Traditional open spine surgery using anatomical landmarks results in rates of free-hand pedicle screw misplacement as high as 40% according to post-operative CT imaging ( 1). Accuracy of screw placement improves to 86.6–94.9% with 2D fluoroscopy ( 2, 3). The evolution of minimally invasive spine (MIS) approaches introduced 2D fluoroscopy using K wires and EMG neuromonitoring to insert percutaneous pedicle screws and have higher accuracy rates of 90.2–97.5% ( 2, 4). However, these approaches require surgical teams to wear lead protection. Three-dimensional spinal navigation with intraoperative 3D fluoroscopy and bone-anchored (spinous process or iliac crest) tracking provides comparable accuracy without requiring lead protection ( 5). This approach also minimises radiation exposure by the surgical team and patient ( 6, 7). Renaissance (Mazor Robotics, Caesarea, Israel) was the first widely used spinal robotic platform. Combined with bone anchoring, Renaissance provides pedicle cannulation for K wires and yields high accuracy for screw placement with reduced exposure to radiation ( 8, 9). Use of a non-invasive, rectangular skin-adhesive stereotactic tracker (SpineMask, Stryker Navigation, Kalamazoo, MI, USA) maintains high accuracy for percutaneous screw placement without requiring bone-anchored tracking or the morbidity of K wires ( 10, 11). Contemporary technologies, including intraoperative CT and new 3D fluoroscopy, offer improved image quality but significantly increase radiation exposure ( 12, 13). With a robust product pipeline in place, we are positioned to provide a well-rounded, end-to-end platform for our surgeon customers, with the ability to incorporate robotics and intelligent handheld instruments in the future.New robotic platforms offer more versatility with integrated navigation and can be used without K wires. “The System is designed for future compatibility with a fully integrated ecosystem, driving more value for our customers. “The versatility of the Q Guidance System will help to streamline our technologies across multiple specialties such as cranial, spine, ENT and orthopaedics,” Robbie Robinson, President of the Spine division, said. When used with Airo TruCT mobile CT scanner, this ecosystem delivers automatic image registration and pairs high performance tracking capabilities with cutting edge intraoperative image quality and scan volume. Q Guidance features completely redesigned software applications, semi-automatic and automatic segmentation features, gesture recognition and broad compatibility with various types of image sets. Stryker’s Q Guidance System aims to deliver surgical spine planning and navigation capability through multiple tracking options, sophisticated software algorithms and smart instrumentation. The Spine Guidance Software is the first spine navigation software to receive clearance from the FDA for use with pediatric patients aged 13 and older. The system, when used with the Spine Guidance Software, is an advanced planning and intraoperative guidance system designed to enable open or percutaneous computer-assisted surgery. Stryker announced that its Q Guidance System, intended for spine applications, received FDA 510(k) clearance.
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