{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:18:47Z","timestamp":1772165927006,"version":"3.50.1"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Surg"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Spinal trauma patients treated in a specialized hybrid operating room (OR) using two robotic systems communicating during surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective review of patients with thoracolumbar or sacral fractures who underwent surgical fixation between Jan 2017 to Jan 2020 with robotic-guided percutaneous pedicle screw insertion in the specialized hybrid OR with Robotic flat panel 3D C-arm (ArtisZeego) for intraoperative interventional imaging connected with the robotic-guidance platform Renaissance (Mazor Robotics).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty eight surgeries were performed in 27 patients; 23 with traumatic spinal fractures, 4 with multi-level thoracolumbar compression fractures due to severe osteoporosis. Average patient age 49 (range 12\u201386). Average radiation exposure time 40\u00a0s (range 12\u2013114\u00a0s). Average radiation exposure dose 11,584\u2009\u00b1\u2009SD uGym\n                      <jats:sup>2<\/jats:sup>\n                      (range 4454\u201358,959). Lumber levels operated on were between T5 and S2 (shortest three vertebras and longest eight vertebras). 235 (range 5\u201311) trajectories were performed. All trajectories were accurate in all cases percutaneous pedicle screws placement was correct, without breach noted at the pedicle in any of the cases. No major complications reported. In all cases, follow-up X-rays showed adequate fracture reduction with restoration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Merging of surgical robotics technologies increases patient safety and surgeon and patient confidence in percutaneous spine traumatic procedures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12893-022-01546-7","type":"journal-article","created":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T06:40:02Z","timestamp":1648795202000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["When giants talk; robotic dialog during thoracolumbar and sacral surgery"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0238-6248","authenticated-orcid":false,"given":"Josh E.","family":"Schroeder","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saadit","family":"Houri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoram A.","family":"Weil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meir","family":"Liebergall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rami","family":"Moshioff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leon","family":"Kaplan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,4,1]]},"reference":[{"key":"1546_CR1","first-page":"7","volume":"97","author":"KT Foley","year":"2002","unstructured":"Foley KT, Gupta SK. Percutaneous pedicle screw fixation of the lumbar spine: preliminary clinical results. J Neurosurg: Spine. 2002;97:7\u201312.","journal-title":"J Neurosurg: Spine"},{"key":"1546_CR2","doi-asserted-by":"publisher","first-page":"193","DOI":"10.21037\/jss.2017.06.05","volume":"3","author":"MJ Winder","year":"2017","unstructured":"Winder MJ, Gilhooly PM. Accuracy of minimally invasive percutaneous thoracolumbar pedicle screws using 2D fluoroscopy: a retrospective review through 3D CT analysis. J Spine Surg. 2017;3:193\u2013203. https:\/\/doi.org\/10.21037\/jss.2017.06.05.","journal-title":"J Spine Surg"},{"key":"1546_CR3","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1007\/s00586-009-1258-4","volume":"19","author":"R Verma","year":"2010","unstructured":"Verma R, Krishan S, Haendlmayer K, Mohsen A. Functional outcome of computer-assisted spinal pedicle screw placement: a systematic review and meta-analysis of 23 studies including 5,992 pedicle screws. Eur Spine J. 2010;19:370\u20135. https:\/\/doi.org\/10.1007\/s00586-009-1258-4.","journal-title":"Eur Spine J"},{"key":"1546_CR4","doi-asserted-by":"publisher","first-page":"E111","DOI":"10.1097\/01.brs.0000254048.79024.8b","volume":"32","author":"V Kosmopoulos","year":"2007","unstructured":"Kosmopoulos V, Schizas C. Pedicle screw placement accuracy: a meta-analysis. Spine. 