Feasibility and Accuracy of Robotic-Assisted Navigation for Thoracic Pedicle Screw Placement Using CT-Like 3D-MRI

作者：Franziska C.S. Altorfer, Michael Kelly, Giuseppe Loggia, Fedan Avrumova, Jiaqi Zhu, Gracyn Campbell, J. Levi Chazen, Ek T. Tan, Darren R. Lebl · 发表于：Spine · 年份：2025 · DOI：10.1097/brs.0000000000005366 · 被引用次数：3 · 研究领域：Spinal Fractures and Fixation Techniques、Intraoperative Neuromonitoring and Anesthetic Effects、Scoliosis diagnosis and treatment

STUDY DESIGN: Cadaveric study. OBJECTIVE: To assess the feasibility and accuracy of robotic positioning of thoracic pedicle screws based on magnetic resonance imaging (MRI). SUMMARY OF BACKGROUND DATA: Robotic-assisted navigation (RAN) has demonstrated enhanced precision in thoracic pedicle screw placement. Currently, preoperative computer tomography (CT) scanning is required, exposing patients to radiation-a particular concern for younger patients undergoing multilevel fusion surgery. CT-like three-dimensional (3D)-MRI sequences may offer a radiation-free alternative, but their application in thoracic pedicle screw placement remains unexplored. METHODS: CT-like 3D-MRI scans of the thoracic spine were obtained in two human cadaveric specimens. A RAN system was employed to plan and guide 48 pedicle screws (bilateral screws in thoracic vertebrae T1-T12) using these MRI scans. Following the placement of the pedicle screws, post-procedure CT scans were obtained to evaluate the accuracy of screw positioning. Accuracy was assessed by comparing the actual placement to the pre-procedure plan (difference in millimetres) and via the Gertzbein-Robbins scale (GRS). RESULTS: A total of 48 thoracic pedicle screws were inserted robotically in two human specimens (T1-T12 bilaterally). Post-procedure CT scan evaluations revealed that all screws achieved an acceptable grade on the GRS (A or B). Specifically, 87.5% of the screws were classified as grade A and 12.5% were classified as grade B. T...