gms | German Medical Science

72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

Accurate pedicle screw placement using navigated robotic guidance – potential advantages and implications in the future of spine surgery

Pedikelschraubenplatzierung mit dem OP Roboter – potentielle Vorteile und Auswirkungen auf die Zukunft der Wirbelsäulenchirurgie

Meeting Abstract

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  • presenting/speaker Peter Douglas Klassen - Bonifatius Hospital Lingen, Neurosurgery, Lingen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocV097

doi: 10.3205/21dgnc095, urn:nbn:de:0183-21dgnc0953

Veröffentlicht: 4. Juni 2021

© 2021 Klassen.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe



Objective: Since the introduction of modern spine robots spine surgeons are persuaded that a paradigmatic shift in spine surgery regarding reliability, safety innovation, simulation, training and radiation exposure is happening. The aim of this study is to see wether these systems can perform efficently.

Methods: Retrospective study from a prospectively collected database in a German spine center of patients who underwent navigated robot-guided spine surgery. From October 2018 to November 2019, 250 Patients underwent pedicle screw instrumentation with navigated robotic guidance. 90 Patients received traditional open lumbar fusion with pedicle screw system (594 screws) with intraoperative imgae adquisition. 140 patients underwent MIS TLIF and thoracic instrumentation procedures with percutaneous pedicle screw system (609 screws). 20 Patients underwent dorsal cervical instrumentation with lateral mass and pedicle screws (94 screws). Intraoperative CT scans were taken if robotic system did not validate complete set of screw placement based on the planned trajectory. Using intraoperative CT scans deviations from the planned screws were measured from the middle of the actual pedicle screw placement to the middle of the pedicle. The measurement of the screws was adjudicated as: perfect (<1.5mm deviation), good (1.5-3mm deviation) and fair (3-5 mm deviation) in relation to the planned trajectory.

Results: 90% of all screws received the intraoperative checkmark from the navigation software. All those screws adjudicated as correct by the verification algorithm where in the range of < 1.5 mm. From the total of 129 screws not adjudicated as correct by the software algorithms, 65 were still in the range < 1.5 mm, whereas 50 were in the range 1,5 - 3 mm and only 14 screws ranged 3 - 5 mm. 6 screws required intraoperative revision, none of them in the cervical spine.

Conclusion: Robotic guided screw placement seems to be safe, efficient and reliable. Training and preoperative simulation seem to be translate into clinical workflow and outcome. Further Investigation is required to compare prospectively different workflows and competing systems.