Background

The purpose of this study was to verify whether a spine robotic system was useful for junior surgeons.

Methods

Twenty-seven patients underwent posterior spinal fusion with open surgery using a spine robotic system (Mazor X Stealth Edition, Medtronic Inc., Dublin, Ireland) from April to August 2021. Pedicle screw insertions were performed by five surgeons. The surgeon and insertion time were recorded for each pedicle screw. Two surgeons who are board-certified spine surgeons by the Japanese Society for Spine Surgery and Related Research (JSSR) were defined as the expert surgeon group. Three surgeons who were training to acquire qualifications as JSSR board certified spine surgeons were defined as the junior surgeon group. In postoperative CT images, the deviation of 255 pedicle screws was evaluated using the Gertzbein-Robbins (GR) grades.

Results

In the expert surgeon group, the GR grades were Grade A for 79 screws (90.8%), Grade B for 6 (6.9%), Grade C for 2 (2.3%), and 0 (0%) for Grades D and E. I In the junior surgeon group, the GR grades were Grade A for 162 screws (96.4%), Grade B for 6 (3.6%), and 0 (0%) for Grades C, D, and E. There was no significant difference in the deviation rate between surgeon groups (p = 0.08). The mean insertion times were 174.5 ± 83.0 s in the expert surgeon group and 191.0 ± 111.0 s in the junior surgeon group. There was no significant difference in the insertion time between surgeon groups (p = 0.22).

Conclusions

There were no significant differences in the deviation rate and the insertion time of robotic-assisted pedicle screw placement between expert surgeons and junior surgeons who were training to acquire qualifications as JSSR board certified spine surgeons. Robotic-assisted pedicle screw placement can be effectively employed by junior surgeons.

中文翻译：

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机器人辅助椎弓根螺钉放置的准确性，初级外科医生与专家外科医生的比较：初级外科医生能否像专家外科医生一样准确地放置椎弓根螺钉？

背景

本研究的目的是验证脊柱机器人系统对初级外科医生是否有用。

方法

2021 年 4 月至 8 月，27 名患者使用脊柱机器人系统（Mazor X Stealth Edition，Medtronic Inc.，都柏林，爱尔兰）接受了后路脊柱融合开放手术。椎弓根螺钉插入由五名外科医生进行。记录每个椎弓根螺钉的外科医生和插入时间。两名获得日本脊柱外科及相关研究学会 (JSSR) 认证的脊柱外科医生被定义为专家外科医生组。三名正在接受 JSSR 委员会认证脊柱外科医生资格培训的外科医生被定义为初级外科医生组。在术后CT图像中，使用Gertzbein-Robbins (GR)等级评估255个椎弓根螺钉的偏差。

结果

在专家组中，GR等级为A级螺钉79枚（90.8%），B级6枚（6.9%），C级2枚（2.3%），D级和E级0枚（0%）。初级外科医生组中，GR 等级为 A 级螺钉 162 枚（96.4%），B 级螺钉 6 枚（3.6%），C、D、E 级螺钉 0（0%），无显着性差异外科医生组之间的偏差率 (p = 0.08)。专家外科医生组的平均插入时间为 174.5 ± 83.0 秒，初级外科医生组的平均插入时间为 191.0 ± 111.0 秒。外科医生组之间的插入时间没有显着差异（p = 0.22）。

结论

专家外科医生和正在接受 JSSR 委员会认证脊柱外科医生资格培训的初级外科医生之间，机器人辅助椎弓根螺钉置入的偏差率和插入时间没有显着差异。机器人辅助椎弓根螺钉置入术可以被初级外科医生有效地使用。