What if the vertebral deformity is difficult to operate on?

 

Recently, Dr. Wang Boyao and his team of the Second Affiliated Hospital of Nanjing Medical University successfully completed a complex percutaneous vertebroplasty for thoracic and lumbar compression fractures with the assistance of Perlove Medical’s orthopedic surgical robot. Dr Wang gave feedback:

1．The use of the robot effectively shortens the operation time: this is a complex operation for double vertebral fracture, which takes at least twice as long to do with bare hands, but with the assistance of the orthopedic surgery robot, the operation is completed within one hour.

2．Single puncture with the robot has high success rate: the orthopedic surgery robot is the best choice for complex surgeries. This kind of complex surgery is time-consuming and labor-intensive with high risk, but the orthopedic surgery robot can complete the puncture at one time after positioning, saving time and effort, and meanwhile the precise positioning improves the safety of the surgery.

3．Robot-assisted vertebroplasty is effective: for simple operations, many surgeons may feel that robots are overqualified, but in fact, robot-assisted injection of bone cement in orthopedic surgery is better diffused and will lead to better recovery.

01 Preoperative Overview and Examination

Patient's age: 60 years old

Patient's gender: female

Patient's condition: low back pain caused by trauma for 1 day

Preoperative examination: T12, L4 compression fracture

▲Preoperative images

Difficulties in this surgery

❖ The diseased vertebrae were far apart, with a total of 5 vertebrae from T12 to L4.

❖ The patient had degenerative changes in the lumbar spine, with scoliosis and vertebral rotation, significant spinal deformity, and the angle of the pedicle completely deviated from the normal anatomical position.

Advantages of using surgical robot to position

Dr Wang and his team studied the patient's medical history and imaging findings several times and concluded that performing bare-handed percutaneous vertebroplasty was difficult, time-consuming and labor-intensive, with significant intraoperative discomfort and poor cooperation of the patient. To better alleviate the patient's pain, they finally decided to perform orthopedic surgery robot-assisted percutaneous vertebroplasty on the patient to shorten bedridden time and reduce complications.

02 Robot-assisted thoracolumbar spine compression fracture surgery

Based on the 3D images of thoracic and lumbar lesions collected by Perlove Medical’s 3D C-arm, surgery path planning is performed on the robot navigation interface to automatically guide the K-wire into the location of the set lesion and the entry direction.

▲Robot Planning Image

The lesions that require repeated fluoroscopic comparison and localization can be precisely targeted for entry at once by the robot's intelligent algorithm. After all the K-wires are implanted, the pedicle of vertebral arch and vertebral body are cannulated in the direction of the K-wires to establish a channel along which the bone cement is injected to restore the height of the vertebral body and to observe its diffusion, and the injection of bone cement is stopped when satisfactory results are achieved.

▲Intraoperative images

The operation was successfully completed with small incisions and less bleeding. The damage to the back muscles, the incidence of postoperative pain, traumatic stress and long-term chronic pain in the lower back was effectively reduced. The number of X-ray exposures was also significantly reduced, which takes care of the health of surgeons and patients.

▲Postoperative images

▲ Minimal invasion

The postoperative examination showed that screw implantation was accurate, the vertebral body height was well restored, and the lower limb sensorimotor is good. On the second day after surgery, under the guidance of medical care, the  patient could turn over independently, and move early under the protection of waist. The degree of pain was significantly reduced, and the activity was significantly improved compared with before surgery.

The devoted 2 decades, a concerted future

Integrated Solution "3D C-arm + Orthopedic Surgical Robot"

Perlove Medical is the first manufacturer in China that combines intraoperative 3D imaging C-arm and spine surgical navigation system. With the self-adaptive calibration, it can realize automatic calibration and registration without manual intervention and the accuracy is not affected by image quality. System compatibility is stronger, information matching is more accurate, and the calibration process is more convenient. Technology contributes health so that orthopedic surgery has more precision.

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