Cervical Spine Navigation and Enabled Robotics: A New Frontier in Minimally Invasive Surgery

2021 ◽  
pp. 155633162110266
Author(s):  
Darren R. Lebl ◽  
Fedan Avrumova ◽  
Celeste Abjornson ◽  
Frank P. Cammisa
Keyword(s):  
Cervical Spine ◽  
Computer Assisted ◽  
Lateral Mass ◽  
Robotic Assisted ◽  
Assisted Navigation ◽  
Robotic Assisted Surgery ◽  
New Frontier ◽  
Cervical Pedicle ◽  
Set Up

Background: Robotic-assisted and computer-assisted navigation (CAN) systems utilization has been rapidly increasing in recent years. Most existing data using these systems are performed in the thoracic, lumbar, and sacral spine. The unique anatomy of the cervical spine maybe where these technologies have the greatest potential. To date, the role of navigation-enabled robotics in the cervical spine remains in its early stages of development and study. Purpose: This review article describes the early experience, case descriptions and technical considerations with cervical spine screw fixation and decompression using CAN and robotic-assisted surgery. Methods: Representative cervical cases with early surgical experience with cervical and robotic assisted surgery with CAN. Surgical set up, technique considerations, instrumentation, screw accuracy and screw placement were elevated and recorded for each representative cervical case. Results: Existing robotic assisted spine surgical systems are reviewed as they pertain to the cervical spine. Method for cervical reference and positioning on radiolucent Mayfield tongs are presented. C1 lateral mass, odontoid fracture fixation, C2 pedicle, translaminar, subaxial lateral mass, mid cervical pedicle, navigated decompression and ACDF cases and techniques are presented. Conclusion: In conclusion, within the last several years, the use of CANs in spinal surgery has grown and the cervical spine shows the greatest potential. Several robotic systems have had FDA clearance for use in the spine, but such use requires simultaneous intraoperative fluoroscopic confirmation. In the coming years, this recommendation will likely be dropped as accuracy improves.

The role of robotic-assisted surgery for the treatment of diverticular disease

2019 ◽  
Vol 14 (1) ◽  
pp. 239-240
Author(s):  
Matteo Bianchini ◽  
Matteo Palmeri ◽  
Gianni Stefanini ◽  
Niccolò Furbetta ◽  
Gregorio Di Franco
Keyword(s):  
Diverticular Disease ◽  
Robotic Assisted ◽  
Robotic Assisted Surgery

Accuracy of Fluoroscopy Versus Computer-Assisted Navigation for the Placement of Anterior Cervical Pedicle Screws

Spine ◽  
2015 ◽  
Vol 40 (7) ◽  
pp. E404-E410 ◽  
Author(s):  
Andrew G. Patton ◽  
Randal P. Morris ◽  
Yong-Fang Kuo ◽  
Ronald W. Lindsey
Keyword(s):  
Pedicle Screws ◽  
Computer Assisted ◽  
Assisted Navigation ◽  
Cervical Pedicle ◽  
Cervical Pedicle Screws

Screw-related complications in the subaxial cervical spine with the use of lateral mass versus cervical pedicle screws

2013 ◽  
Vol 19 (5) ◽  
pp. 614-623 ◽  
Author(s):  
Hiroyuki Yoshihara ◽  
Peter G. Passias ◽  
Thomas J. Errico
Keyword(s):  
Cervical Spine ◽  
Vertebral Artery ◽  
Preoperative Evaluation ◽  
Pedicle Screws ◽  
Complication Rates ◽  
Lateral Mass ◽  
Subaxial Cervical Spine ◽  
Number Of Patients ◽  
Cervical Pedicle ◽  
Cervical Pedicle Screws

Object Lateral mass screws (LMS) have been used extensively with a low complication rate in the subaxial spine. Recently, cervical pedicle screws (CPS) have been introduced, and are thought to provide more optimal stabilization of the subaxial spine in certain circumstances. However, because of the concern for neurovascular injury, the routine use of CPS in this location remains controversial. Despite this controversy, however, there are no articles directly comparing screw-related complications of each procedure in the subaxial cervical spine. The purpose of this study was to evaluate screw-related complications of LMS and CPS in the subaxial cervical spine. Methods A PubMed/MEDLINE and Cochrane Collaboration Library search was executed, using the key words “lateral mass screw” and “cervical pedicle screw.” Clinical studies evaluating surgical procedures of the subaxial cervical spine in which either LMS or CPS were used and complications were reported were included. Studies in which the number of patients who had subaxial cervical spine surgery and the number of screws placed from C-3 to C-7 could not be specified were excluded. Data on screw-related complications of each study were recorded and compared. Results Ten studies of LMS and 12 studies of CPS were included in the analysis. Vertebral artery injuries were slightly but statistically significantly higher with the use of CPS relative to LMS in the subaxial cervical spine. Although the use of LMS was associated with a higher rate of screw loosening, screw pullout, loss of reduction, pseudarthrosis, and revision surgery, this finding was not statistically significant. Conclusions Based on the available literature, it appears that perioperative neurological and late biomechanical complication rates, including pseudarthrosis, are similarly low for both LMS and CPS techniques. In contrast, vertebral artery injuries, although statistically significantly more common when using CPS, are extremely rare with both techniques, which may justify their nonroutine use in select cases. Given the paucity of well-designed studies available, this recommendation may be a reflection of deficiencies in the available studies. Surgeons using either technique should have intimate knowledge of cervical anatomy and an adequate preoperative evaluation for each patient, with the final selection based on individual case requirements and anatomical limitations.

