Ghani Haider, Vaibhavi Shah, Ivan Lopez, Katherine E Wagner, Martin N. Stienen, Anand Veeravagu
{"title":"使用新一代共享控制机器人系统进行脊柱器械手术的经验。","authors":"Ghani Haider, Vaibhavi Shah, Ivan Lopez, Katherine E Wagner, Martin N. Stienen, Anand Veeravagu","doi":"10.23736/S0390-5616.24.06206-4","DOIUrl":null,"url":null,"abstract":"BACKGROUND\nRobotic assistance in spine surgery is emerging as an accurate, effective and enabling technology utilized in the treatment of patients with surgical spinal pathology. The safety and reproducibility of robotic assistance in the placement of pedicle screw instrumentation is still being investigated. The objective of this study was to present our experience of instrumented spinal fusion utilizing an intraoperative robotic guidance system.\n\n\nMETHODS\nWe retrospectively reviewed all cases of spinal instrumentation of the thoracic and lumbo-sacral spine using the Mazor X robotic system (Medtronic Inc, Minneapolis, MN, USA), performed at our institution by one surgeon between July 2017 and June 2020. Wilcoxon Rank test was used to compare time taken to place each screw during the first 20 cases and the cases thereafter.\n\n\nRESULTS\nA total of 28 patients were included. A total of 159 screws were placed using the Mazor X robotic system. The overall mean time for screw placement was 7.8±2.3 minutes and there was a significant reduction in the mean time for screw placement after the 20th case or 120 screws (8.70 vs. 5.42 min, P=0.008). No postoperative neurologic deficit or new radiculopathy was noted to occur secondary to hardware placement. No revision surgery was required for replacement or removal of a mispositioned screw.\n\n\nCONCLUSIONS\nFrom this single-center, single-surgeon series we conclude that robot-assisted spine surgery can be safely and efficiently integrated into the operating room workflow, which improves after a learning curve of approximately 20 operative interventions. We found robot-assisted spinal instrumentation to be reliable, safe, effective and highly precise.","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Experience with the utilization of new-generation shared-control robotic system for spinal instrumentation.\",\"authors\":\"Ghani Haider, Vaibhavi Shah, Ivan Lopez, Katherine E Wagner, Martin N. Stienen, Anand Veeravagu\",\"doi\":\"10.23736/S0390-5616.24.06206-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"BACKGROUND\\nRobotic assistance in spine surgery is emerging as an accurate, effective and enabling technology utilized in the treatment of patients with surgical spinal pathology. The safety and reproducibility of robotic assistance in the placement of pedicle screw instrumentation is still being investigated. The objective of this study was to present our experience of instrumented spinal fusion utilizing an intraoperative robotic guidance system.\\n\\n\\nMETHODS\\nWe retrospectively reviewed all cases of spinal instrumentation of the thoracic and lumbo-sacral spine using the Mazor X robotic system (Medtronic Inc, Minneapolis, MN, USA), performed at our institution by one surgeon between July 2017 and June 2020. Wilcoxon Rank test was used to compare time taken to place each screw during the first 20 cases and the cases thereafter.\\n\\n\\nRESULTS\\nA total of 28 patients were included. A total of 159 screws were placed using the Mazor X robotic system. The overall mean time for screw placement was 7.8±2.3 minutes and there was a significant reduction in the mean time for screw placement after the 20th case or 120 screws (8.70 vs. 5.42 min, P=0.008). No postoperative neurologic deficit or new radiculopathy was noted to occur secondary to hardware placement. No revision surgery was required for replacement or removal of a mispositioned screw.\\n\\n\\nCONCLUSIONS\\nFrom this single-center, single-surgeon series we conclude that robot-assisted spine surgery can be safely and efficiently integrated into the operating room workflow, which improves after a learning curve of approximately 20 operative interventions. We found robot-assisted spinal instrumentation to be reliable, safe, effective and highly precise.\",\"PeriodicalId\":16504,\"journal\":{\"name\":\"Journal of neurosurgical sciences\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2024-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of neurosurgical sciences\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.23736/S0390-5616.24.06206-4\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of neurosurgical sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.23736/S0390-5616.24.06206-4","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景脊柱手术中的机器人辅助技术正逐渐成为治疗脊柱病变患者的一种准确、有效的辅助技术。机器人辅助放置椎弓根螺钉器械的安全性和可重复性仍在研究之中。本研究的目的是介绍我们利用术中机器人引导系统进行器械脊柱融合术的经验。方法我们回顾性地回顾了2017年7月至2020年6月期间本院一名外科医生使用Mazor X机器人系统(美敦力公司,美国明尼苏达州明尼阿波利斯市)进行胸椎和骶骨脊柱器械置入术的所有病例。采用Wilcoxon秩检验比较前20个病例和之后病例放置每颗螺钉所需的时间。共使用 Mazor X 机器人系统置入 159 颗螺钉。放置螺钉的总平均时间为(7.8±2.3)分钟,在第20例或120枚螺钉后,放置螺钉的平均时间显著缩短(8.70对5.42分钟,P=0.008)。没有发现术后神经功能缺损或新的神经根病继发于硬件置入。结论通过这个单中心、单外科医生的系列研究,我们得出结论:机器人辅助脊柱手术可以安全、高效地融入手术室工作流程,在经过约20次手术干预的学习曲线后,手术效果会有所改善。我们发现机器人辅助脊柱器械是可靠、安全、有效和高度精确的。
Experience with the utilization of new-generation shared-control robotic system for spinal instrumentation.
BACKGROUND
Robotic assistance in spine surgery is emerging as an accurate, effective and enabling technology utilized in the treatment of patients with surgical spinal pathology. The safety and reproducibility of robotic assistance in the placement of pedicle screw instrumentation is still being investigated. The objective of this study was to present our experience of instrumented spinal fusion utilizing an intraoperative robotic guidance system.
METHODS
We retrospectively reviewed all cases of spinal instrumentation of the thoracic and lumbo-sacral spine using the Mazor X robotic system (Medtronic Inc, Minneapolis, MN, USA), performed at our institution by one surgeon between July 2017 and June 2020. Wilcoxon Rank test was used to compare time taken to place each screw during the first 20 cases and the cases thereafter.
RESULTS
A total of 28 patients were included. A total of 159 screws were placed using the Mazor X robotic system. The overall mean time for screw placement was 7.8±2.3 minutes and there was a significant reduction in the mean time for screw placement after the 20th case or 120 screws (8.70 vs. 5.42 min, P=0.008). No postoperative neurologic deficit or new radiculopathy was noted to occur secondary to hardware placement. No revision surgery was required for replacement or removal of a mispositioned screw.
CONCLUSIONS
From this single-center, single-surgeon series we conclude that robot-assisted spine surgery can be safely and efficiently integrated into the operating room workflow, which improves after a learning curve of approximately 20 operative interventions. We found robot-assisted spinal instrumentation to be reliable, safe, effective and highly precise.
期刊介绍:
The Journal of Neurosurgical Sciences publishes scientific papers on neurosurgery and related subjects (electroencephalography, neurophysiology, neurochemistry, neuropathology, stereotaxy, neuroanatomy, neuroradiology, etc.). Manuscripts may be submitted in the form of ditorials, original articles, review articles, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work.