Two-dimensional C-arm robotic navigation system (i-Navi) in spine surgery: a pilot study

Int J Comput Assist Radiol Surg. 2022 Dec;17(12):2281-2290. doi: 10.1007/s11548-022-02751-8. Epub 2022 Sep 13.

Abstract

Purpose: Pedicle screws placement is very common procedure in spinal surgery. Robotic assisted surgery has been widely used in this operation. We assessed the accuracy of thoracolumbar spine trans-pedicle screws (TPS) implantation utilizing a noval robotic navigation system (i-Navi robotic navigation system) by planning with two-dimensional (2-D) C-arm.

Methods: This study was approved by the Institutional Review Board of the Cathay General Hospital on June 21, 2018 (IRB number: CGH-P 106,092), and written informed consents were obtained from all the patients. There are 18 patients were enrolled in the study. All the patients received the posterior fusion with TPS insertion under the assistant of our robotic navigation system.

Results: There are 18 patients were included into our study, there are 2 patients were quitted from the study due to the equipment setup was not complete. Other 16 patients completed the entire procedure successfully. There is total 88 pedicle screws were inserted through i-Navi robotic navigation system. There are 79 of 88 screws were graded A, and 9 screws were graded B; no screws were graded C or D. No vascular or nerve injuries were noted after the operations.

Conclusion: We present our i-Navi robotic navigation system, by planning with 2-D C-arm imaging and pre-operative CT scans. According to the results of study, we think it can provide a reliable and easy tool to perform the TPS in thoracic lumbar spine surgery.

Keywords: C-arm; Navigation surgery; Robotic system; Spine surgery.

MeSH terms

  • Humans
  • Lumbar Vertebrae / surgery
  • Pedicle Screws*
  • Pilot Projects
  • Robotic Surgical Procedures*
  • Robotics*
  • Spinal Fusion* / methods
  • Surgery, Computer-Assisted* / methods
  • Tomography, X-Ray Computed