Clinical application of Renaissance spine robot assisted system in spinal disease

Objective To evaluate the safety of Renaissance spine robot assisted system in spinal injury. Methods From March 2014 to May 2016, 38 patients with spinal disease received spinal surgery assisted by spine robot system. They were 20 males and 18 females, with an average age of 42 years (range, from 12 to 69 years). There were 10 lumbar fractures, 8 thoracic fractures and 20 spinal deformities. Pedicle screw implantation was conducted in 30 patients (PS group) and percutaneous vertebroplasty in 8 (PV group). One side was chosen randomly to use Mazor spine robot assisted system (assisted group) and the opposite side the conventional method (non-assisted group). The anteroposterior and lateral X-rays and CT scan of the lumbar and/or thoracic spine were performed in all patients after surgery. The precision of pedicle screws implantation in PS group was evaluated by the Abul-Kasimhierarchy grading system; location of the puncture trajectory, time used for puncture and radiation exposure time in PV group were evaluated. Results 208 pedicle screws were implanted in PS group, including 120 lumbar ones and 88 thoracic ones. For lumbar pedicle screw implantation, the excellent to good rate was 95.0% (57/60) in the assisted group, significantly higher than that in the non-assisted group (80.0%, 48/60) (P< 0.05). For thoracic pedicle screw implantation, the excellent to good rate was 95.5% (42/44) in the assisted group, significantly higher than that in the non-assisted group (77.3%, 34/44) (P< 0.05). There were 24 puncture trajectories in 8 patients in PV group, showing no pedicle penetration or cement leaking in any case. The mean time used for puncture was 5.5±1.4 min in the assisted group, significantly shorter than that in the non-assisted group (17.8±7.5 min) (P< 0.05); the X-ray exposure time was 14.0±4.0 s in the assisted group, significantly shorter than that in the non-assisted group (22.4±6.0 s) (P< 0.05). Conclusions Renaissance spine robot-assisted system deserves more clinical application, because in spinal surgery it can make pedicle screw implantation more precise and safer, and can reduce operation time and X-ray exposure time in percutaneous vertebroplasty. Key words: Spinal diseases; Robot; Vertebroplasty; Bone nails