The aim of this study was to assess the accuracy of pedicle screw placement, as well as intraoperative factors, radiation exposure, and complication rates in adult patients with degenerative disorders of the thoracic and lumbar spines who have undergone robotic-navigated spinal surgery using a contemporary system. The authors reviewed the prospectively collected data on 196 adult patients who had pedicle screws implanted with robot-navigated assistance (RNA) using the Mazor X Stealth system between June 2019 and March 2022. Pedicle screws were implanted by one experienced spinal surgeon after completion of a learning period. The accuracy of pedicle screw placement was determined using intraoperative 3D fluoroscopy.Aims
Methods
Introduction. We prospectively examined the effect of pedicle screw placement at a young age (<5 years) for early-onset spinal deformity on the growth and development of pedicles and the spinal canal. Methods. Patients with early-onset deformity who received pedicle screw placement before the age of 5 years and had preoperative and final follow-up axial imaging were included. To increase sample size, patients who had the same criteria but with no preoperative axial images were also included. Anteroposterior and transverse diameters of the canal and pedicle length were measured on axial images cutting through the middle of the pedicle (figures 1 and 2). Results. 13 patients (five male, eight female) met inclusion criteria. Average age at surgery was 46·6 months (29–60), and average follow-up 49·8 months (24–82). 77 instrumented and 32 non-instrumented levels were studied. The table summarises measurements. In the nine patients without preoperative axial imaging, pedicle lengths and canal diameters seemed to accord with previously published normative morphological data for this age group. Conclusions. Animal studies have shown the potential slowing of pedicle and canal growth in immature spines with pedicle screws. This is the first study to examine the behaviour of instrumented immature human vertebrae prospectively. Early application of pedicle screws does not seem to cause adverse effects on pedicle and canal growth in young patients. This discordance between human and animal studies may have three explanations: (1) although the neurocentral cartilage is still visible it may not be physiologically active in this age group; (2) a
