Comparison of surgical efficacy between O-arm combined with CT 3D real-time navigation system and Tinavi robot-assisted treatment of adolescent congenital scoliosis.

Abstract

OBJECTIVE: To compare the orthopedic function and clinical efficacy between the orthopedic surgery guided by the Stealth Station 8 Navigation System and the Tinavi robot-assisted orthopedic surgery for the treatment of congenital scoliosis. METHODS: A retrospective analysis was performed on the patients who underwent surgical treatment for congenital scoliosis between May 2021 and October 2021. Patients were divided into the navigation group or the robotic group according to the adjunct system used. Postoperative computed tomography (CT) and digital radiography (DR) scans were conducted to assess the orthopedic outcomes. Specifically, the pedicle screw placement accuracy was measured, and the accuracy rate was calculated based on the parameters of the Scoliosis Research Society (SRS), sagittal vertical axis (SVA), distance between the C7 plumb line and the central sacral vertical line (C7PL-CSVL), lumbar lordosis (LL), and spine correction rate. Clinical data of both groups were recorded. RESULTS: A total of 60 patients, including 20 cases in the navigation group and 40 cases in the Tinavi group, were selected for this study. All patients were followed up for a mean of 12.1 months. We found that the spine correction rate, C7PL-CSVL, and SVA were better in the navigation group than in the robot group, while there was no significant difference in the pedicle screw placement accuracy between these two groups (P=0.806). However, the rate of small joint protrusion was significantly higher in the navigation group (P=0.000), and the screws were also closer to the anterior cortex in the navigation group (P=0.020). In contrast, the number of scans and intraoperative fluoroscopic dose were higher in the robot group than in the navigation group. The rest of the data were not significantly different between these two groups. CONCLUSION: O-arm combined with CT 3D real-time navigation system not only has a better orthopedic effect than Tinavi orthopedic robot which also uses optical tracking system in the treatment of adolescent congenital scoliosis, but also exhibits a satisfactory clinical effect. Therefore, although it has several drawbacks, the navigation system is still a good clinical treatment option for scoliosis.