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66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

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Comparison of percutaneous transpedicular spinal fusion using either 3D-reconstructed navigation or robotic-assisted device

Meeting Abstract

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  • Sarah Sperker - Klinik für Neurochirurgie, Klinikum München Bogenhausen, Akademisches Lehrkrankenhaus Technische Universität München, München, Deutschland
  • David Schul - Klinik für Neurochirurgie, Klinikum München Bogenhausen, Akademisches Lehrkrankenhaus Technische Universität München, München, Deutschland
  • André Tomasino - Klinik für Neurochirurgie, Klinikum München Bogenhausen, Akademisches Lehrkrankenhaus Technische Universität München, München, Deutschland
  • Christianto B. Lumenta - Klinik für Neurochirurgie, Klinikum München Bogenhausen, Akademisches Lehrkrankenhaus Technische Universität München, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocDI.24.04

doi: 10.3205/15dgnc236, urn:nbn:de:0183-15dgnc2364

Published: June 2, 2015

© 2015 Sperker et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: There have been published different techniques to perform percutaneous transpedicular interbody fusion. Correct placement and low intraoperative complication rate are the most important goals of this procedure. Safe and correct placement of pedicle screws can be achieved in different techniques. In the attempt to evaluate two different percutaneous methods we compared percutaneous transpedicular spinal fusion using either 3D-reconstructed navigation or robotic-assisted device.

Method: This is a prospective not randomized study. 40 patients suffering of vertebral fractures or spondylodiscitis were operated between January 2012 and November 2014. Patients were divided into two groups according to the different techniques. 20 patients underwent transpedicular spinal fusion using 3D-reconstructed navigation (Siemens Röntgen 3D, BrainLab Navigation) in 20 cases there was used robotic-assisted device (Mazor Robotics Guidance System). Intraoperative blood loss, operating time, operated segments, number of screws, time per screw, screw placement and radiation exposure were recorded.

Results: 20 patients with a mean age of 53,9 years (21-74) were included in the group of 3D-reconstructed navigation. The group using robotic-assisted device included 20 patients with a mean age of 67,0 years (21-84). The robotic-assisted device group showed shorter operation time (230 min (180-300) vs. 260 min (180-330)) and lower blood loss (190 ml (100-500) vs. 250 ml (100-500)). There were in average 6 operated segments using 8,6 scews in the robotic-device group, in the 3D-navigation group there were 4,2 operated segments using 6,4 screws. Radiation exposure was little less in the 3D-navigation group (1870 cGycm2 (1400-2580) vs. 1900 cGycm2 (1400-2580)). Time per screw was lower in the robotic-device group (21 min 8-30) vs. 31,5 min (15-60)).

Using the Rongming Xu criteria to evaluate the screw positions showed a high accuracy and high percentage of satisfying screw placements (type I), 95,31% in the 3D-navigation group and 97,70% in the robotic-assisted device group.

Conclusions: Percutaneous transpedicular interbody fusion using robotic-assisted device showed lower intraoperative stress combined with good clinical results. Concerning older patients with multimorbidity this could be a safe and valuable additional techique.

Both techniques showed favorable outcome and no procedure related complications.