Robot assisted midline lumbar fusion with cortical bone trajectory screw

Objective: Midline lumbar fusion with cortical bone trajectory(CBT) screw is a novel technique operation, robot system is the new developed system which can help CBT insertion. In this retrospective study, we compare the CBT accuracy by the assistance of navigation system and robot system. Clinical result is also compared. Result: 55 patients were involved in this retrospective study, 29 patients are assisted by navigation system, 26 patients are by robot system. Mean follow-up is over 12 months. The mean VAS is significant improved at the final follow up for navigation group from 6.2±1.5 to 3.2±1.1(back pain), 7.5±0.9 to1.8±0.7(leg pain), same as the robot system from 6.8±1.5 to 2.9±0.8(back pain), 7.7±1.0 to 1.6±0.8 (leg pain). The JOA score pre-operation is 14.7±4.5 and 14.5±4.1 for navigation and robot system, at the final follow up, it is 24.3±4.2 and 23.9±4.4. the number of penetration cortex has no difference between 2 groups(n=0.363). Conclusion: MIDLF with CBT screw is effective for the treatment of lumbar degenerative disease. Using navigation and robot system will help the insertion of CBT screw safety and accurate, robot can release the surgeon from part of aiming work.

[1]  Alpesh A. Patel,et al.  Differences in bone mineral density of fixation points between lumbar cortical and traditional pedicle screws. , 2016, The spine journal : official journal of the North American Spine Society.

[2]  K. Nishizawa,et al.  Short-Term Clinical Result of Cortical Bone Trajectory Technique for the Treatment of Degenerative Lumbar Spondylolisthesis with More than 1-Year Follow-Up , 2016, Asian spine journal.

[3]  Hironobu Sakaura,et al.  Posterior lumbar interbody fusion with cortical bone trajectory screw fixation versus posterior lumbar interbody fusion using traditional pedicle screw fixation for degenerative lumbar spondylolisthesis: a comparative study. , 2016, Journal of neurosurgery. Spine.

[4]  Toshiki Yoshimine,et al.  Significance of the Pars Interarticularis in the Cortical Bone Trajectory Screw Technique: An In Vivo Insertional Torque Study , 2016, Asian spine journal.

[5]  T. Kaito,et al.  Clinical Outcomes After Posterior Lumbar Interbody Fusion: Comparison of Cortical Bone Trajectory and Conventional Pedicle Screw Insertion , 2017, Clinical spine surgery.

[6]  Toshiki Yoshimine,et al.  Radiological Evaluation of the Initial Fixation between Cortical Bone Trajectory and Conventional Pedicle Screw Technique for Lumbar Degenerative Spondylolisthesis , 2016, Asian spine journal.

[7]  Yi-Ren Chen,et al.  Minimally Invasive Lumbar Pedicle Screw Fixation Using Cortical Bone Trajectory – A Prospective Cohort Study on Postoperative Pain Outcomes , 2016, Cureus.

[8]  K. Chin,et al.  Clinical Outcomes With Midline Cortical Bone Trajectory Pedicle Screws Versus Traditional Pedicle Screws in Moving Lumbar Fusions From Hospitals to Outpatient Surgery Centers , 2017, Clinical spine surgery.

[9]  H H BOUCHER,et al.  A method of spinal fusion. , 1959, The Journal of bone and joint surgery. British volume.

[10]  Choll W. Kim,et al.  The current state of minimally invasive spine surgery. , 2011, The Journal of bone and joint surgery. American volume.

[11]  Kirsten Schmieder,et al.  Percutaneous Placement of Pedicle Screws in the Lumbar Spine Using a Bone Mounted Miniature Robotic System: First Experiences and Accuracy of Screw Placement , 2009, Spine.

[12]  Andrew T Dailey,et al.  Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 1: introduction and methodology. , 2014, Journal of neurosurgery. Spine.

[13]  O. Danisa,et al.  Early complications after instrumentation of the lumbar spine using cortical bone trajectory technique , 2016, Journal of Clinical Neuroscience.

[14]  C. Puttlitz,et al.  Cortical bone trajectory for lumbar pedicle screws. , 2009, The spine journal : official journal of the North American Spine Society.

[15]  Wei He,et al.  Lumbar spinal stenosis: an update on the epidemiology, diagnosis and treatment , 2017 .