scholarly journals Is There a Difference in Screw Accuracy, Robot Time Per Screw, Robot Abandonment, and Radiation Exposure Between the Mazor X and the Renaissance? A Propensity-Matched Analysis of 1179 Robot-Assisted Screws

2021 ◽  
pp. 219256822110298
Author(s):  
Nathan J. Lee ◽  
Scott L. Zuckerman ◽  
Ian A. Buchanan ◽  
Venkat Boddapati ◽  
Justin Mathew ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Spine Surgery ◽  
Cohort Analysis ◽  
Sensory Function ◽  
Robot Assisted ◽  
Included Patient ◽  
Robot Systems ◽  
Preoperative Ct ◽  
Planning Processes ◽  
Perioperative Planning

Study Design: Prospective single-cohort analysis. Objectives: To compare the outcomes/complications of 2 robotic systems for spine surgery. Methods: Adult patients (≥18-years-old) who underwent robot-assisted spine surgery from 2016-2019 were assessed. A propensity score matching (PSM) algorithm was used to match Mazor X to Renaissance cases. Preoperative CT scan for planning and an intraoperative O-arm for screw evaluation were preformed. Outcomes included screw accuracy, robot time/screw, robot abandonment, and radiation. Screw accuracy was measured using Vitrea Core software by 2 orthopedic surgeons. Screw breach was measured according to the Gertzbein/Robbins classification. Results: After PSA, a total of 65 patients (Renaissance: 22 vs. X: 43) were included. Patient/operative factors were similar between robot systems ( P > .05). The pedicle screw accuracy was similar between robots (Renaissance: 1.1%% vs. X: 1.3%, P = .786); however, the S2AI screw breach rate was significantly lower for the X (Renaissance: 9.5% vs. X: 1.2%, P = .025). Robot time per screw was not statistically different (Renaissance: 4.6 minutes vs. X: 3.9 minutes, P = .246). The X was more reliable with an abandonment rate of 2.3% vs. Renaissance:22.7%, P = .007. Radiation exposure were not different between robot systems. Non-robot related complications including dural tear, loss of motor/sensory function, and blood transfusion were similar between robot systems. Conclusion: This is the first comparative analyses of screw accuracy, robot time/screw, robot abandonment, and radiation exposure between the Mazor X and Renaissance systems. There are substantial improvements in the X robot, particularly in the perioperative planning processes, which likely contribute to the X’s superiority in S2AI screw accuracy by nearly 8-fold and robot reliability by nearly 10-fold.

scholarly journals Radiation Exposure during Fluoroscopic Assistance for Pedicle Screw Insertion during Instrumented Spine Surgery

2015 ◽  
Vol 5 (1_suppl) ◽  
pp. s-0035-1554581-s-0035-1554581
Author(s):  
José Vicente Ballesteros Plaza ◽  
Ratko Jovan Yurac Barrientos ◽  
Enrique Andrés Viveros Pereira
Keyword(s):  
Radiation Exposure ◽  
Pedicle Screw ◽  
Spine Surgery ◽  
Screw Insertion ◽  
Pedicle Screw Insertion ◽  
Instrumented Spine Surgery

A semi-active milling procedure in view of preparing implantation beds in robot-assisted orthopaedic surgery

2005 ◽  
Vol 219 (3) ◽  
pp. 163-174 ◽  
Author(s):  
G Van Ham ◽  
K Denis ◽  
J Vander Sloten ◽  
R Van Audekercke ◽  
G Van der Perre ◽  
...  
Keyword(s):  
Robot Motion ◽  
Robot Assisted ◽  
Cavity Preparation ◽  
Feed Force ◽  
Robot Systems ◽  
Surface Irregularities ◽  
Robot Assistance ◽  
Set Up ◽  
Tool Motion

