Isador H Lieberman, Stanley Kisinde, Shea Hesselbacher
Preoperative planning software and a robotic device facilitate the placement of pedicle screws, especially in patients with difficult anatomy, thereby increasing the feasibility, accuracy, and efficiency of the procedure. The robot functions as a semiactive surgical assistive device whose goal is not to substitute but to offer the surgeon a set of versatile tools that can broaden his or her ability to treat patients1 . Description: The robotic guidance system consists of a bed-mounted surgical arm and a workstation...
April 2020: JBJS Essential Surgical Techniques
Xingwen Wang, Longbing Ma, Zhenlei Liu, Zan Chen, Hao Wu, Fengzeng Jian
Background: Although the single-stage posterior realignment craniovertebral junction (CVJ) surgery could treat most of the basilar invagination (BI) and atlantoaxial dislocation (AAD), there are still some cases with incomplete decompression of the spinal cord, which remains a technique challenging situation. Methods: Eleven patients were included with remained myelopathic symptoms after posterior correction due to incomplete decompression of the spinal cord. Transoral odontoidectomy assisted by image-guided navigation and intraoperative CT was performed...
2020: Chinese Neurosurgical Journal
Elizabeth Riedman, Haley Scott, Philippa Clarke, Michelle Meade, Martin Forchheimer, Denise Tate
PURPOSE: People aging with spinal cord injury (SCI) can experience the premature onset of comorbid conditions, as well as the development and progression of secondary health conditions. The aim of this study was to understand the subjective experiences of persons aging with SCI in relation to their surrounding social and physical environments, including the impact of barriers and facilitators. Material/Methods: Eleven individuals who had an SCI for more than ten years and were 45 years or older participated in a semi-structured phone interview about their experiences with healthy aging, social participation, social supports, and community barriers...
September 13, 2020: Disability and Rehabilitation
Jinpeng Du, Lin Gao, Dageng Huang, Lequn Shan, Wentao Wang, Yong Fan, Dingjun Hao, Liang Yan
BACKGROUND Pedicle screw fixation is one of the most commonly used methods in spine surgery. We introduce a surgical robot system from China based on 3-dimensional fluoroscopy imaging and compare it with the commonly used O-arm navigation system. We study the differences in accuracy, safety, and clinical effect in auxiliary pedicle screw fixation. MATERIAL AND METHODS Patients who underwent thoracolumbar internal fixation in our hospital from 2017 to 2019 were divided into a robot and navigation group according to whether surgery was assisted by the Tinavi orthopedic robot or O-arm navigation system...
September 12, 2020: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Jennifer Z Mao, Justice O Agyei, Asham Khan, Ryan M Hess, Patrick K Jowdy, Jeffrey P Mullin, John Pollina
Spine surgery is continuously evolving. The synergy between medical imaging and advances in computation has allowed for stereotactic neuronavigation and its integration with robotic technology to assist in spine surgery. The discovery of X-rays in 1895, the development of image intensifiers in 1940, and then advancements in computational science and integration have allowed for the development of computed tomography (CT). In combination with the advancements of stereotaxy in the late 1980s and manipulation of volumetric and special data for three-dimensional reconstruction in 1998, CT has revolutionized neuronavigational systems...
September 8, 2020: World Neurosurgery
Chih-Chang Chang, Chao-Hung Kuo, Hsuan-Kan Chang, Tsung-Hsi Tu, Li-Yu Fay, Jau-Ching Wu, Henrich Cheng, Wen-Cheng Huang
BACKGROUND: The conventional pedicle-screw-based dynamic stabilization process involves dissection of the Wiltse plane to cannulate the pedicles, which cannot be undertaken with minimal surgical invasion. Despite some reports having demonstrated satisfactory outcomes of dynamic stabilization in the management of low-grade spondylolisthesis, the extensive soft tissue dissection involved during pedicle screw insertion substantially compromises the designed rationale of motion (muscular) preservation...
September 10, 2020: BMC Musculoskeletal Disorders
Houssem-Eddine Gueziri, Charles X B Yan, D Louis Collins
Spinal instrumentation and surgical manipulations may cause loss of navigation accuracy requiring an efficient re-alignment of the patient anatomy with pre-operative images during surgery. While intra-operative ultrasound (iUS) guidance has shown clear potential to reduce surgery time, compared with clinical computed tomography (CT) guidance, rapid registration aiming to correct for patient misalignment has not been addressed. In this article, we present an open-source platform for pedicle screw navigation using iUS imaging...
