ArticleMedicina (Kaunas, Lithuania)2022
CT-Navigated Spinal Instrumentations-Three-Dimensional Evaluation of Screw Placement Accuracy in Relation to a Screw Trajectory Plan.
Article in Medicina (Kaunas, Lithuania), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Development and Validation of a Computer-Assisted Screw Trajectory Planning Model Based on Iterative Closest Point Registration and Weighted K-Nearest Neighbors Algorithms for Cortical Bone and Pedicle Screw Techniques.Global spine journal · 2026Article
- Comparative evaluation of CT-to-Fluoroscopy and Scan-and-Plan registration techniques in robot-assisted pedicle screw placement: a preliminary cadaveric faesibility study.Journal of robotic surgery · 2026Article
- Accuracy of a high-resolution augmented reality (AR) guidance system with novel 3D stereoscopic targeting for spinal surgery.Journal of spine surgery (Hong Kong) · 2026Article
- Evaluation of pedicle screw accuracy and deviation from preoperative planning in intraoperative Cone-Beam Computed Tomography-Navigated lumbar spinal fusion: a prospective study.Brain & spine · 2026Article
- Robotic-assisted pedicle screw placement improves accuracy, precision, and breach rates compared with freehand and image-guided navigation techniques: a cadaveric study.Spine deformity · 2025Article
- Revolutionizing spine surgery with emerging AI-FEA integration.Journal of robotic surgery · 2025Review
- Article
- Advancing spine surgery: Evaluating the potential for full robotic automation.Brain & spine · 2025Review
- Development and Validation of Deep Learning Preoperative Planning Software for Automatic Lumbosacral Screw Selection Using Computed Tomography.Bioengineering (Basel, Switzerland) · 2024Article
- Article
- Fully automated determination of robotic pedicle screw accuracy and precision utilizing computer vision algorithms.Journal of robotic surgery · 2024Article
- Evaluation of Augmented Reality Surgical Navigation in Percutaneous Endoscopic Lumbar Discectomy: Clinical Study.Bioengineering (Basel, Switzerland) · 2023Article
- Automatic 3D Postoperative Evaluation of Complex Orthopaedic Interventions.Journal of imaging · 2023Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and Objectives: In the literature, spinal navigation and robot-assisted surgery improved screw placement accuracy, but the majority of studies only qualitatively report on screw positioning within the vertebra. We sought to evaluate screw placement accuracy in relation to a preoperative trajectory plan by three-dimensional quantification to elucidate technical benefits of navigation for lumbar pedicle screws. Materials and Methods: In 27 CT-navigated instrumentations for degenerative disease, a dedicated intraoperative 3D-trajectory plan was created for all screws. Final screw positions were defined on postoperative CT. Trajectory plans and final screw positions were co-registered and quantitatively compared computing minimal absolute differences (MAD) of screw head and tip points (mm) and screw axis (degree) in 3D-space, respectively. Differences were evaluated with consideration of the navigation target registration error. Clinical acceptability of screws was evaluated using the Gertzbein−Robbins (GR) classification. Results: Data included 140 screws covering levels L1-S1. While screw placement was clinically acceptable in all cases (GR grade A and B in 112 (80%) and 28 (20%) cases, respectively), implanted screws showed considerable deviation compared to the trajectory plan: Mean axis deviation was 6.3° ± 3.6°, screw head and tip points showed mean MAD of 5.2 ± 2.4 mm and 5.5 ± 2.7 mm, respectively. Deviations significantly exceeded the mean navigation registration error of 0.87 ± 0.22 mm (p < 0.001). Conclusions: Screw placement was clinically acceptable in all screws after navigated placement but nevertheless, considerable deviation in implanted screws was noted compared to the initial trajectory plan. Our data provides a 3D-quantitative benchmark for screw accuracy achievable by CT-navigation in routine spine surgery and suggests a framework for objective comparison of screw outcome after navigated or robot-assisted procedures. Factors contributing to screw deviations should be considered to assure optimal surgical results when applying navigation for spinal instrumentation.
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