2007;32:E111\u201320. https:\/\/doi.org\/10.1097\/01.brs.0000254048.79024.8b.","journal-title":"Spine"},{"key":"1546_CR5","doi-asserted-by":"publisher","first-page":"196","DOI":"10.3171\/2013.11.SPINE13413","volume":"20","author":"A Mason","year":"2014","unstructured":"Mason A, Paulsen R, Babuska JM, Rajpal S, Burneikiene S, Nelson EL, et al. The accuracy of pedicle screw placement using intraoperative image guidance systems. J Neurosurg Spine. 2014;20:196\u2013203. https:\/\/doi.org\/10.3171\/2013.11.SPINE13413.","journal-title":"J Neurosurg Spine"},{"key":"1546_CR6","doi-asserted-by":"publisher","DOI":"10.1177\/2192568220927713","author":"AM Tarawneh","year":"2020","unstructured":"Tarawneh AM, Salem KM. A systematic review and meta-analysis of randomized controlled trials comparing the accuracy and clinical outcome of pedicle screw placement using robot-assisted technology and conventional freehand technique. Glob Spine J. 2020. https:\/\/doi.org\/10.1177\/2192568220927713.","journal-title":"Glob Spine J"},{"key":"1546_CR7","doi-asserted-by":"publisher","first-page":"E12","DOI":"10.3171\/2017.3.FOCUS16534","volume":"42","author":"ML Schr\u00f6der","year":"2017","unstructured":"Schr\u00f6der ML, Staartjes VE. Revisions for screw malposition and clinical outcomes after robot-guided lumbar fusion for spondylolisthesis. Neurosurg Focus. 2017;42:E12. https:\/\/doi.org\/10.3171\/2017.3.FOCUS16534.","journal-title":"Neurosurg Focus"},{"key":"1546_CR8","doi-asserted-by":"publisher","first-page":"E13","DOI":"10.3171\/2017.3.FOCUS1710","volume":"42","author":"V Solomiichuk","year":"2017","unstructured":"Solomiichuk V, Fleischhammer J, Molliqaj G, Warda J, Alaid A, von Eckardstein K, et al. Robotic versus fluoroscopy-guided pedicle screw insertion for metastatic spinal disease: a matched-cohort comparison. Neurosurg Focus. 2017;42:E13. https:\/\/doi.org\/10.3171\/2017.3.FOCUS1710.","journal-title":"Neurosurg Focus"},{"key":"1546_CR9","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1097\/BRS.0b013e3181cbfd09","volume":"36","author":"B Ravi","year":"2011","unstructured":"Ravi B, Zahrai A, Rampersaud R. Clinical accuracy of computer-assisted two-dimensional fluoroscopy for the percutaneous placement of lumbosacral pedicle screws. Spine. 2011;36:84\u201391. https:\/\/doi.org\/10.1097\/BRS.0b013e3181cbfd09.","journal-title":"Spine"},{"key":"1546_CR10","doi-asserted-by":"publisher","first-page":"2109","DOI":"10.1097\/BRS.0b013e3181d323ab","volume":"35","author":"DP Devito","year":"2010","unstructured":"Devito DP, Kaplan L, Dietl R, Pfeiffer M, Horne D, Silberstein B, et al. Clinical acceptance and accuracy assessment of spinal implants guided with SpineAssist surgical robot: retrospective study. Spine. 2010;35:2109\u201315. https:\/\/doi.org\/10.1097\/BRS.0b013e3181d323ab.","journal-title":"Spine"},{"key":"1546_CR11","doi-asserted-by":"publisher","first-page":"151","DOI":"10.3109\/10929080500229744","volume":"10","author":"U-W Thomale","year":"2005","unstructured":"Thomale U-W, Kneissler M, Hein A, Maetzig M, Kroppenstedt S-N, Lueth T, et al. A spine frame for intra-operative fixation to increase accuracy in spinal navigation and robotics. Comput Aided Surg. 2005;10:151\u20135. https:\/\/doi.org\/10.3109\/10929080500229744.","journal-title":"Comput Aided Surg"},{"key":"1546_CR12","doi-asserted-by":"publisher","first-page":"E373","DOI":"10.1097\/BRS.0000000000002449","volume":"43","author":"PA Laudato","year":"2018","unstructured":"Laudato PA, Pierzchala K, Schizas C. Pedicle screw insertion accuracy using O-arm, robotic guidance, or freehand technique: a comparative study. Spine. 2018;43:E373\u20138. https:\/\/doi.org\/10.1097\/BRS.0000000000002449.","journal-title":"Spine"},{"issue":"5","key":"1546_CR13","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1109\/TRA.2003.817075","volume":"19","author":"M Shoham","year":"2003","unstructured":"Shoham M, Burman M, Zehavi E. Bone-mounted miniature robot for surgical procedures: concept and clinical applications. IEEE Trans Robot Autom. 