Feasibility of laser-guided percutaneous pedicle screw placement in the lumbar spine using a hybrid-OR

Int J Comput Assist Radiol Surg. 2017 May;12(5):873-879. doi: 10.1007/s11548-017-1529-1. Epub 2017 Feb 10.

Abstract

Purpose: Innovations in intraoperative imaging lead to major changes in orthopaedic surgery. In our setting, a 3D flat-panel c-arm (Artis zeego) is mounted on a robotic arm offering an integrated aiming tool (Syngo iGuide). Our aim was to investigate the feasibility of Syngo iGuide for pedicle screw placement in comparison with fluoroscopic screw implantation.

Methods: In 10 lumbar models, 100 screws were implanted. In 5 models, a standard fluoroscopic technique was used. Syngo iGuide was used in all other models. Afterwards, CT-scans were performed and screw accuracy was investigated.

Results: The procedure time for the new technique was significantly longer in comparison with the standard technique. The post-operative CT showed the same accuracy in both groups.

Conclusions: Syngo iGuide proofed feasible for percutaneous implantation of pedicle screws in anatomic models. Syngo iGuide can be a help for screw implantation in difficult anatomic regions without the need of an additional navigation system.

Keywords: Accuracy; Hybrid-OR; Minimally invasive; Pedicle screw; Syngo iGuide.

MeSH terms

  • Bone Screws*
  • Equipment Design
  • Feasibility Studies
  • Fluoroscopy / methods*
  • Humans
  • Lasers
  • Lumbar Vertebrae / surgery*
  • Orthopedic Procedures / methods*
  • Pedicle Screws
  • Surgery, Computer-Assisted / methods*
  • Tomography, X-Ray Computed