Bone cutting in total joint reconstructions requires a high accuracy to obtain a well-functioning and long-lasting prosthesis. Hence robot assistance can be useful to increase the precision of the surgical actions. A drawback of current robot systems is that they autonomously machine the bone, in that way ignoring the surgeon's experience and introducing a safety risk. This paper presents a semi-active milling procedure to overcome that drawback. In this procedure the surgeon controls robot motion by exerting forces on a force-controlled lever that is attached to the robot end effector. Meanwhile the robot constrains tool motion to the planned motion and generates a tool feed determined by the feed force that the surgeon executes. As a case study the presented milling procedure has been implemented on a laboratory set-up for robot-assisted preparation of the acetabulum in total hip arthroplasty. Two machining methods have been considered. In the first method the surgeon determines both milling trajectory and feed by the forces that he/she executes on the force-controlled lever. In the second method the cavity is machined contour by contour, and the surgeon only provides the feed. Machining experiments have shown that the first method results in large surface irregularities and is not useful. The second method, however, results in accurate cavity preparation and has therefore potential to be implemented in future robot systems.

Switching to a Pediatric Dose O-Arm Protocol in Spine Surgery Significantly Reduced Patient Radiation Exposure

2016 ◽  
Vol 36 (6) ◽  
pp. 621-626 ◽  
Author(s):  
Alvin W. Su ◽  
T. David Luo ◽  
Amy L. McIntosh ◽  
Beth A. Schueler ◽  
Jennifer A. Winkler ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Spine Surgery ◽  
Pediatric Dose ◽  
Patient Radiation Exposure

Ninety-day complication, revision, and readmission rates for current-generation robot-assisted thoracolumbar spinal fusion surgery: results of a multicenter case series

2021 ◽  
pp. 1-8
Author(s):  
Jason I. Liounakos ◽  
Asham Khan ◽  
Karen Eliahu ◽  
Jennifer Z. Mao ◽  
Christopher R. Good ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Revision Surgery ◽  
Readmission Rate ◽  
Revision Rate ◽  
Case Series ◽  
Pedicle Screws ◽  
Robot Assisted ◽  
Readmission Rates ◽  
Current Generation ◽  
Guidance Systems

OBJECTIVE Robotics is a major area for research and development in spine surgery. The high accuracy of robot-assisted placement of thoracolumbar pedicle screws is documented in the literature. The authors present the largest case series to date evaluating 90-day complication, revision, and readmission rates for robot-assisted spine surgery using the current generation of robotic guidance systems. METHODS An analysis of a retrospective, multicenter database of open and minimally invasive thoracolumbar instrumented fusion surgeries using the Mazor X or Mazor X Stealth Edition robotic guidance systems was performed. Patients 18 years of age or older and undergoing primary or revision surgery for degenerative spinal conditions were included. Descriptive statistics were used to calculate rates of malpositioned screws requiring revision, as well as overall complication, revision, and readmission rates within 90 days. RESULTS In total, 799 surgical cases (Mazor X: 48.81%; Mazor X Stealth Edition: 51.19%) were evaluated, involving robot-assisted placement of 4838 pedicle screws. The overall intraoperative complication rate was 3.13%. No intraoperative implant-related complications were encountered. Postoperatively, 129 patients suffered a total of 146 complications by 90 days, representing an incidence of 16.1%. The rate of an unrecognized malpositioned screw resulting in a new postoperative radiculopathy requiring revision surgery was 0.63% (5 cases). Medical and pain-related complications unrelated to hardware placement accounted for the bulk of postoperative complications within 90 days. The overall surgical revision rate at 90 days was 6.63% with 7 implant-related revisions, representing an implant-related revision rate of 0.88%. The 90-day readmission rate was 7.13% with 2 implant-related readmissions, representing an implant-related readmission rate of 0.25% of cases. CONCLUSIONS The results of this multicenter case series and literature review suggest current-generation robotic guidance systems are associated with low rates of intraoperative and postoperative implant-related complications, revisions, and readmissions at 90 days. Future outcomes-based studies are necessary to evaluate complication, revision, and readmission rates compared to conventional surgery.

Impact of robot-assisted spine surgery on health care quality and neurosurgical economics: A systemic review

2018 ◽  
Vol 43 (1) ◽  
pp. 17-25 ◽  
Author(s):  
Brian Fiani ◽  
Syed A. Quadri ◽  
Mudassir Farooqui ◽  
Alessandra Cathel ◽  
Blake Berman ◽  
...  
Keyword(s):  
Health Care ◽  
Spine Surgery ◽  
Health Care Quality ◽  
Care Quality ◽  
Systemic Review ◽  
Robot Assisted
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