{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T16:46:44Z","timestamp":1788540404313,"version":"build-2803163510"},"reference-count":18,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Spine surgery is complex and involves various steps. Current robotic technology is mostly aimed at assisting with pedicle screw insertion. This report evaluates the feasibility of robot-assisted pedicle instrumentation in an academic environment with the involvement of residents and fellows.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The Renaissance Guidance System was used to plan and execute pedicle screw placement in open and percutaneous consecutive cases performed in the period of December 2015 to December 2016. The database was reviewed to assess the usability of the robot by neurosurgical trainees. Outcome measures included time per screw, fluoroscopy time, breached screws, and other complications. Screw placement was assessed in patients with postoperative CT studies. The speed of screw placement and fluoroscopy time were collected at the time of surgery by personnel affiliated with the robot\u2019s manufacturer. Complication and imaging data were reviewed retrospectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 306 pedicle screws were inserted in 30 patients with robot guidance. The average time for junior residents was 4.4 min\/screw and for senior residents and fellows, 4.02 min\/screw (p = 0.61). Among the residents dedicated to spine surgery, the average speed was 3.84 min\/screw, while nondedicated residents took 4.5 min\/screw (p = 0.41). Evaluation of breached screws revealed some of the pitfalls in using the robot.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>No significant difference regarding the speed of pedicle instrumentation was detected between the operators\u2019 years of experience or dedication to spine surgery, although more participants are required to investigate this completely. On the other hand, there was a trend toward improved efficiency with more cases performed. To the authors\u2019 knowledge, this is the first reported academic experience with robot-assisted spine instrumentation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2017.2.focus175","type":"journal-article","created":{"date-parts":[[2017,5,2]],"date-time":"2017-05-02T15:57:03Z","timestamp":1493740623000},"page":"E4","source":"Crossref","is-referenced-by-count":79,"title":["Initial academic experience and learning curve with robotic spine instrumentation"],"prefix":"10.3171","volume":"42","author":[{"given":"Timur M.","family":"Urakov","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken Hsuan-kan","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Shelby","family":"Burks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Y.","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Orthopedics","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20100625-14","article-title":"Pedicle screw placement in the thoracic spine: a comparison study of computer-assisted navigation and conventional techniques","volume":"33","author":"Han W","year":"2010","unstructured":"Han W, Gao ZL, Wang JC, Li YP, Peng X, Rui J, : Pedicle screw placement in the thoracic spine: a comparison study of computer-assisted navigation and conventional techniques. Orthopedics 33:10.3928\/01477447-20100625-11, 20102070410510.3928\/01477447-20100625-14"},{"key":"b2","series-title":"Eur Spine J","doi-asserted-by":"publisher","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 X","year":"2013","unstructured":"Hu X, Ohnmeiss DD, Lieberman IH: Robotic-assisted pedicle screw placement: lessons learned from the first 102 patients. Eur Spine J 22:661\u2013666, 201310.1007\/s00586-012-2499-122975723"},{"key":"b3","series-title":"Indian J Orthop","doi-asserted-by":"publisher","first-page":"555","DOI":"10.4103\/0019-5413.144216","article-title":"Navigated pedicle screw placement using computed tomographic data in dorsolumbar fractures","volume":"48","author":"Kapoor S","year":"2014","unstructured":"Kapoor S, Sharma R, Garg S, Jindal R, Gupta R, Goe A: Navigated pedicle screw placement using computed tomographic data in dorsolumbar fractures. Indian J Orthop 48:555\u2013561, 20142540476610.4103\/0019-5413.144216"},{"key":"b4","series-title":"Spine J [epub ahead of