1. Robotic Assistance for Minimally Invasive Cervical Pedicle Instrumentation: Report on Feasibility and Safety
- Author
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Mikael Meyer, Stéphane Fuentes, Henry Dufour, Faisal Albader, Benjamin Blondel, Kaissar Farah, Solène Prost, Hôpital de la Timone [CHU - APHM] (TIMONE), Institut des Sciences du Mouvement Etienne Jules Marey (ISM), and Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)
- Subjects
Adult ,Male ,Research Report ,[SDV.OT]Life Sciences [q-bio]/Other [q-bio.OT] ,medicine.medical_specialty ,Percutaneous ,Cirq robotic ,03 medical and health sciences ,0302 clinical medicine ,Robotic Surgical Procedures ,Pedicle Screws ,Cervical spine ,Humans ,Minimally Invasive Surgical Procedures ,Medicine ,Minimally invasive ,Pedicle screw fixation ,Pedicle screw ,Aged ,Retrospective Studies ,Fixation (histology) ,Surgical team ,business.industry ,Radiation dose ,Mean age ,Middle Aged ,030220 oncology & carcinogenesis ,Cervical Vertebrae ,Feasibility Studies ,Female ,Spinal Diseases ,Surgery ,Neurology (clinical) ,Radiology ,business ,030217 neurology & neurosurgery ,Airo navigation - Abstract
International audience; BackgroundAccurate screw placement remains challenging, especially in the cervical spine. We present our first experience of minimally invasive posterior cervical and upper thoracic pedicle screw fixation in the lower cervical spine.MethodsThis study reports a case series of patients, undergoing posterior percutaneous pedicle fixation using Cirq robotic assistance coupled to the Airo intraoperative computed tomography scan and Brainlab navigation system. Routine computed tomography was performed on postoperative day 2 to evaluate pedicle screw placement. The effective dose was calculated.ResultsBetween February 2020 and December 2020, 7 patients (4 men and 3 women) were treated. The mean age was 58.8 years (range, 29–75 years). Fixation was performed with a cannulated PASS OCT Reconstruction System (Medicrea). Overall, 28 screws were placed within cervical and upper thoracic pedicles. According to the Neo and Heary classification, 85.7% were rated as acceptable and 14.3% as poor. The radiation dose received by the patient was 9.1 mSv (range, 7.7–10.6 mSv). The radiation dose received by the surgical staff was 0 mSv. The postoperative course was excellent.ConclusionsPosterior miniopen fixation using Cirq robotic assistance coupled with an intraoperative computed tomography navigation system is a major innovation that can improve the accuracy of pedicle screw positioning, with acceptable patient radiation and reduced surgical team exposure.
- Published
- 2021