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Robotic Assisted Pedicle Screw Placement for Traumatic Thoracolumbar Spine Fractures Using the Mazor X Robot
Journal article   Open access   Peer reviewed

Robotic Assisted Pedicle Screw Placement for Traumatic Thoracolumbar Spine Fractures Using the Mazor X Robot

Amol H. Trivedi, Kyle Holmberg, Jonathan Acosta, Athan G. Zavras, Ryan Sauber, Boyle Cheng and Daniel T. Altman
Journal of Orthopaedic Reports, 100495
Oct 2024
DOI: https://doi.org/10.1016/j.jorep.2024.100495
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https://doi.org/10.1016/j.jorep.2024.100495View
Published, Version of Record (VoR) Open

Abstract

Fracture Mazor X Robotic Spine Trauma
In spine surgery, robotic platforms are primarily involved in the planning and insertion of pedicle screws to stabilize the vertebral column. However, the utility of robotic-assisted placement of pedicle screws in thoracolumbar spine fractures has not been widely reported. At our institution, these fractures are stabilized using pedicle screw fixation with either fluoroscopy, computer navigation, or using robotic assistance. We aim to report our initial experience with using the Mazor X articulating surgical robot in the treatment of patients with traumatic spine fractures. The purpose of our study is to identify the potential efficiency of robot-assisted placement of pedicle screws in stabilization of thoracolumbar spine fractures. A retrospective chart review was performed focusing on patients admitted to our Level 1 Trauma center with a diagnosis of traumatic spine fracture from 2018 to 2023. The inclusion criteria consisted of patients 18 years and over who underwent stabilization of traumatic spine fracture with pedicle screw and rod constructs using robotic assistance with an articulating surgical robot. Our primary outcome measures included screw malposition, screw failure, intraoperative revisions, and complications. Secondary outcome measures were mean operative time, estimated blood loss, and mean fluoroscopy time. A total of five surgeons treated 45 patients with robotic-assisted pedicle screws for the stabilization of traumatic thoracolumbar spine fracture. There was a total of 381 screws inserted in 182 levels of the spine (thoracolumbar, sacral, and lumbopelvic segments) including 373 pedicle screws placed using an articulating robotic arm with zero screws requiring intraoperative revision for malposition. There were 3 complications of infection, 2 deep and 1 superficial, requiring a second operation for irrigation and debridement. There were no neurological complications, instances of hardware failure, or revisions. Robotic-assisted pedicle screw fixation with the Mazor X Robot shows promising surgical outcomes in patients with thoracolumbar trauma. This approach yielded no screw-related complications, no revision surgeries, and three postoperative complications of infection. Although this is a potentially safe and effective surgical technique, we hope future studies have larger cohorts and directly compare to conventional techniques specifically for unstable traumatic spine fractures.

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