print]","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20100625-14","article-title":"Biomechanical advantages of robot-assisted pedicle screw fixation in posterior lumbar interbody fusion compared with freehand technique in a prospective randomized controlled trial-perspective for patient-specific finite element analysis","author":"Kim HJ","year":"2016","unstructured":"Kim HJ, Kang KT, Park SC, Kwon OH, Son J, Chang BS, : Biomechanical advantages of robot-assisted pedicle screw fixation in posterior lumbar interbody fusion compared with freehand technique in a prospective randomized controlled trial-perspective for patient-specific finite element analysis. Spine J [epub ahead of print], 201610.3928\/01477447-20100625-14"},{"key":"b5","series-title":"PLoS One","doi-asserted-by":"publisher","first-page":"e0153235","DOI":"10.1371\/journal.pone.0153235","article-title":"Assessing the intraoperative accuracy of pedicle screw placement by using a bone-mounted miniature robot system through secondary registration","volume":"11","author":"Kuo KL","year":"2016","unstructured":"Kuo KL, Su YF, Wu CH, Tsai CY, Chang CH, Lin CL, : Assessing the intraoperative accuracy of pedicle screw placement by using a bone-mounted miniature robot system through secondary registration. PLoS One 11:e0153235, 20162705436010.1371\/journal.pone.0153235"},{"key":"b6","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1007\/s00586-015-3758-8","article-title":"Robot-assisted spine surgery: feasibility study through a prospective case-matched analysis","volume":"25","author":"Lonjon N","year":"2016","unstructured":"Lonjon N, Chan-Seng E, Costalat V, Bonnafoux B, Vassal M, Boetto J: Robot-assisted spine surgery: feasibility study through a prospective case-matched analysis. Eur Spine J 25:947\u2013955, 201610.1007\/s00586-015-3758-825575857"},{"key":"b7","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1007\/s00586-013-2879-1","article-title":"Robot-assisted and fluoroscopy-guided pedicle screw placement: a systematic review","volume":"23","author":"Marcus HJ","year":"2014","unstructured":"Marcus HJ, Cundy TP, Nandi D, Yang GZ, Darzi A: Robot-assisted and fluoroscopy-guided pedicle screw placement: a systematic review. Eur Spine J 23:291\u2013297, 201410.1007\/s00586-013-2879-123801017"},{"key":"b8","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"636","DOI":"10.3171\/2014.3.SPINE13714","article-title":"Safety and accuracy of robot-assisted versus fluoroscopy-guided pedicle screw insertion for degenerative diseases of the lumbar spine: a matched cohort comparison","volume":"20","author":"Schatlo B","year":"2014","unstructured":"Schatlo B, Molliqaj G, Cuvinciuc V, Kotowski M, Schaller K, Tessitore E: Safety and accuracy of robot-assisted versus fluoroscopy-guided pedicle screw insertion for degenerative diseases of the lumbar spine: a matched cohort comparison. J Neurosurg Spine 20:636\u2013643, 20142472518010.3171\/2014.3.SPINE13714"},{"issue":"Suppl 19","key":"b9","series-title":"Spine (Phila Pa 2976)","first-page":"B2","article-title":"Robot-assisted posterior C1\u20132 transarticular screw fixation for atlantoaxial instability: a case report","volume":"41","author":"Tian W","year":"2016","unstructured":"Tian W: Robot-assisted posterior C1\u20132 transarticular screw fixation for atlantoaxial instability: a case report. Spine (Phila Pa 2976) 41 (Suppl 19):B2\u2013B5, 2016"},{"key":"b1","series-title":"Orthopedics","article-title":"Pedicle screw placement in the thoracic spine: a comparison study of computer-assisted navigation and conventional techniques","volume":"33","author":"Han W","year":"2010","unstructured":"Han W, Gao ZL, Wang JC, Li YP, Peng X, Rui J, : Pedicle screw placement in the thoracic spine: a comparison study of computer-assisted navigation and conventional techniques. Orthopedics 33:10.3928\/01477447-20100625-11, 201020704105"},{"key":"b2","series-title":"Eur Spine J","doi-asserted-by":"publisher","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 X","year":"2013","unstructured":"Hu X, Ohnmeiss DD, Lieberman IH: Robotic-assisted pedicle screw placement: lessons learned from the first 102 patients. Eur Spine J 22:661\u2013666, 201310.1007\/s00586-012-2499-122975723"},{"key":"b3","series-title":"Indian J Orthop","doi-asserted-by":"publisher","first-page":"555","DOI":"10.4103\/0019-5413.144216","article-title":"Navigated