2003;19(5):893\u2013901.","journal-title":"IEEE Trans Robot Autom"},{"key":"1546_CR14","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1002\/rcs.1718","volume":"12","author":"M Kraus","year":"2016","unstructured":"Kraus M, Fischer E, Gebhard F, Richter PH. Image quality and effective dose of a robotic flat panel 3D C-arm vs computed tomography. Int J Med Robot. 2016;12:743\u201350. https:\/\/doi.org\/10.1002\/rcs.1718.","journal-title":"Int J Med Robot"},{"key":"1546_CR15","doi-asserted-by":"publisher","first-page":"144","DOI":"10.3171\/2010.3.SPINE09369","volume":"13","author":"R Nasser","year":"2010","unstructured":"Nasser R, Yadla S, Maltenfort MG, Harrop JS, Anderson DG, Vaccaro AR, et al. Complications in spine surgery. J Neurosurg Spine. 2010;13:144\u201357. https:\/\/doi.org\/10.3171\/2010.3.SPINE09369.","journal-title":"J Neurosurg Spine"},{"key":"1546_CR16","doi-asserted-by":"publisher","first-page":"990","DOI":"10.1007\/s00586-015-3853-x","volume":"24","author":"AA Aoude","year":"2015","unstructured":"Aoude AA, Fortin M, Figueiredo R, Jarzem P, Ouellet J, Weber MH. Methods to determine pedicle screw placement accuracy in spine surgery: a systematic review. Eur Spine J. 2015;24:990\u20131004. https:\/\/doi.org\/10.1007\/s00586-015-3853-x.","journal-title":"Eur Spine J"},{"key":"1546_CR17","doi-asserted-by":"publisher","first-page":"E11","DOI":"10.3171\/2017.2.FOCUS16552","volume":"42","author":"N Keric","year":"2017","unstructured":"Keric N, Doenitz C, Haj A, Rachwal-Czyzewicz I, Renovanz M, Wesp DMA, et al. Evaluation of robot-guided minimally invasive implantation of 2067 pedicle screws. Neurosurg Focus. 2017;42:E11. https:\/\/doi.org\/10.3171\/2017.2.FOCUS16552.","journal-title":"Neurosurg Focus"},{"issue":"353","key":"1546_CR18","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1097\/BRS.0000000000001778","volume":"42","author":"S-J Hyun","year":"2017","unstructured":"Hyun S-J, Kim K-J, Jahng T-A, Kim H-J. minimally invasive robotic versus open fluoroscopic-guided spinal instrumented fusions: a randomized controlled trial. Spine. 2017;42(353):358. https:\/\/doi.org\/10.1097\/BRS.0000000000001778.","journal-title":"Spine"},{"key":"1546_CR19","doi-asserted-by":"publisher","first-page":"E4","DOI":"10.3171\/2017.2.FOCUS175","volume":"42","author":"TM Urakov","year":"2017","unstructured":"Urakov TM, Chang KH-K, Burks SS, Wang MY. Initial academic experience and learning curve with robotic spine instrumentation. Neurosurg Focus. 2017;42:E4. https:\/\/doi.org\/10.3171\/2017.2.FOCUS175.","journal-title":"Neurosurg Focus"},{"key":"1546_CR20","doi-asserted-by":"publisher","DOI":"10.1002\/rcs.1779","author":"H-J Kim","year":"2017","unstructured":"Kim H-J, Jung W-I, Chang B-S, Lee C-K, Kang K-T, Yeom JS. A prospective, randomized, controlled trial of robot-assisted vs freehand pedicle screw fixation in spine surgery. Int J Med Robot. 2017. https:\/\/doi.org\/10.1002\/rcs.1779.","journal-title":"Int J Med Robot"},{"key":"1546_CR21","doi-asserted-by":"publisher","first-page":"E496","DOI":"10.1097\/BRS.0b013e31824b7767","volume":"37","author":"F Ringel","year":"2012","unstructured":"Ringel F, St\u00fcer C, Reinke A, Preuss A, Behr M, Auer F, et al. Accuracy of robot-assisted placement of lumbar and sacral pedicle screws: a prospective randomized comparison to conventional freehand screw implantation. Spine. 2012;37:E496-501. https:\/\/doi.org\/10.1097\/BRS.0b013e31824b7767.","journal-title":"Spine"},{"key":"1546_CR22","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.11.190","author":"A Khan","year":"2018","unstructured":"Khan A, Meyers JE, Yavorek S, O\u2019Connor TE, Siasios I, Mullin JP, et al. Comparing next-generation robotic technology with three-dimensional computed tomography navigation technology for the insertion of posterior pedicle screws. World Neurosurg. 