September 6, 2020: Ultrasound in Medicine & Biology
Kris B Siemionow, Karina M Katchko, Paul Lewicki, Cristian J Luciano
Purpose: Augmented reality-based image overlay of virtual bony spine anatomy can be projected onto real spinal anatomy using computer tomography-generated DICOM images acquired intraoperatively. The aim of the study was to develop a technique and assess the accuracy and feasibility of lumbar vertebrae pedicle instrumentation using augmented reality-assisted surgical navigation. Subjects and Methods: An augmented reality and artificial intelligence (ARAI)-assisted surgical navigation system was developed...
April 2020: Journal of Craniovertebral Junction and Spine
Bhavuk Garg, Nishank Mehta, Rajesh Malhotra
The endeavour to make spine surgery safe with reproducible, consistent outcomes has led to growing interest and research in the field of intraoperative imaging, navigation and robotics. The advent of surgical robot systems in spine surgery is relatively recent - with only a few systems approved for commercial use. At present, pedicle screw insertion remains the primary application of robotic systems in spine surgery. The purported advantages of robot-assisted pedicle screw insertion over other conventional techniques are its increased accuracy, reproducible consistency and reduced radiation exposure...
September 2020: Journal of Clinical Orthopaedics and Trauma
Mehdi Boudissa, Marc Prod'homme, Gaël Kerschbaumer, Sébastien Ruatti, Jérôme Tonetti
The Surgivisio system is a new generation of intraoperative 3D imaging, used in our institution for pedicle insertion in minimally invasive spine surgery since January 2018. The purpose of this technical note is to describe the Surgivisio system, its advantages and its limitations, in percutaneous spinal surgery. Results of the first year of use were analyzed, in a series of 29 patients, to evaluate accuracy of pedicle screw insertion, operative time and radiation exposure. On the Heary and Gertzbein classifications, 95...
September 3, 2020: Orthopaedics & Traumatology, Surgery & Research: OTSR
Tao Liu, Yonghang Tai, Chengming Zhao, Lei Wei, Jun Zhang, Junjun Pan, Junsheng Shi
BACKGROUND: Neurosurgery has exceptionally high requirements for minimally invasive and safety. This survey attempts to analyze the practical application of AR in neurosurgical navigation. Also, this survey describes future trends in augmented reality neurosurgical navigation systems. METHODS: In this survey, we searched related keywords "augmented reality", "virtual reality", "neurosurgery", "surgical simulation", "brain tumor surgery", "neurovascular surgery", "temporal bone surgery", and "spinal surgery" through Google Scholar, World Neurosurgery, PubMed and Science Direct...
September 5, 2020: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
Andrew M Gardeck, Xuan Pu, Qiuyu Yang, David W Polly, Kristen E Jones
OBJECTIVE: Residency work-hour restrictions necessitate efficient, reproducible training. Simulation training for spinal instrumentation placement shows significant benefit to learners' subjective and objective proficiency. Cadaveric laboratories are most effective but have high cost and low availability. The authors' goal was to create a low-cost, efficient, reproducible spinal instrumentation placement simulation curriculum for neurosurgery and orthopedic surgery residents using synthetic models and 3D computer-assisted navigation, assessing subjective and objective proficiency with placement of thoracolumbar pedicle screws...
September 4, 2020: Journal of Neurosurgery. Spine
Gururaj Sangondimath, Abhinandan Reddy Mallepally, Nandan Marathe, Kin-Cheung Mak, Suman Salimath
Advances in patient selection, surgical techniques, and postoperative care have facilitated spine surgeons to manage complex spine cases with shorter operative times, reduced hospital stay and improved outcomes. We focus this article on a few areas which have shown maximum developments in management of degenerative cervical myelopathy and also throw a glimpse into the future ahead. Imaging modalities, surgical decision making, robotics and neuro-navigation, minimally invasive spinal surgery, motion preservation, use of biologics are few of them...
September 2020: Journal of Clinical Orthopaedics and Trauma
Gerrard Gan, Arun-Kumar Kaliya-Perumal, Chun Sing Yu, Colum Patrick Nolan, Jacob Yoong-Leong Oh
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: We intend to evaluate the accuracy and safety of cervical pedicle screw (CPS) insertion under O-arm-based 3-dimensional (3D) navigation guidance. METHODS: This is a retrospective study of patients who underwent CPS insertion under intraoperative O-arm-based 3D navigation during the years 2009 to 2018. The radiological accuracy of CPS placement was evaluated using their intraoperative scans...
