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Practice Guideline
. 2019 Apr;11(2):153-159.
doi: 10.1111/os.12453.

Guideline for Thoracolumbar Pedicle Screw Placement Assisted by Orthopaedic Surgical Robot

Wei Tian  1   2 , Ya-Jun Liu  1 , Bo Liu  1 , Da He  1 , Jing-Ye Wu  1 , Xiao-Guang Han  1 , Jing-Wei Zhao  1 , Ming-Xing Fan  1 ; Technical Committee on Medical Robot Engineering of Chinese Society of Biomedical Engineering; Technical Consulting Committee of National Robotic Orthopaedic Surgery Application Center
Affiliations
Practice Guideline

Guideline for Thoracolumbar Pedicle Screw Placement Assisted by Orthopaedic Surgical Robot

Wei Tian et al. Orthop Surg. 2019 Apr.

Abstract

The pedicle screw placement procedure is the most commonly used technique for spinal fixation and can provide reliable three-column stabilization. Accurate screw placement is necessary in clinical practice. To avoid screw malposition, which may decrease the stiffness of the screw-rod construct or increase the likelihood of neural and vascular injuries, the surgeons must fully understand the regional anatomy. Deformities, such as scoliosis, kyphosis or congenital anomalies, may complicate the application of the pedicle screw placement technique and increase the chance of screw encroachments. Incidences of pedicle screw malposition vary in different districts and hospitals and with surgeons and techniques. Today, the minimally invasive spinal surgery is well developed. However, the narrow corridors and limited views for surgeons increase the difficulty of pedicle screw placement and the possibility of screw encroachment. Evidenced by previous studies, robotic surgery can provide accurate screw placement, especially in settings of spinal deformities, anatomical anomalies, and minimally invasive procedures. Based on the consensus of consultant specialists, the literature review and our local experiences, this guideline introduces the robotic system and describes the workflow of robot-assisted procedures and the precautions to take during procedures. This guideline aims to outline a standardized method for robotic surgery for thoracolumbar pedicle screw placement.

Keywords: Accuracy; Pedicle screw; Robot-assisted surgery; Thoracolumbar spine.

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Figures

Figure 1
Figure 1
The working principles of TianJi Robot system.
Figure 2
Figure 2
TianJi Robot system.
Figure 3
Figure 3
TianJi Robot navigation and positioning tool installation, including fixed ring, tracker, tool guider, lock screw, and holder base.
Figure 4
Figure 4
Schematic diagram of operation room. When performing robotic surgery, it is recommended that the operation room be arranged as shown.
Figure 5
Figure 5
Workflow of robot‐assisted procedures.
See this image and copyright information in PMC

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