title: Evaluation of a Robotic Assistance-System For Percutaneous Computed Tomography-Guided (CT-Guided) Facet Joint Injection: A Phantom Study.
abstract: BACKGROUND The aim of this study was to compare robotic assisted and freehand facet joint puncture on a phantom model in regards to time requirements and puncture accuracy. MATERIAL AND METHODS Forty facet joints were punctured, 20 using a robotic guidance system and 20 using a freehand procedure. Side and height of the facet joints were randomized and identical for both groups. Procedural accuracy, defined as axial and sagittal deviation, as well as the number of corrections were assessed. Procedure times for each step were documented and time requirements for pre-positioning, reconstruction, planning, and total intervention were calculated. RESULTS Total procedure time for robotic guidance was 259±111 seconds versus 119±77 seconds for freehand procedure (p=1.0). Procedural accuracy for robotic guidance was significantly higher with 0 corrections versus 1.3 corrections for freehand procedure (p=0.02). Needle deviation in the robotics arm was 0.35±1.1 mm in the axial and 2.15±1.2 mm in the sagittal reconstruction. CONCLUSIONS Robotic assisted puncture of the facet joint allowed accurate positioning of the needle with a lower number of needle readjustments. Higher procedural accuracy was marginally offset by a slightly longer intervention time.
authors.affiliation: Department of Radiology, University Hospital Regensburg, Regensburg, Germany.
authors.forename: Lukas Philipp
authors.initials: LP
authors.lastname: Beyer
authors.affiliation: Department of Radiology, University Hospital Regensburg, Regensburg, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Michalik
authors.affiliation: Department of Radiology, University Hospital Regensburg, Regensburg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Niessen
authors.affiliation: Department of Radiology, University Hospital Regensburg, Regensburg, Germany.
authors.forename: Natascha
authors.initials: N
authors.lastname: Platz Batista da Silva
authors.affiliation: Department of Radiology, University Hospital Regensburg, Regensburg, Germany.
authors.forename: Isabell
authors.initials: I
authors.lastname: Wiesinger
authors.affiliation: Department of Radiology, University Hospital Regensburg, Regensburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Stroszczynski
authors.affiliation: Department of Radiology, University Hospital Regensburg, Regensburg, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Wiggermann
mesh_terms: D006801:Humans; D007270:Injections, Intra-Articular; D009339:Needles; D059408:Pain Management / Q000379:methods; D019047:Phantoms, Imaging; D011677:Punctures / Q000295:instrumentation* / Q000379:methods*; D065287:Robotic Surgical Procedures / Q000295:instrumentation / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D021801:Zygapophyseal Joint / Q000000981:diagnostic imaging* / Q000601:surgery*