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An HSS research examined the effectiveness of robot-assisted and augmented actuality surgical procedures. | Supply: Adobe Inventory
A research on the Hospital for Particular Surgical procedure, or HSS, evaluating robot-assisted navigation to using augmented actuality in spinal surgical procedure discovered that each methods display wonderful accuracy and security for pedicle screw placement.
Greater than 1.2 million spinal surgical procedures are carried out within the U.S. every year, in line with the Nationwide Heart for Well being Statistics. Many of those procedures contain implants referred to as pedicle screws to stabilize the backbone, and exact positioning is important for a profitable surgical procedure.
“In comparison with standard free-hand methods, each robotic-assisted navigation [RAN] and using augmented actuality [AR] have demonstrated superior accuracy,” mentioned Darren R. Lebl, M.D., MBA. “Our research is the primary to instantly examine RAN to AR with respect to screw placement precision.”
Lebl is a backbone surgeon and director of analysis at HSS, plus principal investigator of the research. The analysis was printed on-line within the journal Backbone.
HSS is a number one educational medical middle targeted on musculoskeletal well being. Based in 1863, the New York-based healthcare supplier claimed it has the bottom readmission charges within the nation for orthopedics, in addition to a number of the lowest an infection and complication charges.
Along with affected person care, HSS mentioned it helps analysis, innovation, and training. The HSS Analysis Institute contains 20 laboratories and 300 workers members targeted on advancing musculoskeletal well being by means of the prevention of degeneration, tissue restore, and tissue regeneration.
Darren R. Lebl is a backbone surgeon and director of analysis at HSS. | Supply: Hospital for Particular Surgical procedure
Robotic-assisted surgical procedure and AR provide support
Over the previous decade, quite a few robot-assisted navigation and augmented actuality techniques have emerged for backbone surgical procedure.
“Along with enhanced accuracy, the potential benefits of each applied sciences embody decreased radiation publicity and supply for improved security in backbone surgical procedure,” famous Dr. Lebl. “A rising variety of main medical facilities nationwide are utilizing at the very least one in all these applied sciences.”
RAN entails robotic steerage of surgeon-operated devices. A robotic arm, together with 3D pictures of the affected person’s anatomy and navigation know-how just like GPS, permits the surgeon to carry out a minimally invasive process that’s deliberate forward of time on superior software program.
AR-assisted backbone surgical procedure superimposes 3D pictures of a affected person’s anatomy onto the surgeon’s visible area throughout surgical procedure by way of a headset. A preoperative CT scan of the affected person’s backbone is used to plan and carry out the surgical procedure.
Examine analyzes spinal surgical procedures
The HSS research included 212 grownup backbone surgical procedure sufferers who had a complete of 1,211 pedicle screws positioned between June 2020 and October 2023. It adopted 108 individuals who acquired 827 screws utilizing robots and 104 sufferers who acquired 384 screws with augmented actuality.
They underwent surgical procedure within the lumbar and/or sacral backbone for degenerative spinal circumstances. One skilled surgeon carried out all the robotic circumstances, whereas two different skilled backbone surgeons used the AR system.
The place of every pedicle screw was assessed after surgical procedure primarily based on both CT scan or 3D fluoroscopy utilizing the Gertzbein-Robbins classification system, which assigns a grade of A, B, C or D to judge accuracy. The HSS researchers thought-about Grades A and B to be acceptable.
The A score is assigned to screw placement fully throughout the pedicle, a bony construction on the vertebra that protects the spinal twine. Grade B, nonetheless acceptable, is assigned to a screw that’s 2mm (1/16 inch) outdoors of the specified location. Within the research, any screw with a Grade C or D could be deemed unacceptable.
After surgical procedure, two impartial backbone surgeons assigned a grade to all of the pedicle screws. The research discovered no important distinction between robot-assisted and AR screw placement when it comes to accuracy, with 99.6% of RAN screws rated as Grade A or B, and 98.7% of AR screws labeled as A or B. Total, 92.6% of the screws achieved the highest Grade A score.
“Our outcomes confirmed wonderful accuracy for each methods, making each robotics and AR secure instruments for correct positioning of lumbosacral pedicle screws,” Dr. Lebl mentioned. “Nonetheless, the next charge of Grade A screws was seen within the RAN group, doubtlessly highlighting superior precision for robotics.”
