Robot-assisted Magerl screw fixation for upper cervical diseases
Objective The technique of transarticular screw fixation (Magerl screws) is a major surgical approach for upper cervical diseases. Traditional methods demand technical proficiency with a steep learning curve,resulting in a high incidence of neurovascular complications due to screw misplacement. With the growing application of robot-assisted spinal surgeries, the high precision of robotic technology offers new prospects for safe and accurate placement of Magerl screws. This study retrospectively analyzes the safety and accuracy of robot-assisted Magerl screw fixation procedures. Methods A total of 18 patients with upper cervical diseases who underwent robot-assisted Magerl screw fixation using the TiRobot system at Beijing Jishuitan Hospital from August 2017 to July 2022 were included. Safety parameters, including operative time, blood loss, screw-related neurovascular complications, neurological improvement at 1-year follow-up, changes in neck pain, and graft fusion,were recorded. Accuracy parameters involved screw placement accuracy calculated with intraoperative cone-beam CT images using overlay technology, as well as the cortical violation of screws assessed by postoperative CT scan. Results Thirty-six Magerl screws were inserted in the 18 patients. The mean operative time was (186. 1±61. 9) min,with a mean blood loss of (352. 8±133. 4) mL. No screw-related neurovascular complications were observed. At 1-year follow-up,all patients with spinal cord compression symptoms showed neurological improvement,neck pain symptoms improved in all patients,and successful graft fusion was achieved in all cases. The mean translational and angular deviations of screw placement were (1. 47±0. 30) mm and 2. 30°±0. 47°,respectively. Postoperative CT assessment indicated Type Ⅰ screws in 88. 9％(32/36) and Type Ⅱ screws in 11. 1％(4/36),with no Type Ⅲ screws. Conclusions Robot-assisted Magerl screw fixation is a safe and accurate technique for treating upper cervical diseases.
万方数据
维普
