{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T15:42:11Z","timestamp":1791042131447,"version":"4.1.0"},"reference-count":13,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T00:00:00Z","timestamp":1657584000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>(1) Background: Robotics coupled with navigation (RAN) is a modern surgical platform shown to increase screw placement accuracy during pediatric scoliosis surgery. Our institution uses a technique which combines the RAN platform for apical pedicle screw placement and the freehand (FH) technique for terminal pedicle screw placement during scoliosis surgery (termed hybrid technique). We question if the complementary use of the RAN technology affects intraoperative outcomes, relative to the FH-only approach. (2) Methods: 60 adolescent idiopathic scoliosis (AIS) patients, ages 11\u201319 at surgery, who were operated on from 2019 through 2020 by a single surgeon, were retrospectively reviewed. Patients were separated by surgery type (hybrid RAN or FH), matched on demographic and surgical factors, and their intraoperative outcomes were compared statistically. (3) Results: Hybrid RAN patients had more screws placed (p = 0.01) and were of a higher BMI percentile (p = 0.005). Controlling for the number of screws placed, BMI%, and initial curve magnitude, there were no statistical differences in estimated blood loss per screw (p = 0.51), curve correction (p = 0.69), complications (p = 0.52), or fluoroscopy time (p = 0.88), between groups. However, operative time was two minutes longer per screw for hybrid RAN patients (p &lt; 0.001). (4) Conclusions: Hybrid RAN surgeries took longer than FH, but yielded comparable effectiveness and safety as the FH technique during the initial RAN adoption phase.<\/jats:p>","DOI":"10.3390\/s22145204","type":"journal-article","created":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T23:02:01Z","timestamp":1657666921000},"page":"5204","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Pedicle Screw Placement in Adolescent Idiopathic Scoliosis: A Comparison between Robotics Coupled with Navigation versus the Freehand Technique"],"prefix":"10.3390","volume":"22","author":[{"given":"Gabriel S.","family":"Linden","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Boston Children\u2019s Hospital, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Semhal","family":"Ghessese","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Boston Children\u2019s Hospital, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Boston Children\u2019s Hospital, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Hedequist","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Boston Children\u2019s Hospital, Boston, MA 02115, USA"},{"name":"Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.2106\/JBJS.J.00678","article-title":"Pediatric pedicle screws: Comparative effectiveness and safety: A systematic literature review from the Scoliosis Research Society and the Pediatric Orthopaedic Society of North America task force","volume":"93","author":"Ledonio","year":"2011","journal-title":"J. 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Tech."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1097\/BSD.0b013e31825bfecd","article-title":"Pedicle screws adjacent to the great vessels or viscera: A study of 2132 pedicle screws in pediatric spine deformity","volume":"27","author":"Sarwahi","year":"2014","journal-title":"J. Spinal Disord. Tech."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"110","DOI":"10.21037\/jss.2018.12.09","article-title":"Instrumentation complication rates following spine surgery: A report from the Scoliosis Research Society (SRS) morbidity and mortality database","volume":"5","author":"Shillingford","year":"2019","journal-title":"J. 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Orthop."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2109","DOI":"10.1097\/BRS.0b013e3181d323ab","article-title":"Clinical acceptance and accuracy assessment of spinal implants guided with SpineAssist surgical robot: Retrospective study","volume":"35","author":"Devito","year":"2010","journal-title":"Spine"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1007\/s11701-020-01159-3","article-title":"Initial intraoperative experience with robotic-assisted pedicle screw placement with stealth navigation in pediatric spine deformity: An evaluation of the first 40 cases","volume":"15","author":"Gonzalez","year":"2020","journal-title":"J. Robot. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.jspd.2018.05.009","article-title":"Major Complications at Two Years After Surgery Impact SRS Scores for Adolescent Idiopathic Scoliosis Patients","volume":"7","author":"Bastrom","year":"2019","journal-title":"Spine Deform."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1097\/01.BRS.0000092216.16155.33","article-title":"The Lenke classification of adolescent idiopathic scoliosis: How it organized curve patterns as a template to perform selective fusions of the spine","volume":"28","author":"Lenke","year":"2003","journal-title":"Spine"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/j.jspd.2018.11.012","article-title":"Intraoperative Computed Tomography-Guided Navigation for Pediatric Spine Patients Reduced Return to Operating Room for Screw Malposition Compared With Freehand\/Fluoroscopic Techniques","volume":"7","author":"Baky","year":"2019","journal-title":"Spine Deform."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"88","DOI":"10.14245\/ns.2040060.030","article-title":"Robotic Spine Surgery and Augmented Reality Systems: A State of the Art","volume":"17","author":"Ambrosio","year":"2020","journal-title":"Neurospine"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/22\/14\/5204\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:48:38Z","timestamp":1760140118000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/22\/14\/5204"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,12]]},"references-count":13,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["s22145204"],"URL":"https:\/\/doi.org\/10.3390\/s22145204","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,12]]}}}