639 - Pedicle Screw Insertion in Spine: A Randomized Controlled Study betwee...

Oral Posters: MIS

Presented by: W. Tian - View Audio/Video Presentation (Members Only)

Author(s):

W. Tian(1), M. Fan(1), Y. Liu(1)

(1) Beijing Jishuitan Hospital, Beijing, China

Abstract

Objective: To introduce a new robot-assisted surgical system for spinal screw fixation. To investigate the different of accuracy and safety between robot-assisted surgery and conventional freehand pedicle screw insertion procedures.

Methods: In this randomized controlled study, 40 patients were involved from Feb 2016 to June 2016. 17patients were treated by free-hand fluoroscopy-guided surgery, and 23 patients were treated by robot-assisted method. After surgery, the operation time of the two groups were compared, further, the computer tomographic scans were used to assess the accuracy and safety of the inserted pedicle screws between the two groups using the Gertzbein-Robbins methods. SPSS 20.0 software was used for data analysis.

Results: A total of 190 pedicle screws were implanted in 40 patients. There were no differences between the two groups in baseline information and overall operation time. None of screws needed re-surgery for revised placement. In the robot-assisted method group, the assessment of pedicle screw accuracy showed that 102 of 102 screws (100%) were safely placed (< 2 mm, category A+B), mean deviation in entry point was 1.70±0.83mm, mean deviation in end point was 1.84±1.04mm, Mean difference in screw insertion was 1.77±0.78mm; In the conventional freehand group, assessment of pedicle screw accuracy showed that 87 of 88 (98.9%) were safely placed (< 2 mm, category A+B), 1 screw in category C , mean deviation in entry point of all screws in this group was 3.73±2.28mm, mean deviation in end point was 4.11±2.31mm , Mean difference in screw insertion was 3.92±1.80mm.

Conclusions: This study verified that robot-assisted pedicle screw placement is a more accuracy and safer method, and also revealed great clinical potential of robot-assisted surgery in spine.