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Cited by 15Spinal Fractures and Fixation TechniquesAnesthesia and Pain ManagementSpine and Intervertebral Disc Pathology

Autonomous Spinal Robotic System for Transforaminal Lumbar Epidural Injections: A Proof of Concept of Study

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Margalit, Adam, Phalen, Henry, Gao, Cong, Ma, Justin, Suresh, Krishna V., Jain, Punya, Farvardin, Amirhossein, Taylor, Russell H. +3 more·2024·Global Spine Journal
DOI 10.1177/21925682221096625PMC PMC10676186
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Abstract

Study Design: Phantom study Objective: The aim of our study is to demonstrate in a proof-of-concept model whether the use of a marker less autonomous robotic controlled injection delivery system will increase accuracy in the lumbar spine. Methods: Ideal transforaminal epidural injection trajectories (bilateral L2/3, L3/4, L4/5, L5/S1 and S1) were planned out on a virtual pre-operative planning software by 1 experienced provider. Twenty transforaminal epidural injections were administered in a lumbar spine phantom model, 10 using a freehand procedure, and 10 using a marker less autonomous spinal robotic system. Procedural accuracy, defined as the difference between pre-operative planning and actual post-operative needle tip distance (mm) and angular orientation (degrees), were assessed between the freehand and robotic procedures. Results: Procedural accuracy for robotically placed transforaminal epidural injections was significantly higher with the difference in pre- and post-operative needle tip distance being 20.1 (±5.0) mm in the freehand procedure and 11.4 (±3.9) mm in the robotically placed procedure ( P < .001). Needle tip precision for the freehand technique was 15.6 mm (26.3 – 10.7) compared to 10.1 mm (16.3 – 6.1) for the robotic technique. Differences in needle angular orientation deviation were 5.6 (±3.3) degrees in the robotically placed procedure and 12.0 (±4.8) degrees in the freehand procedure ( P = .003). Conclusion: The robotic system allowed for comparable placement of transforaminal epidural injections as a freehand technique by an experienced provider, with additional benefits of improved accuracy and precision.

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  • Registration pose error, TRE, and success rate are general measures to report 2D/3D registration performance, commonly used in the literature.

    “Our results presented using registration pose error, TRE, and success rate are general measures to report the 2D/3D registration performance, which are commonly used in the literature [51], [18], [24].”

    From A Fully Differentiable Framework for 2D/3D Registration and the Projective Spatial Transformers (2024) · cites this paper as [24]

    The Robotic Technique section describes a 2D/3D registration pipeline, but does not identify measures for evaluating its performance. Statistical Analysis reports needle-tip distance and angular-orientation errors for the injection procedure, not registration pose error, TRE, or registration success rate. The searched passages do not address whether those three measures are commonly used in the literature; page numbers are unavailable in our copy. (LLM, conf=0.75)

    Experimental — accuracy not yet measured

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Research works printed but not linked: 25

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Cited by

Sorted by citations

Authors
Margalit, A., Phalen, H., Gao, C., Ma, J., Suresh, K. V., Jain, P., Farvardin, A., Taylor, R. H., Armand, M., Chattre, A., & Jain, A.
Affiliations
Johns Hopkins University (US)
Corresponding author
Jain, Amit
ORCID
Venue
Global Spine Journal
Publisher
SAGE Publications
Published
2022-04-25
Volume
14
Issue
1
Pages
138-145
ISSN
  • 2192-5682 (ISSN-L)
  • 2192-5690
DOI
10.1177/21925682221096625
PMC
PMC10676186
OpenAlex
W4224470041
Cited by
15
References
0
Citations by year
2026: 4 · 2025: 4 · 2024: 4 · 2023: 3
FWCI
2.63
Type
journal article
Language
en
Open access
Licence
Locations
  • Global Spine Journal (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • NIH (R01EB023939)
  • T32 postdoctoral training (T32AR067708-06)
  • National Science Foundation Graduate Research (DGE-1746891)
Topics
  • Health Sciences › Medicine › Surgery › Spinal Fractures and Fixation Techniques
  • Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
Keywords
autonomous robots, needle placement accuracy, surgical planning

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