NDLI: The positional consistency between guidewire and cannulated or solid screw in robot-assisted spinal internal fixation surgery

Content Provider	Springer Nature : BioMed Central
Author	Zhao, Jingwei Zhang, Yunxian Fan, Mingxing Han, Xiaoguang Liu, Bo He, Da Tian, Wei
Abstract	Background This study aimed to investigate the positional consistency between the guidewire and the screw in spinal internal fixation surgery. Methods This study involved 64 patients who underwent robot-assisted thoracic or lumbar pedicle screw fixation surgery. Guidewires were inserted with the assistance of the Tirobot. Either cannulated screws or solid screws were inserted. Guidewire and screw accuracy was measured using CT images based on the Gertzbein and Robbins scale. The positional consistency between guidewire and screw was evaluated based on the fused CT images, which could graphically and quantitatively demonstrate the consistency. The consistency was evaluated based on a grading system that considered the maximum distance and angulation between the centerline of the guidewire and the screw in the region of the pedicle. Results A total of 322 screws were placed including 206 cannulated ones and 116 solid ones. Based on the Gertzbein and Robbins scale, 97.5% of the guidewires were grade A, and 94.1% of the screws were grade A. Based on our guidewire-screw consistency scale, 85% in cannulated group, and 69.8% in solid group, were grade A. Both solid and cannulated screws may alter trajectory compared to the guidewires. The positional accuracy and guidewire-screw consistency in the solid screw group is significantly worse than that in the cannulated screw group. The cortical bone of the pedicle has a positive guide effect on either solid or cannulated screws. Conclusion The pedicle screws may alter trajectory despite the guidance of the guidewires. Solid screws show worse positional accuracy and guidewire-screw consistency compared with cannulated screws. Trial registration The study was retrospectively registered and approved by our center’s institutional review board.
Related Links	https://josr-online.biomedcentral.com/counter/pdf/10.1186/s13018-023-04053-4.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
DOI	10.1186/s13018-023-04053-4
Journal	Journal of Orthopaedic Surgery and Research
Issue Number	1
Volume Number	18
Language	English
Publisher	BioMed Central
Publisher Date	2024-01-05
Access Restriction	Open
Subject Keyword	Orthopedics Surgical Orthopedics Positional consistency Guidewire Screw Spinal surgery Robot-assisted Percutaneous Image fusion Intra-operative CT Post-operative CT Cone-beam CT
Content Type	Text
Resource Type	Article
Subject	Surgery Orthopedics and Sports Medicine
Journal Impact Factor	2.8/2023
5-Year Journal Impact Factor	3/2023

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