2018. https:\/\/doi.org\/10.1016\/j.wneu.2018.11.190.","journal-title":"World Neurosurg"},{"key":"1546_CR23","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2020.05.246","author":"CR Good","year":"2020","unstructured":"Good CR, Schroerlucke SR, Cannestra AF, Hsu VW, et al. Complications and revision rates in minimally invasive Mazor robotic-guided vs fluoroscopic-guided spinal fusions: the MIS ReFRESH prospective comparative study. Spine J. 2020. https:\/\/doi.org\/10.1016\/j.spinee.2020.05.246.","journal-title":"Spine J"},{"key":"1546_CR24","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-030389","volume":"9","author":"VE Staartjes","year":"2019","unstructured":"Staartjes VE, Molliqaj G, van Kampen PM, Eversdijk HAJ, Amelot A, Bettag C, et al. The European Robotic Spinal Instrumentation (EUROSPIN) study: protocol for a multicentre prospective observational study of pedicle screw revision surgery after robot-guided, navigated and freehand thoracolumbar spinal fusion. BMJ Open. 2019;9: e030389. https:\/\/doi.org\/10.1136\/bmjopen-2019-030389.","journal-title":"BMJ Open"},{"key":"1546_CR25","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1002\/rcs.90","volume":"2","author":"Y Barzilay","year":"2006","unstructured":"Barzilay Y, Liebergall M, Fridlander A, Knoller N. Miniature robotic guidance for spine surgery\u2014introduction of a novel system and analysis of challenges encountered during the clinical development phase at two spine centres. Int J Med Robot. 2006;2:146\u201353. https:\/\/doi.org\/10.1002\/rcs.90.","journal-title":"Int J Med Robot"},{"key":"1546_CR26","doi-asserted-by":"publisher","first-page":"1839","DOI":"10.1007\/s11999-013-3291-1","volume":"472","author":"X Hu","year":"2014","unstructured":"Hu X, Lieberman IH. What is the learning curve for robotic-assisted pedicle screw placement in spine surgery? Clin Orthop Relat Res. 2014;472:1839\u201344. https:\/\/doi.org\/10.1007\/s11999-013-3291-1.","journal-title":"Clin Orthop Relat Res"},{"key":"1546_CR27","doi-asserted-by":"publisher","first-page":"S129","DOI":"10.1016\/S0020-1383(15)30032-2","volume":"46","author":"PH Richter","year":"2015","unstructured":"Richter PH, Yarboro S, Kraus M, Gebhard F. One year orthopaedic trauma experience using an advanced interdisciplinary hybrid operating room. Injury. 2015;46:S129\u201334. https:\/\/doi.org\/10.1016\/S0020-1383(15)30032-2.","journal-title":"Injury"},{"key":"1546_CR28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11548-018-1747-1","volume":"13","author":"K Schuetze","year":"2018","unstructured":"Schuetze K, Kraus M, Eickhoff A, Gebhard F, Richter PH. Radiation exposure for intraoperative 3D scans in a hybrid operating room: how to reduce radiation exposure for the surgical team. Int J Comput Assist Radiol Surg. 2018;13:1\u201310. https:\/\/doi.org\/10.1007\/s11548-018-1747-1.","journal-title":"Int J Comput Assist Radiol Surg"},{"key":"1546_CR29","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000100","author":"Y Barzilay","year":"2013","unstructured":"Barzilay Y, Schroeder J, Hiller N, Singer G, Hasharoni A, Safran O, et al. Robotic assisted vertebral body augmentation: a radiation reduction tool. Spine. 2013. https:\/\/doi.org\/10.1097\/BRS.0000000000000100.","journal-title":"Spine"}],"container-title":["BMC Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-022-01546-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12893-022-01546-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-022-01546-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T09:38:12Z","timestamp":1648805892000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcsurg.biomedcentral.com\/articles\/10.1186\/s12893-022-01546-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,1]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["1546"],"URL":"https:\/\/doi.org\/10.1186\/s12893-022-01546-7","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-728215\/v1","asserted-by":"object"}]},"ISSN":["1471-2482"],"issn-type":[{"value":"1471-2482","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,1]]},"assertion":[{"value":"31 May 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 March 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 April 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved for the Hadassah Medical Center Ethics committee. All patients consented in witting to participate in the study in minors parents or legal guardians approved to participate.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"125"}}