Cirq robotic arm-assisted transpedicular instrumentation with intraoperative navigation: technical note and case series with 714 thoracolumbar screws


doi: 10.1007/s11701-021-01313-5.


Online ahead of print.

Affiliations

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Kelsi Chesney et al.


J Robot Surg.


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Abstract

The Cirq is a surgeon-controlled robotic arm that provides a new technique for accurately placing transpedicular screws. This report aims to present a technical report and our experience with this new robotic arm combined with intraoperative navigation. Technique and workflow using the Cirq robotic arm with intraoperative navigation is described. A retrospective review was conducted of all patients undergoing elective open thoracic/lumbar fusion surgery by a single surgeon in the first year of using the novel Cirq robotic arm. Descriptive analysis of patient and operative variables was performed. A total of 84 patients underwent placement of a total 714 transpedicular screws using the Cirq robotic arm. Most (69.1%) underwent 3-6 level fusion procedures. Mean operative time was 198 min total and 28 min when adjusted per screw. There was a learning curve with operative time per screw decreasing from 32 to 25 min from the first to second half of cases (p = 0.057). There were no intraoperative screw revisions and 2.4% (2/84) required instrumentation revision and return to the operating room. The Cirq robotic arm is seamlessly incorporated into the workflow of a transpedicular fusion. Our experience with over 700 pedicle screw placements using the Cirq robot demonstrates efficacy and safety although further comparative studies are needed.


Keywords:

Fusion; Intraoperative navigation; Lumbar; Pedicle screw; Robotic surgery; Thoracic.

References

    1. Martin BI, Mirza SK, Spina N, et al (2019) Trends in Lumbar Fusion Procedure Rates and Associated Hospital Costs for Degenerative Spinal Diseases in the United States, 2004 to 2015. Spine (Phila Pa 1976) 44:369–376. https://doi.org/10.1097/BRS.0000000000002822

    1. Perdomo-Pantoja A, Ishida W, Zygourakis C et al (2019) Accuracy of current techniques for placement of pedicle screws in the spine: a comprehensive systematic review and meta-analysis of 51,161 screws. World Neurosurg 126:664-678.e3. https://doi.org/10.1016/j.wneu.2019.02.217



      DOI



      PubMed

    1. Jacob C, Annoni E, Haas JS et al (2016) Burden of disease of reoperations in instrumental spinal surgeries in Germany. Eur Spine J 25:807–813. https://doi.org/10.1007/s00586-015-4073-0



      DOI



      PubMed

    1. Krieg SM, Meyer B (2018) First experience with the jump-starting robotic assistance device Cirq. Neurosurg Focus 45:V3. https://doi.org/10.3171/2018.7.FocusVid.18108



      DOI



      PubMed

    1. Farah K, Meyer M, Prost S, et al (2020) Cirq® Robotic Assistance for Minimally Invasive C1-C2 Posterior Instrumentation: report on Feasibility and Safety. Oper Neurosurg (Hagerstown) opaa208. https://doi.org/10.1093/ons/opaa208

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