ArticleJournal of orthopaedic surgery and research2025
Simulation and analysis of non-navigational errors in robot-assisted pedicle Kirschner wire placement surgery.
Article in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Augmented reality in non-instrumentation minimally invasive spine surgery: a narrative review and future perspectives.Journal of spine surgery (Hong Kong) · 2026Review
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5 authors.
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Abstract
backgroundSurgical errors of orthopedics robotic are influenced by a multitude of factors. This study aims to investigate the impact of non-navigational errors on the accuracy of pedicle screw placement in orthopedic surgery.
methodsInitially, a robot-assisted Kirschner wire (K-wire) placement simulation system was constructed, comprising a universal arm, wide-angle cameras, microscope cameras, and a vertebral base. Utilizing this system, we conducted a systematic analysis of the effects of four factors on non-navigational errors: operator habits, guide-to-bone surface distance, robotic arm stiffness, and vertebral fixation stiffness.We investigated two distinct operator habits: Habit 1 involves first positioning the K-wire against the bone surface through the guide and then inserting it using a bone drill; Habit 2 involves clamping the K-wire onto the bone drill and then inserting it together. Based on the control variable method, we designed precision measurement experiments for K-wire placement under different factors, forming 26 variable combinations to investigate the K-wire placement errors under each factor and their proportions in the overall error.
resultsA total of 933 K-wire placements were performed in this study. The average deviation under Habit 2 conditions was 0.51 mm, compared to 0.13 mm under Habit 1 conditions; the average deviation was 0.36 mm when the guide-to-bone surface distance was 5 cm, and 0.28 mm when the distance was 1 cm; the average deviation was 0.36 mm under the 600 mm robotic arm condition, and 0.24 mm under the 500 mm robotic arm condition; the average deviation was 0.37 mm in the Plaster-Fixed Vertebra Group, and 0.85 mm in the Silicone-Fixed Vertebra Group.
conclusionsOperator habits and vertebral fixation stiffness are the primary factors influencing non-navigational errors, while guide-to-bone surface distance and robotic arm stiffness are secondary factors. This study recommends adopting Habit 1 in clinical surgeries, minimizing the guide-to-bone surface distance, and enhancing the stiffness of the robotic arm and vertebral fixation to reduce non-navigational errors and improve the accuracy of robot-assisted pedicle screw placement.
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