Evidence map›Paper›PMID 35195035›Full record

ArticleGlobal spine journal2023

Anatomical and Technical Considerations of Robot-Assisted Cervical Pedicle Screw Placement: A Cadaveric Study.

Jennifer Z Mao, Mohamed A R Soliman, Brian A Karamian, Asham Khan, Alexander G Fritz, Naval Avasthi, Stephen DiMaria, Bennett R Levy, Timothy E O'Connor, Gregory Schroeder and 3 more

Abstract read
In one paragraph

Article in Global spine journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Robotic assistance for upper cervical instrumentation: report on accuracy and safety.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025
    Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Jennifer Z MaoDepartment of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo NY, USA.ORCID 0000-0001-8336-3808
Mohamed A R SolimanDepartment of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo NY, USA.
Brian A KaramianDepartment of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia PA, USA.ORCID 0000-0003-0512-6019
Asham KhanDepartment of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo NY, USA.
Alexander G FritzJacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo NY, USA.
Naval AvasthiJacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo NY, USA.
Stephen DiMariaDepartment of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia PA, USA.
Bennett R LevyGeorge Washington University, School of Medicine and Health Sciences, Washington DC, USA.
Timothy E O'ConnorDepartment of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo NY, USA.
Gregory SchroederDepartment of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia PA, USA.
John PollinaDepartment of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo NY, USA.ORCID 0000-0002-6234-4517
Alexander R VaccaroDepartment of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia PA, USA.
Jeffrey P MullinDepartment of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo NY, USA.ORCID 0000-0003-0640-2329

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designCadaver study.

objectivesAssess the feasibility of robot-assisted cervical pedicle screw (RA-CPS) placement and understand the anatomical considerations of this technique.

methodsFour cadaver specimens free from bony pathology were acquired. Anatomical considerations, such as pedicle width (PW) and height (PH), transverse pedicle angle (TPA), and maximal screw length (MSL), were recorded from preoperative computational tomography (CT) scans. Intraoperative cone-beam CT was acquired and registered to the robotic system. After cervical levels were segmented, screw sizes and trajectories were planned, and RA-CPS were placed. Accuracy was assessed using Gertzbein and Robbin's classification on postoperative CT scans.

resultsThirty-five RA-CPS were placed. Major breaches (≥Grade C) occurred in 28.57% screws. Grade A or B accuracy was found in 71.43% of screws, with the most common direction of breach being medial (81.3%). The greatest proportion of breach per level occurred in the upper subaxial levels, (C3:71.4%, C4 66.6%, C5:50%) which had the smallest PW (C3: 4.34 ± .96 mm, C4: 4.48 ± .60, C5: 5.76 ± 1.11). PH was greatest at C2 (8.14 ± 1.89 mm) and ranged subaxial from 6.36 mm (C3) to 7.48 mm (C7). The mean PW was 5.37 mm and increased caudally from 4.34 mm (C3) to 6.31 mm (C7). The mean TPA was 39.9° and decreased moving caudally 46.9°) to C7 (34.4°). The MSL was 37.1 mm and increased from C2 (26.3 mm) to C7 (41.0 mm).

conclusionRA-CPS has the potential to be feasible, but technological and instrument modifications are necessary to increase the accuracy in the cervical region.

Indexed as

anatomicalcadavercervical pedicle screwrobot-assistedtechnical

Identifiers

PMID35195035
PMCPMC10556891

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.