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. 2021 Oct;17(3):289-293.
doi: 10.1177/15563316211027166. Epub 2021 Jul 23.

The Use of Robotics Coupled With Navigation for Pediatric Congenital Spine Deformity

Andrew N Sawires  1 , Craig M Birch  2 , Daniel Hedequist  2
Affiliations

The Use of Robotics Coupled With Navigation for Pediatric Congenital Spine Deformity

Andrew N Sawires et al. HSS J. 2021 Oct.

Abstract

Background: Spinal instrumentation in children with congenital spine deformity poses challenges to the surgeon, given the small patient size and the anomalous anatomy often encountered. Purpose: We aimed to investigate the accuracy of screw placement when robotics coupled with real-time navigation was used for surgical treatment of pediatric congenital spine deformity at 1 institution. Methods: We conducted a retrospective search of our institution's database for all patients younger than 18 years of age with congenital spine deformity who were treated with the robotics surgical platform coupled with navigation between June 2019 and December 2020. We recorded data on demographics, location and type of anomaly, procedure performed, and intraoperative variables related to robotics and navigation. We reviewed the images of patients who had intraoperative 3-dimensional imaging or postoperative computed tomographic scans to determine the accuracy of screw placement using the Gertzbein-Robbins scale. Results: In 14 patients identified, a total of 95 screws were attempted, with 94 successfully placed using robotics coupled with navigation. There were no noted screw-related complications (neurologic or visceral) and no return to the operating room for screw malposition. Conclusion: Patients with congenital spine deformity present potentially unique challenges due to variant anatomy. This retrospective series suggests that robotics coupled with navigation for congenital spine deformity correction in the pediatric population may aid in accurate screw placement and reduce complication rates. More rigorous study is warranted.

Keywords: congenital; pediatric; robotic-assisted navigation; scoliosis; spine deformity.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Fig. 1.
Fig. 1.
Sagittal MRI of 33-month-old patient with congenital dislocation of spine, lumbar compression, and spinal cord syrinx. MRI magnetic resonance imaging.
Fig. 2.
Fig. 2.
Sagittal CT scan of patient detailing bony anatomy. CT computed tomography.
Fig. 3.
Fig. 3.
Intraoperative fluoroscopic view showing anatomical trajectory of robotically placed screws.
Fig. 4.
Fig. 4.
Intraoperative photo showing complete VCR with circumferential decompression of dural sac. VCR vertebral column resection.
Fig. 5.
Fig. 5.
Coronal CT documenting containment of pedicle screws. CT computed tomography.
Fig. 6.
Fig. 6.
Sagittal CT documenting decompression and restoration of alignment with intervertebral cage placement for anterior column support and arthrodesis. CT computed tomography.
See this image and copyright information in PMC

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