Robot-Assisted Instrumented Fusion of a T8-9 Extension Distraction Fracture and Epidural Hematoma Evacuation : 2-Dimensional Operative Video
Copyright © 2020 by the Congress of Neurological Surgeons..
The utilization of robotics has been gaining increased popularity in spine surgery. It can be used to assist in pedicle screw insertion when anatomy is complex in deformity surgery, but is also helpful in degenerative spine as it can minimize tissue dissection and fluoroscopy use.1-6 We present an operative video that demonstrates the use of a robotic system (Globus Excelsius GPS, Audubon, Pennsylvania) for thoracic instrumentation in an unstable fracture. The patient we present is a 64-yr-old male who sustained a T8-9 distraction extension fracture after falling down a flight of stairs. His computed tomography (CT) scan showed ossification of the anterior longitudinal ligament making ankylosing spondylitis the likely underlying condition.7,8 His magnetic resonance imaging showed an epidural hematoma extending from T7 to T11. Due to the unstable nature of this fracture and the presence of the hematoma, informed consent was obtained and the patient underwent thoracic pedicle screw fixation from T7 to T11 and laminectomy for hematoma evacuation. A preoperative CT was done for screw trajectory planning. Paraspinal muscle dissection was limited to the hematoma level to allow for laminectomy and evacuation. After registration of the patient to the robotic system using C-arm fluoroscopy, pilot burr holes are drilled using a rigid robotic arm and with optical tracking in real time. This reduces the degrees of freedom and allows for higher precision of screw placement. To the authors' knowledge, this video is the first one to show the utilization of robotics for thoracic instrumentation in an acute fracture.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:19 |
|---|---|
| Enthalten in: |
Operative neurosurgery (Hagerstown, Md.) - 19(2020), 4 vom: 15. Sept., Seite E420-E421 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Al Saiegh, Fadi [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Arthrodesis |
|---|
| Anmerkungen: |
Date Completed 21.06.2021 Date Revised 31.05.2022 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1093/ons/opaa061 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM308445333 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM308445333 | ||
| 003 | DE-627 | ||
| 005 | 20231225131744.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1093/ons/opaa061 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1028.xml |
| 035 | |a (DE-627)NLM308445333 | ||
| 035 | |a (NLM)32259253 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Al Saiegh, Fadi |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Robot-Assisted Instrumented Fusion of a T8-9 Extension Distraction Fracture and Epidural Hematoma Evacuation |b 2-Dimensional Operative Video |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 21.06.2021 | ||
| 500 | |a Date Revised 31.05.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 by the Congress of Neurological Surgeons. | ||
| 520 | |a The utilization of robotics has been gaining increased popularity in spine surgery. It can be used to assist in pedicle screw insertion when anatomy is complex in deformity surgery, but is also helpful in degenerative spine as it can minimize tissue dissection and fluoroscopy use.1-6 We present an operative video that demonstrates the use of a robotic system (Globus Excelsius GPS, Audubon, Pennsylvania) for thoracic instrumentation in an unstable fracture. The patient we present is a 64-yr-old male who sustained a T8-9 distraction extension fracture after falling down a flight of stairs. His computed tomography (CT) scan showed ossification of the anterior longitudinal ligament making ankylosing spondylitis the likely underlying condition.7,8 His magnetic resonance imaging showed an epidural hematoma extending from T7 to T11. Due to the unstable nature of this fracture and the presence of the hematoma, informed consent was obtained and the patient underwent thoracic pedicle screw fixation from T7 to T11 and laminectomy for hematoma evacuation. A preoperative CT was done for screw trajectory planning. Paraspinal muscle dissection was limited to the hematoma level to allow for laminectomy and evacuation. After registration of the patient to the robotic system using C-arm fluoroscopy, pilot burr holes are drilled using a rigid robotic arm and with optical tracking in real time. This reduces the degrees of freedom and allows for higher precision of screw placement. To the authors' knowledge, this video is the first one to show the utilization of robotics for thoracic instrumentation in an acute fracture | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Video-Audio Media | |
| 650 | 4 | |a Arthrodesis | |
| 650 | 4 | |a Fusion | |
| 650 | 4 | |a Instrumentation | |
| 650 | 4 | |a Robot | |
| 650 | 4 | |a Robotics | |
| 650 | 4 | |a Spine surgery | |
| 650 | 4 | |a Surgical technique | |
| 700 | 1 | |a Leibold, Adam |e verfasserin |4 aut | |
| 700 | 1 | |a Mouchtouris, Nikolaos |e verfasserin |4 aut | |
| 700 | 1 | |a Sabourin, Victor |e verfasserin |4 aut | |
| 700 | 1 | |a Stefanelli, Anthony |e verfasserin |4 aut | |
| 700 | 1 | |a Franco, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Harrop, James |e verfasserin |4 aut | |
| 700 | 1 | |a Jallo, Jack |e verfasserin |4 aut | |
| 700 | 1 | |a Prasad, Srinivas |e verfasserin |4 aut | |
| 700 | 1 | |a Heller, Joshua |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Operative neurosurgery (Hagerstown, Md.) |d 2007 |g 19(2020), 4 vom: 15. Sept., Seite E420-E421 |w (DE-627)NLM169485293 |x 2332-4260 |7 nnns |
| 773 | 1 | 8 | |g volume:19 |g year:2020 |g number:4 |g day:15 |g month:09 |g pages:E420-E421 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/ons/opaa061 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 19 |j 2020 |e 4 |b 15 |c 09 |h E420-E421 | ||