Clinical Study With a Robotic Assistant in Patients Requiring a Spinal Transpedicular Fixation

Multicenter non-comparative clinical trial.

This interventional study aims to assess the safety and performance of a robotic assistant, based on a electromechanical tracking system, in patients requiring transpedicular screw fixation.The primary focus is on overcoming the limitations of traditional minimally invasive surgeries and enhancing the accuracy of pedicle screw placement, especially within the complex pedicle region adjacent to the spinal canal.

The study design is a prospective interventional trial conducted in two hospital centers in Spain, with two principal investigators leading the investigation. Patients requiring transpedicular screw fixation will be recruited. The robotic assistant will be employed to facilitate transpedicular screw fixation. The system aims to improve accuracy and safety in screw placement, in comparison with conventional techniques used.

Patients will include individuals with spinal fractures, spinal stenosis, kyphosis, and other conditions requiring transpedicular screw fixation. Two principal investigators in Spain will lead the recruitment process.

The study aims to answer several key questions:

• Determine Screw Accuracy: Assess the degree of screw invasion into the pedicle using the Gertzbein-Robbins scale, with a target of achieving 96% acceptable screw placement.
• Evaluate Planning vs. Final Screw Placement: Determine the accuracy of screw placement by comparing planned positions with the actual final positions.
• System Performance: Assess the overall performance of the robotic system during the surgical procedure.
• Reoperation and Postoperative Time: Determine the need for reoperation and evaluate postoperative recovery time.
• Adverse Events: Detect and document any adverse events occurring during the surgical process.

Trained radiologists will play a crucial role in evaluating the accuracy of screw placement, focusing on the degree of invasion into the pedicle using the Gertzbein-Robbins scale. The study is set to span a duration of 12 months,during which patients will undergo regular assessments, and outcomes will be closely monitored. The inclusion of the electromechanical tracking system in the robotic assistant adds a technological dimension to the investigation, contributing to advancements in the field of minimally invasive spinal surgeries.

Inclusion criteria

• Patient scheduled for spinal fusion Surgery requiring pedicle screw insertion.
• Open or minimally invasive (MIS) technique.
• Spinal regions: lumbar, thoracic and/or sacral (one patient may cover several regions).
• Signed informed consent.

Exclusion criteria

• Paediatric patient (< 18 years)
• Pedicular Surgery history with screw insertion in the vertebra to be operated.
• Any contraindication for the pedicular screw placement.
• Severe scoliosis.
• Severe osteoporosis.
• Infection or neoplasia.
• Obesity.
• Pregnancy and lactancy.
• Any other disease or disorder that, in the opinión of the neurosurgeron, may put the patient at risk or may influence the results of the study.
• Simultaneous participation in other clinical studies.
• For whatever reason, the Clinical protocol cannot be followed.
• The patient is unable, or unwilling, to sign the informed consent.
• Patients in emergency situation who are not legally able to participate in the study.