【ClinicalCase】Robot-assisted Percutaneous Kyphoplasty to Get Rid of Illness for an Octogenarian!

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Recently, with close cooperation of team members, the Second Affiliated Hospital of Nanjing Medical University successfully performed minimally invasive spine surgery on an 81-year-old female patient with thoracic spine (T12) compression fracture with the assistance of the orthopedic surgery robot produced by Perlove Medical. Dr. Wang Boyao exclaimed, “The precise positioning of thoracic spine fractures is a crucial factor affecting the surgical outcome. Traditional surgery requires the doctor’s extensive surgical experience, but with the assistance of robotic navigation, we can control the error to less than 0.7 mm, making the surgery more precise and efficient.”

❖ Patient Information

Case Name: Robot-assisted percutaneous kyphoplasty.

Operation Unit: The Second Affiliated Hospital of Nanjing Medical University.

Patient’s Age: 81 years old.

Admission Diagnosis: Thoracic Compression Fracture (T12) (primary diagnosis); Lumbar Spondylolisthesis; Cerebral Infarction; Stage 1 Hypertension; Diabetes.

* Preoperative images of the patient

Through detailed communication with the patient, Dr. Wang Boyao led his medical team to evaluate the safety of vertebroplasty in treating ultra-high-age vertebral compression fractures and the complexity of the patient’s condition, and finally decided to use intelligent means to develop a personalized surgical plan for the patient and perform robot-assisted T12 percutaneous kyphoplasty.

How does the robot assist in surgery?

Part 01. C-arm 3D Reconstruction + Robotic Surgery Planning

The patient’s thoracic spine is scanned and reconstructed in 3D using the Perlove Medical’s 3D C-arm, and the images are transmitted simultaneously to the Perlove Medical’s orthopedic surgery robot navigation system.

With the help of the planning software of the orthopedic surgery robot, the preoperative surgical path simulation is planned to find the best puncture position and angle, and the robotic arm is operated to quickly complete the precise positioning of the surgical entry point.

*Preoperative Planning

Part 2. Surgical Execution

A 1-2 cm long incision is made on the patient’s body surface, and a Kirschner needle pilot sleeve is delivered through the incision to the focal vertebral body in the direction of the robotic arm positioning point, and a Kirschner needle is driven in the direction of the sleeve for positioning. The working sleeve is inserted along the pilot sleeve. The pilot sleeve is removed, and after completing PKP, the bone cement is injected slowly through the bone cement injector precisely at the fracture site to help restore the shape and strength of the vertebral body.

Part 3. Confirmation of Surgical Results

*Good results with bone cement placement

The clinical experience was a perfect cooperation between the Perlove Medical spine surgery navigation and positioning system and the surgeons. The sub-millimeter precision positioning, intuitive preoperative planning and precise execution of the robotic arm allow the surgeons to understand the location of the injured spine and the best puncture path in all aspects with only preoperative 3D reconstruction, which not only greatly improves the one-time puncture success rate, but also significantly reduces the surgical requirements for surgeon experience and makes the surgery less difficult to start.

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