Journal article
A feasibility cadaver study for placing screws in various pelvic osseous fracture pathways using a robotic arm
European journal of orthopaedic surgery & traumatology
19 Jan 2024
PMID: 38240824
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Introduction The use of a robotic system for the placement of pedicle screws in spine surgeries is well documented in the literature. However, there is only a single report in the United States describing the use of a robotic system to place two screws in osseous fixation pathways (OFPs) commonly used in the treatment of pelvic and acetabular fractures in a simulated bone model. The purpose of this study was to demonstrate the use of a robotic system to place screws in multiple, clinically relevant OFPs in a cadaveric model and to quantitatively measure accuracy of screw placement relative to the preoperative plan.Methods A single cadaveric specimen was obtained for the purpose of this study. All surrounding soft tissues were left intact. Screws were placed in OFPs, namely iliosacral (IS), trans-sacral (TS), Lateral Compression-II (LC-II), antegrade anterior column (AC) and antegrade posterior column (PC) of the right hemipelvis using standard, fluoroscopically assisted percutaneous or mini-open technique. Following the placement of screws into the right hemipelvis using standard techniques, screws were planned and placed in the same OFPs of the contralateral hemipelvis using the commercially available ExcelsiusGPS (R) robotic system (Globus Medical Inc., Audubon, PA). After robotic-assisted screw placement, a post-procedure CT scan was obtained to evaluate actual screw placement against the pre-procedure plan. A custom-made image analysis program was devised to measure screw tip/tail offset and angular offset on axial and sagittal planes.Results For different OFPs, the mean tip offset, tail offset and angular offsets were 1.6 +/- 0.9 mm (Range 0.0-3.6 mm), 1.4 +/- 0.4 mm (Range 0.3-2.5 mm) and 1.1 +/- 0.4 degrees (Range 0.5-2.1), respectively.Conclusion In this feasibility study, surgeons were able to place screws into the clinically relevant fracture pathways of the pelvis using ExcelsiusGPS (R) for robotic-assisted surgery. The measured accuracy was encouraging; however, further investigation is needed to demonstrate that robotic-assisted surgery can be used to successfully place the screws in the bony corridors of the pelvis to treat traumatic pelvic injuries.
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Details
- Title
- A feasibility cadaver study for placing screws in various pelvic osseous fracture pathways using a robotic arm
- Creators
- Austin F. Smith - University of LouisvilleMatin Lendhey - Globus MedicalJalen Winfield - Drexel UniversityJonathan M. Mahoney (Corresponding Author) - Globus MedicalBrandon S. Bucklen - Globus MedicalJon B. Carlson - University of Louisville
- Publication Details
- European journal of orthopaedic surgery & traumatology
- Publisher
- Springer Nature
- Number of pages
- 7
- Grant note
- No Statement Available
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- School of Biomedical Engineering, Science, and Health Systems
- Web of Science ID
- WOS:001145794100001
- Scopus ID
- 2-s2.0-85182644759
- Other Identifier
- 991021860730404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Orthopedics
- Surgery