Hello, my name is Dr. Vigloria. I'm the current Clinical Spine Fellow at the University of South Florida Tampa General Hospital. The presented video is for an upholstery that has been accepted to the Spine Summit 2024 in Vegas. The title of the upholstery is Computer Assisted Root Contouring in Deformity Surgery. Is it worth it? The authors of the paper are Dr. Jay Kumar, Ahmad Baig, Brian Clampett, Elliot Pressman, and Dr. Pooja Alikhani, and finally my persona, Dr. Adolfo Vigloria Hidalgo. As an introduction, in adult spinal deformity surgery, root contouring is a critical step that determines postoperative alignment. While the root is traditionally contoured manually, novel computer-assisted systems have emerged in the hopes of minimizing operation time and blood loss and improving accuracy. However, this system requires aggressive bending that may increase risk of root fractures. Incidence of fracture after computer-assisted contouring versus that after manual contouring has been poorly reported. For this reason, we carry on a retrospective review of prospectively maintained database of consecutive cases at our institution from January 2016 through November 2021. This was carried on at the Tampa General Hospital, University of South Florida. The inclusion criteria were being older than 18 years old, undergoing spinal fusion that include more than five vertebrae with rot implantation, and a minimum one-year follow-up with radiographs. Patients were divided into computer-assisted group versus a traditional contouring manual group. The incidence of root fracture between these two groups was determined. Mann-Whitney nonparametric test was used to compare medians between the groups, and a p-value less than 0.05 was considered statistically significant. So as a result, in total, we identified 177 patients. Of these 177 patients, 32 in the computer-assisted contouring bending were identified, and the remaining 145 belonged to the traditional contouring manual group of the rot bending. The most frequent age was between 60 and 69 years old in both groups, with no statistical significance in age, sex, body mass index. The root fracture incidence was 34.4% in the computer-assisted bending group versus 17.9% in the traditional manual contouring group. The risk of presenting rot fracture in the MIS group or the group that underwent computer-assisted bending was 1.92 times higher than those who underwent the classic traditional bending of the rot. As a conclusion, the use of computer-assisted rot contouring in deformity surgery was associated with a higher incidence of rot fractures. This can predispose patients to osteoarthrosis, postoperative pain, neurological deficits, and re-operation. Finally, increased risk of fracture may be due to aggressive bending and notching of the rot that is associated more with a computer-assisted system than with traditional manual systems. Thank you so much.

Computer Assisted Root Contouring

Spinal Deformity Surgery

Spine Summit 2024

Root Fractures

Automated System