pedicle screw placement using computed tomographic data in dorsolumbar fractures","volume":"48","author":"Kapoor S","year":"2014","unstructured":"Kapoor S, Sharma R, Garg S, Jindal R, Gupta R, Goe A: Navigated pedicle screw placement using computed tomographic data in dorsolumbar fractures. Indian J Orthop 48:555\u2013561, 20142540476610.4103\/0019-5413.144216"},{"key":"b4","series-title":"Spine J [epub ahead of print]","article-title":"Biomechanical advantages of robot-assisted pedicle screw fixation in posterior lumbar interbody fusion compared with freehand technique in a prospective randomized controlled trial-perspective for patient-specific finite element analysis","author":"Kim HJ","year":"2016","unstructured":"Kim HJ, Kang KT, Park SC, Kwon OH, Son J, Chang BS, : Biomechanical advantages of robot-assisted pedicle screw fixation in posterior lumbar interbody fusion compared with freehand technique in a prospective randomized controlled trial-perspective for patient-specific finite element analysis. Spine J [epub ahead of print], 2016"},{"key":"b5","series-title":"PLoS One","doi-asserted-by":"publisher","first-page":"e0153235","DOI":"10.1371\/journal.pone.0153235","article-title":"Assessing the intraoperative accuracy of pedicle screw placement by using a bone-mounted miniature robot system through secondary registration","volume":"11","author":"Kuo KL","year":"2016","unstructured":"Kuo KL, Su YF, Wu CH, Tsai CY, Chang CH, Lin CL, : Assessing the intraoperative accuracy of pedicle screw placement by using a bone-mounted miniature robot system through secondary registration. PLoS One 11:e0153235, 20162705436010.1371\/journal.pone.0153235"},{"key":"b6","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1007\/s00586-015-3758-8","article-title":"Robot-assisted spine surgery: feasibility study through a prospective case-matched analysis","volume":"25","author":"Lonjon N","year":"2016","unstructured":"Lonjon N, Chan-Seng E, Costalat V, Bonnafoux B, Vassal M, Boetto J: Robot-assisted spine surgery: feasibility study through a prospective case-matched analysis. Eur Spine J 25:947\u2013955, 201610.1007\/s00586-015-3758-825575857"},{"key":"b7","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1007\/s00586-013-2879-1","article-title":"Robot-assisted and fluoroscopy-guided pedicle screw placement: a systematic review","volume":"23","author":"Marcus HJ","year":"2014","unstructured":"Marcus HJ, Cundy TP, Nandi D, Yang GZ, Darzi A: Robot-assisted and fluoroscopy-guided pedicle screw placement: a systematic review. Eur Spine J 23:291\u2013297, 201410.1007\/s00586-013-2879-123801017"},{"key":"b8","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"636","DOI":"10.3171\/2014.3.SPINE13714","article-title":"Safety and accuracy of robot-assisted versus fluoroscopy-guided pedicle screw insertion for degenerative diseases of the lumbar spine: a matched cohort comparison","volume":"20","author":"Schatlo B","year":"2014","unstructured":"Schatlo B, Molliqaj G, Cuvinciuc V, Kotowski M, Schaller K, Tessitore E: Safety and accuracy of robot-assisted versus fluoroscopy-guided pedicle screw insertion for degenerative diseases of the lumbar spine: a matched cohort comparison. J Neurosurg Spine 20:636\u2013643, 20142472518010.3171\/2014.3.SPINE13714"},{"issue":"Suppl 19","key":"b9","series-title":"Spine (Phila Pa 2976)","first-page":"B2","article-title":"Robot-assisted posterior C1\u20132 transarticular screw fixation for atlantoaxial instability: a case report","volume":"41","author":"Tian W","year":"2016","unstructured":"Tian W: Robot-assisted posterior C1\u20132 transarticular screw fixation for atlantoaxial instability: a case report. Spine (Phila Pa 2976) 41 (Suppl 19):B2\u2013B5, 2016"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/42\/5\/article-pE4.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/42\/5\/article-pE4.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/42\/5\/article-pE4.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T08:20:48Z","timestamp":1780734048000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/42\/5\/article-pE4.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5]]},"references-count":18,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2017.2.focus175","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5]]}}}