Genauigkeit der Implantatlage und perioperativer klinischer Verlauf nach konventioneller, minimalinvasiver und Roboter-assistierter Implantation von Pedikelschrauben

Perioperative course and accuracy of screw positioning in conventional, open robotic-guided and percutaneous robotic-guided, pedicle screw placement

by Stefan Bärwinkel
Doctoral thesis
Date of Examination:2014-01-28
Date of issue:2014-01-27
Advisor:PD Dr. Sven Kantelhardt
Referee:Prof. Dr. Anna-Kathrin Hell
Referee:Prof. Dr. Martin Oppermann
Persistent Address: http://dx.doi.org/10.53846/goediss-4333

 

 

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Abstract

English

Robotic-guided and percutaneous pedicle screw placement are emerging technologies. We here report a retrospective cohort analysis comparing conventional open to open robotic-guided and percutaneous robotic-guided pedicle screw placement. 112 patient records and CT scans were analyzed concerning the intraoperative and perioperative course. 35 patients underwent percutaneous, 20 open robotic-guided and 57 open conventional pedicle screw placement. 94.5% of robot-assisted and 91.4% of conventionally placed screws were found to be accurate. Percutaneous robotic and open robotic-guided subgroups did not differ obviously. Average X-ray exposure per screw was 34 s in robotic-guided compared to 77 s in conventional cases. Subgroup analysis indicates that percutaneously operated patients required less opioids, had a shorter hospitalization and lower rate of adverse events in the perioperative period. The use of robotic guidance significantly increased accuracy of screw positioning while reducing the X-ray exposure. Patients seem to have a better perioperative course following percutaneous procedures.
Keywords: Spine assist
Schlagwörter: Spine assist
 
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