Computer assisted surgery is becoming more prevalent in spinal surgery with most published literature suggesting an improvement in accuracy and reduction in radiation exposure. This has been particularly highlighted in scoliosis surgery with regard to the placement of pedicle screws. Anecdotally this has been challenged with concerns with regard to the steep learning curve using this equipment and the high cost of purchasing said systems. The more traditional technique utilises the surgeon's knowledge of anatomic landmarks and tactile palpation added with fluoroscopy to place pedicle screws. We retrospectively looked at 161 scoliosis corrections performed using this technique over three years by 3 main surgeons at the same centre (Frenchay). With an average of 10 levels per procedure and over 2000 pedicle screws inserted. We reviewed the radiation time exposure and dose of radiation given during each case. Our results compared favourably to published data using computer and robot assisted surgery with an average exposure time of 80 seconds and a mean dose of 144 mGy using a standard C-arm guided fluoroscopy. Our study suggests that armed with good surgical knowledge and technique it is possible to obtained low levels of radiation exposure of benefit to both patient and the operating team

Aims

The aim of this study was to systematically compare the safety and accuracy of robot-assisted (RA) technique with conventional freehand with/without fluoroscopy-assisted (CT) pedicle screw insertion for spine disease.