scholarly journals Role of the O-arm and Computer-assisted Navigation of Safe Screw Fixation in Children with Traumatic Rotatory Atlantoaxial Subluxation

2012 ◽  
Vol 6 (4) ◽  
pp. 266 ◽  
Author(s):  
Walid Attia ◽  
Tamer Orief ◽  
Khaled Almusrea ◽  
Mohamed Alfawareh ◽  
Lahbib Soualmi ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Atlantoaxial Subluxation ◽  
Computer Assisted ◽  
Assisted Navigation

Analysis of adjacent-segment cervical kinematics: the role of construct length and the dorsal ligamentous complex

2020 ◽  
Vol 32 (1) ◽  
pp. 15-22
Author(s):  
Daniel Lubelski ◽  
Andrew T. Healy ◽  
Prasath Mageswaran ◽  
Robb Colbrunn ◽  
Richard P. Schlenk
Keyword(s):  
Cervical Spine ◽  
Industrial Robot ◽  
Adjacent Segment ◽  
Segmental Motion ◽  
Lateral Mass ◽  
Subaxial Cervical Spine ◽  
Flexion Extension ◽  
Cervical Kinematics

OBJECTIVELateral mass fixation stabilizes the cervical spine while causing minimal morbidity and resulting in high fusion rates. Still, with 2 years of follow-up, approximately 6% of patients who have undergone posterior cervical fusion have worsening kyphosis or symptomatic adjacent-segment disease. Based on the length of the construct, the question of whether to extend the fixation system to undisrupted levels has not been answered for the cervical spine. The authors conducted a study to quantify the role of construct length and the terminal dorsal ligamentous complex in the adjacent-segment kinematics of the subaxial cervical spine.METHODSIn vitro flexibility testing was performed using 6 human cadaveric specimens (C2–T8), with the upper thoracic rib cage and osseous and ligamentous integrity intact. An industrial robot was used to apply pure moments and to measure segmental motion at each level. The authors tested the intact state, followed by 9 postsurgical permutations of laminectomy and lateral mass fixation spanning C2 to C7.RESULTSConstructs spanning a single level exerted no significant effects on immediate adjacent-segment motion. The addition of a second immobilized segment, however, created significant changes in flexion-extension range of motion at the supradjacent level (+164%). Regardless of construct length, resection of the terminal dorsal ligaments did not greatly affect adjacent-level motion except at C2–3 and C7–T1 (increasing by +794% and +607%, respectively).CONCLUSIONSDorsal ligamentous support was found to contribute significant stability to the C2–3 and C7–T1 segments only. Construct length was found to play a significant role when fixating two or more segments. The addition of a fused segment to support an undisrupted cervical level is not suggested by the present data, except potentially at C2–3 and C7–T1. The study findings emphasize the importance of the C2–3 segment and its dorsal support.

scholarly journals Computer-assisted navigation in complex cervical spine surgery: tips and tricks

2020 ◽  
Vol 6 (1) ◽  
pp. 136-144
Author(s):  
Nicholas Wallace ◽  
Nathaniel E. Schaffer ◽  
Brett A. Freedman ◽  
Ahmad Nassr ◽  
Bradford L. Currier ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Spine Surgery ◽  
Computer Assisted ◽  
Tips And Tricks ◽  
Assisted Navigation ◽  
Cervical Spine Surgery

scholarly journals The Role of Robotic Surgery in Benign Otolaryngology Head and Neck Surgery: A Systematic Review of the Literature.

2021 ◽  
Vol 9 (2) ◽  
Author(s):  
Sarah Gillanders ◽  
Akshaya Ravi ◽  
Shawkat Abdulrahman
Keyword(s):  
Systematic Review ◽  
Head And Neck ◽  
Neck Surgery ◽  
Review Of The Literature ◽  
Inclusion Criteria ◽  
Robot Assisted ◽  
Robotic Assisted ◽  
Robotic Assisted Surgery ◽  
Near Future

The role of robotic-assisted surgery has increased exponentially in many surgical specialities over recent years. However, common usage within otolaryngology still appears limited. We aim to explore the alternative uses for robot-assisted surgery in benign otolaryngology, head and neck pathologies. A systematic review of the literature was performed by searching electronic databases and references libraries. 2485 papers were identified through our search. 96 studies met our inclusion criteria. Our results are categorized and displayed in table format. There are multiple novel adaptations of robotic-assisted surgery being performed across the world in benign otolaryngology, head and neck pathologies. Exciting advances in technology and availability will expand this scope even further in the near future.

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