Abstract
BackgroundThis study evaluated the minimal invasiveness, safety, and accuracy of robot-assisted pedicle screw placement procedure using a modified tracer fixation device.MethodsPatients were randomly assigned to conventional fixation group (25 patients) and modified fixation group (27 patients).ResultsNo baseline statistical difference was observed between the groups (P > 0.05). The length of unnecessary incision, amount of bleeding, and fixation duration for tracer fixation respectively were 6.08 ± 1.02 mm, 1.46 ± 0.84 ml, and 1.56 ± 0.32 min in the modified fixation group and 40.28 ± 8.52 mm, 12.02 ± 2.24 ml, and 5.08 ± 1.06 min in the conventional group. The difference between both groups was significant (P < 0.05). However, no significant difference between the two groups was observed in terms of the accuracy of pedicle screw placement (P > 0.05).ConclusionsThe modified minimally invasive procedure for tracer fixation results in minimal trauma and is simple, reliable, and highly safe. Additionally, the procedure does not compromise the accuracy of pedicle screw placement. Thus, it has great clinical applicable value.Trial registrationChinese Clinical Trial Registry: Registration number, ChiCTR1800016680; Registration Date, 15/06/2018.
Highlights
This study evaluated the minimal invasiveness, safety, and accuracy of robot-assisted pedicle screw placement procedure using a modified tracer fixation device
A total of 52 patients met the criteria for this study
In the modified minimally invasive tracer fixation group, 121 screws were placed, 118 of which were evaluated as Grade A; and 3, as B according to the Gertzhein and Robbins classification
Summary
This study evaluated the minimal invasiveness, safety, and accuracy of robot-assisted pedicle screw placement procedure using a modified tracer fixation device. Robot-assisted spinal operation involves the preoperative or intraoperative acquisition of images and imageguided surgery after registration and calibration [9, 10]. A conventional tracer system includes a nonmetallic tracer and metallic spinous process clamp, which fixes the tracer on the Yongqi et al BMC Musculoskeletal Disorders (2020) 21:208 spinous process of a patient. This tracer system is composed of a relatively stable combination and intraoperatively prevents the movement of the coordinate system origin, thereby preventing pedicle screw misplacement. An additional 3–4 cm incision is necessary for fixing the metallic clamp to adjacent spinous process, so it may lead to greater trauma, increase the risk of infection and affect fluoroscopy
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