Robot-assisted percutaneous balloon dilatation of the vertebral body

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Recently, the Second Affiliated Hospital of Nanjing Medical University successfully performed minimally visible spine surgery on an 81-year-old female with a thoracic spine (T12) compression fracture with the assistance of Perlove Medical’s orthopedic surgery robot and close collaboration among team members. Director Wang Boyao exclaimed, “The precise positioning of thoracic spine fractures is a crucial factor affecting the surgical outcome. Traditional surgery requires the surgeon’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.”

minimally visible spine surgery assisted by Perlove Medical's orthopedic surgery robot
After being positioned by robot, doctors inserted the screws

Case: Robot-assisted percutaneous vertebral body balloon dilatation angioplasty

Unit: The Second Affiliated Hospital of Nanjing Medical University

Patient’s age: 81 years old

Patient’s gender: female

Admission diagnosis: thoracic compression fracture (T12) (primary diagnosis); lumbar spondylolisthesis; cerebral infarction; hypertension grade 1; diabetes mellitus.

preoperative x ray image by orthopedic surgery robot
Preoperative X-ray image of the patient

How does the robot assist in surgery?

C-Arm 3D Reconstruction + Robotic Surgery Planning

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

C-Arm 3D Reconstruction + Robotic Surgery Planning
images by medical c arm machine

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.

precise positioning compeleted by orthepedic surgery robot

Surgical procedure

A 1-2 cm long incision is incised on the patient’s body surface, and a Kirschner needle guide sleeve is sent 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.

Surgical procedure assisted by orthepedic surgery
Surgical procedure assisted by orthepedic surgery 1

The working sleeve is inserted along the guide needle, the guide needle is removed, and after completing the balloon expansion, 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.

Confirmation of surgical results

Confirmation of surgical results 1
Confirmation of surgical results 5
Impact shows an excellent cement placement results

The clinical experience was a perfect match between Perlove Medical’s spinal surgical navigation and positioning system and the surgeon. The sub-millimeter precision positioning, intuitive preoperative planning and precise execution of the robotic arm allow the surgeon to understand the location of the injured spine and the optimal puncture path with only preoperative 3D reconstruction, without expanding the incision to locate the needle path, which not only greatly increases the one-time puncture success rate, but also significantly reduces the requirement for surgeon experience and makes the surgery less difficult to start.

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