January 27, 2020: Global Spine Journal
Michael J Strong, Timothy J Yee, Siri Sahib S Khalsa, Yamaan S Saadeh, Kevin N Swong, Osama N Kashlan, Nicholas J Szerlip, Paul Park, Mark E Oppenlander
OBJECTIVE: The lateral lumbar interbody fusion (LLIF) technique is used to treat many common spinal degenerative pathologies including kyphoscoliosis. The use of spinal navigation for LLIF has not been broadly adopted, especially in adult spinal deformity. The purpose of this study was to evaluate the feasibility as well as the intraoperative and navigation-related complications of computer-assisted 3D navigation (CaN) during multiple-level LLIF for spinal deformity. METHODS: Retrospective analysis of clinical and operative characteristics was performed for all patients > 18 years of age who underwent multiple-level CaN LLIF combined with posterior instrumentation for adult spinal deformity at the University of Michigan between 2014 and 2020...
September 2020: Neurosurgical Focus
Frédéric Clarençon, Eimad Shotar, Arnaud Pouvelle, Kevin Premat, Stéphanie Lenck, Mehdi Drir, Gonzague Guillaumet, Elisabeth Maillart, Nader-Antoine Sourour
Left unattended, spinal epidural arteriovenous fistulas (EAVFs) have a potentially severe clinical course. Embolization using ethylene vinyl alcohol (EVOH) copolymers through regular dual-lumen balloons has emerged as a potential option for the treatment of spinal arteriovenous (AV) fistulas;1-3 the main issue with this technique is the navigability of these balloons. The Scepter Mini is a low-profile, dual-lumen balloon, which may be helpful for EVOH embolization of spinal AV fistulas, as it may help to overcome the navigation drawbacks...
August 28, 2020: Journal of Neurointerventional Surgery
Jan-Helge Klingler, Ulrich Hubbe, Christoph Scholz, Florian Volz, Marc Hohenhaus, Ioannis Vasilikos, Waseem Masalha, Ralf Watzlawick, Yashar Naseri
OBJECTIVE: Intraoperative 3D imaging and navigation is increasingly used for minimally invasive spine surgery. A novel, noninvasive patient tracker that is adhered as a mask on the skin for 3D navigation necessitates a larger intraoperative 3D image set for appropriate referencing. This enlarged 3D image data set can be acquired by a state-of-the-art 3D C-arm device that is equipped with a large flat-panel detector. However, the presumably associated higher radiation exposure to the patient has essentially not yet been investigated and is therefore the objective of this study...
August 28, 2020: Journal of Neurosurgery. Spine
Sarah C Tepper, Alan T Blank, Steven Gitelis, Matthew W Colman
BACKGROUND AND OBJECTIVES: Internal hemipelvectomy is a complex procedure used to treat malignancy that involves the pelvis. Reconstruction of the pelvis after type I or type I/IV resection remains controversial due to high complication rates and debatable functional benefit. Modern reconstruction options may provide a rapid, intuitive, and reliable way to reconstitute the pelvic ring. METHODS: This is a retrospective case series of four patients who underwent a novel reconstruction method involving computer navigation and segmental spinal instrumentation applied to the pelvis after type I or type I/IV pelvic resection for malignancy between 2015 and 2020...
August 25, 2020: Journal of Surgical Oncology
Bin Xu, Zhiyong Yang, Shan Jiang, Zeyang Zhou, Bowen Jiang, Shiwu Yin
STUDY DESIGN: Prospective observational study OBJECTIVE.: This paper aims to develop a spatial augmented reality-based surgical navigation system to assist in the placement of pedicle screws in minimally invasive spine surgery and to verify the accuracy of this method. SUMMARY OF THE BACKGROUND DATA: Due to their high accuracy and good visualization ability, augmented reality surgical navigation systems have been used in minimally invasive surgeries. However, augmented reality does not allow information to be shared and restricts doctors...
August 20, 2020: Spine
Ranjit Ganguly, Amy Minnema, Varun Singh, Andrew Grossbach
Minimally invasive spine surgery techniques for pedicle screw instrumentation are being more frequently used. They offer shorter operative times, shorter hospital stays for patients, faster recovery, less blood loss, and less damage to surrounding tissues. However, they may rely heavily on fluoroscopic imaging, and confer radiation exposure to the surgeon and team members. Use of the AIRO Mobile Intraoperative CT by Brainlab during surgery is a way to eliminate radiation exposure to staff and may improve accuracy rates for pedicle screw instrumentation...
August 15, 2020: Clinical Neurology and Neurosurgery
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