential injury to vertebral arteries, nerve roots, and the spinal cord. Robot-assisted technology in cervical pedicle screw fixation emerges as an innovative technique, encompassing spatial mapping, image registration, and execution planning. These processes enable the robot to oversee the entire procedure from image analysis and trajectory planning of screws to robotic arm movement control. Current research underscores that robot assistance enhances precision and safety in cervical spine surgeries. Indications for such robot-assisted surgeries extend to stability reconstruction and deformity correction within the cervical spine. Conversely, contraindications include infections in posterior cervical structures, trauma-induced or tumor-related injuries to the pedicle and vertebral body, and anatomical anomalies such as absent or very narrow pedicles. X-ray and CT imaging are essential preoperative steps to ascertain the fixation level and identify atypical anatomical structures. Depending on the disease and soft tissue tension, either a conventional midline incision or bilateral percutaneous incisions can be chosen. Following image acquisition and registration, the workstation facilitates screw planning. Under robotic guidance, insertion of the sleeve proceeds, followed by guide pins and screws placement. During the operation, constant attention should be paid to the precision of the robotic arm. In cases of significant positional deviation, operations should be stopped, and the causes should be carefully investigated. Robot-assisted cervical pedicle screw fixation is distinguished by its precision, stability, and reproducibility, surpassing the limitations of conventional surgery and bolstering surgical outcomes. As a novel application in spinal surgery robotics, this technology harbors significant potential for expansive clinical implementation.
