Our Summary

This research paper is about a study that looked at the effectiveness, precision, and potential complications of using robotic-assisted navigation (RAN) for placing screws in pediatric spine surgery.

The study reviewed 162 cases at a single pediatric institution between 2019 and 2021. Most of the patients were adolescents with scoliosis (a condition where the spine curves abnormally). The study found that nearly all (99.6%) of the 1467 screws attempted were placed successfully, with failures only occurring in a specific type of pedicle (a part of the vertebra).

When postoperative CT scans were used, it was found that all of the screws were placed correctly. In 4% of the cases, it was found that the robot’s positioning had moved slightly, but this was detected before drilling began. There were no instances of neurological damage or patients needing to return to the operating room.

The study made two changes during the research period to improve the technique. First, they started using a high-speed navigated drill, which significantly reduced the chances of screws being misplaced. Second, they started drilling all pilot holes robotically first, then placing the screws, which helped avoid any movement disrupting the robot’s positioning.

In conclusion, the study found that using RAN in pediatric spine surgery is safe and highly accurate for screw placement. However, it’s important to note that this study is considered Level III evidence, meaning it’s based on retrospective observational studies, and more research is needed to confirm these findings.

FAQs

  1. What is the success rate of using robotic-assisted navigation (RAN) for screw placement in pediatric spine surgery based on this study?
  2. What changes were made during the study to improve the technique of using RAN in pediatric spine surgery?
  3. Were there any complications or instances of neurological damage found in the study when using RAN for pediatric spine surgery?

Doctor’s Tip

A doctor might tell a patient that using robotic-assisted navigation for pediatric scoliosis surgery can be highly effective and precise in placing screws, with minimal risk of complications such as neurological damage. It is important to follow postoperative care instructions carefully to ensure the best possible outcome. Additionally, ongoing research is being conducted to further validate the benefits of this technique.

Suitable For

Pediatric patients who are recommended for scoliosis surgery typically have moderate to severe curvature of the spine that is not responding to conservative treatments such as bracing or physical therapy. Surgery may be recommended for patients with a curvature of the spine greater than 45-50 degrees, progressive curvature that is worsening over time, or significant pain or discomfort associated with the scoliosis.

Additionally, patients who have other underlying conditions such as neuromuscular scoliosis, congenital scoliosis, or syndromic scoliosis may also be candidates for surgery. These conditions may require a more complex surgical approach to correct the curvature of the spine.

Overall, pediatric scoliosis surgery is recommended for patients who have significant curvature of the spine that is impacting their quality of life and is not responding to conservative treatments. The use of robotic-assisted navigation, as shown in the study, can help improve the accuracy and safety of screw placement during surgery, leading to better outcomes for pediatric patients undergoing spinal surgery for scoliosis.

Timeline

Before pediatric scoliosis surgery:

  • Patient is diagnosed with scoliosis and recommended for surgical intervention
  • Patient undergoes preoperative evaluations, including imaging tests and physical examinations
  • Surgical plan is discussed with the patient and their family, including the use of robotic-assisted navigation for screw placement
  • Surgery date is scheduled

After pediatric scoliosis surgery:

  • Patient is admitted to the hospital for surgery
  • Surgery is performed using robotic-assisted navigation for screw placement
  • Postoperative care is provided, including pain management and monitoring for any complications
  • Patient undergoes postoperative imaging tests to ensure correct screw placement
  • Patient is discharged from the hospital and begins the recovery process, including physical therapy and follow-up appointments with the surgeon

Overall, the use of robotic-assisted navigation in pediatric scoliosis surgery has been shown to be effective, precise, and safe, with minimal complications reported in this study.

What to Ask Your Doctor

  1. What is the success rate of using robotic-assisted navigation for placing screws in pediatric spine surgery?
  2. Are there any potential complications or risks associated with using this technology?
  3. How does using robotic-assisted navigation compare to traditional methods for placing screws in pediatric scoliosis surgery?
  4. What experience does the surgical team have with using robotic-assisted navigation for pediatric spine surgery?
  5. How long does the surgery typically take when using robotic-assisted navigation?
  6. Will I need any additional follow-up appointments or monitoring after the surgery?
  7. How will the use of robotic-assisted navigation impact my recovery time and overall outcome?
  8. Are there any specific guidelines or restrictions I should follow after the surgery to ensure the best results?
  9. What are the alternative options to robotic-assisted navigation for pediatric scoliosis surgery, and why is this technology recommended in my case?
  10. Are there any ongoing research or advancements in robotic-assisted navigation for pediatric spine surgery that I should be aware of?

Reference

Authors: Welch N, Mota F, Birch C, Hutchinson L, Hedequist D. Journal: J Pediatr Orthop. 2023 May-Jun 01;43(5):e337-e342. doi: 10.1097/BPO.0000000000002381. Epub 2023 Mar 21. PMID: 36952248