Does the accuracy of pedicle screw placement differ between the attending surgeon and resident in navigated robotic-assisted minimally invasive spine surgery?

• DOI: 10.1007/s11701-019-01019-9
• Publication Date: 2019-09-21T12:02:28Z
• Authors: Arnold B. Vardiman; David J. Wallace; Grant A. Booher; Neil R. Crawford; Jessica R. Riggleman; Samantha L. Greeley; Charles G. Ledonio
• Keywords: Adult; Aged, 80 and over; Male; Lumbosacral Region; Middle Aged; Sensitivity and Specificity; Spine; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Robotic Surgical Procedures; Surgery, Computer-Assisted; Pedicle Screws; Humans; Minimally Invasive Surgical Procedures; Original Article; Female; Aged; Retrospective Studies

Robotic assistance with integrated navigation is an area of high interest for improving the accuracy minimally invasive pedicle screw placement. This study analyzes placement between attending spine surgeon and a resident by comparing left right sides first 101 consecutive cases using navigated robotic in private practice clinical setting. A retrospective, Institutional Review Board-exempt review 106 robot-assisted surgery was performed. One one performed consistently on either or side (researchers were blinded). CT-based Gertzbein Robbins system (GRS) used to classify accuracy, grade B considered accurate. There 630 lumbosacral screws placed. Thirty (5 patients) placed without robot due discretion. Of 600 inserted guidance (101 patients), only 1.5% (9/600) repositioned intraoperatively. Based GRS grading breach, 98.67% (296/300) left-side graded B, 1.3% (4/300) C, 0% (0/300) D. For right-side screws, 97.67% (293/300) 1.67% (5/300) 0.66% (2/300) demonstrated level (based GRS) no significant differences left- placements (98.67% vs. 97.67%, respectively) use navigated, surgery.