{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:06:52Z","timestamp":1790892412343,"version":"4.1.0"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2019,2,7]],"date-time":"2019-02-07T00:00:00Z","timestamp":1549497600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Minimally invasive surgery (MIS) and anterior (ALIF), transforaminal (TLIF), or lateral lumbar interbody fusion (LLIF) often require percutaneous pedicle screw fixation (PSF) to achieve circumferential fusion. Robotic guidance technology may augment workflow to improve screw placement and decrease operative time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To report surgical experience with robotically assisted percutaneous screw placement following LLIF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Data from fusions with robotically assisted PSF in prone or lateral decubitus positions was reviewed. A CT-guided robotic guidance arm was used for screw placement (Excelsius GPS\u2122, Globus Medical Inc, Audubon, Pennsylvania). Postoperative CT imaging facilitated screw localization. 3-dimensional and 2-dimensional coordinates of the screw tip and tail were calculated and compared with a target trajectory to calculate targeting errors. Breach was defined as a violation of the lateral or medial pedicle wall.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Robotic-guided screw placement was successful in 28\/31 patients. In those patients, 116\/116 screws were successfully implanted. The breach rate was 3.4% (4\/116). Across 17 patients (70 screws), mean 3-D accuracy was 5.0\u00a0\u00b1\u00a02.4 mm, mean 2-D accuracy was 2.6\u00a0\u00b1\u00a01.1 mm, and mean angular offset was 5.6\u00a0\u00b1\u00a04.3\u00b0 with corresponding intraclass correlation coefficients (ICC) of 0.775 and 0.693. 3-dimensional accuracy correlated with age (R\u00a0=\u00a00.306,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.011) and BMI (R\u00a0=\u00a00.252,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.038). Accuracy did not significantly differ among vertebral body levels (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&gt;\u00a0.22). Mean operative time for MIS-TLIF and percutaneous screws was 277\u00a0\u00b1\u00a052 and 183\u00a0\u00b1\u00a054 min, respectively. Operative time did not significantly decrease across either group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&gt;\u00a0.187).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>The Excelsius GPS\u2122 robotic guidance system allows accurate PSF in most cases with 2 mm 2-D accuracy. Future studies are needed to demonstrate the utility of this novel guidance system and workflow improvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opy413","type":"journal-article","created":{"date-parts":[[2019,2,6]],"date-time":"2019-02-06T21:00:39Z","timestamp":1549486839000},"page":"389-395","source":"Crossref","is-referenced-by-count":67,"title":["A Quantitative Assessment of the Accuracy and Reliability of Robotically Guided Percutaneous Pedicle Screw Placement: Technique and Application Accuracy"],"prefix":"10.1227","volume":"17","author":[{"given":"Jakub","family":"Godzik","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corey T","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cory","family":"Hartman","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo","family":"de Andrada","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clinton D","family":"Morgan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Mastorakos","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Turner","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall W","family":"Porter","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Snyder","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Uribe","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,10]]},"reference":[{"issue":"5","key":"bib1-20231017","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1097\/BSD.0b013e318218a5ef","article-title":"Assessment of pedicle screw placement accuracy, procedure time, and radiation exposure using a miniature robotic guidance system","volume":"25","author":"Lieberman","year":"2012","journal-title":"J Spinal Disord Tech"},{"issue":"3S","key":"bib2-20231017","doi-asserted-by":"crossref","first-page":"S86","DOI":"10.1093\/neuros\/nyw077","article-title":"Navigation and robotics in spinal surgery: Where are we 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Assess."},{"issue":"6","key":"bib9-20231017","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1097\/BRS.0000000000001778","article-title":"Minimally invasive robotic versus open fluoroscopic-guided spinal instrumented fusions","volume":"42","author":"Hyun","year":"2017","journal-title":"Spine (Phila Pa 1976)"},{"issue":"3","key":"bib10-20231017","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1007\/s00586-012-2499-1","article-title":"Robotic-assisted pedicle screw placement: lessons learned from the first 102 patients","volume":"22","author":"Hu","year":"2013","journal-title":"Eur Spine J"},{"key":"bib11-20231017","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1007\/978-3-211-99651-5_38","article-title":"Robotic technology in spine surgery: current applications and future developments","volume":"109","author":"Stuer","year":"2011","journal-title":"Acta Neurochir. Suppl"},{"issue":"16","key":"bib12-20231017","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1001\/jama.2017.14586","article-title":"Association of robotic-assisted vs laparoscopic radical nephrectomy with perioperative outcomes and health care costs, 2003 to 2015","volume":"318","author":"Jeong","year":"2017","journal-title":"JAMA"}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opy413","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:45:10Z","timestamp":1786121110000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opy413"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,6]]},"references-count":12,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opy413","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,6]]}}}