Accurate screw placement remains challenging, especially in the cervical spine. We present our first experience of minimally invasive posterior cervical and upper thoracic pedicle screw fixation in ...the lower cervical spine.
This study reports a case series of patients, undergoing posterior percutaneous pedicle fixation using Cirq robotic assistance coupled to the Airo intraoperative computed tomography scan and Brainlab navigation system. Routine computed tomography was performed on postoperative day 2 to evaluate pedicle screw placement. The effective dose was calculated.
Between February 2020 and December 2020, 7 patients (4 men and 3 women) were treated. The mean age was 58.8 years (range, 29–75 years). Fixation was performed with a cannulated PASS OCT Reconstruction System (Medicrea). Overall, 28 screws were placed within cervical and upper thoracic pedicles. According to the Neo and Heary classification, 85.7% were rated as acceptable and 14.3% as poor. The radiation dose received by the patient was 9.1 mSv (range, 7.7–10.6 mSv). The radiation dose received by the surgical staff was 0 mSv. The postoperative course was excellent.
Posterior miniopen fixation using Cirq robotic assistance coupled with an intraoperative computed tomography navigation system is a major innovation that can improve the accuracy of pedicle screw positioning, with acceptable patient radiation and reduced surgical team exposure.
Introduction
The Cirq robotic alignment system (Brainlab, Munich, Germany) is a manually adjustable electronic arm with a robotic alignment module on its distal end, enabling the neurosurgeon to ...automatically and accurately align surgical instruments to a preoperatively planned trajectory. In this study, we share our first experiences and results using Cirq for intracranial tumor biopsy in children.
Methods
From May 2021 until October 2022, all consecutive patients that underwent a brain tumor biopsy using Cirq were included and compared to a historical cohort of patients biopsied with the non-robotic system Varioguide (Brainlab, Munich, Germany). Patient-related data, tumor-related data, and surgery-related data were collected. Registration accuracy was calculated for different patient-to-image registration methods. Pre- and postoperative images were fused, and entry error, target error, and angulation error were calculated.
Results
Thirty-seven patients, aged 1–19 years, were included (14 with Cirq and 23 with Varioguide). An integrated histopathological and molecular diagnosis was acquired in all cases. Patient-to-image registration was significantly more accurate when based on bone screw fiducials combined with intraoperative CT, as compared to surface matching or skin fiducials. The target error (Euclidian distance) was 5.3 mm for Cirq as compared to 8.3 mm for Varioguide, but this was not statistically significant. Entry error and angulation error were also not significantly different between both groups.
Conclusion
Intracranial biopsy with the Cirq robotic system is feasible and safe, and its accuracy does not differ from the Varioguide system.
Background
To report the feasibility and safety of C1 kyphoplasty using the Cirq® robotic assistance coupled to the AIRO® intraoperative computed tomography (iCT)-scan and BrainLab® navigation ...system.
Methods
A 47-year-old woman with C1 osteolytic lesion responsible of intractable left-sided suboccipital pain was admitted. She underwent a percutaneous kyphoplasty of left lateral mass of C1 using Cirq® robotic assistance. She reported postoperative substantial pain relief. CT scan showed adequate filling of the osteolytic lesion without obvious leakage of cement.
Conclusion
Percutaneous kyphoplasty of C1 using Cirq® robotic assistance is a safe and effective alternative in selected patients with C1 lateral mass metastasis.
Finding a minimum is an essential part of mathematical models, and it plays an important role in some optimization problems. Durr and Hoyer proposed a quantum searching algorithm (DHA), with a ...certain probability of success, to achieve quadratic speed than classical ones. In this paper, we propose an optimized quantum minimum searching algorithm with sure-success probability, which utilizes Grover-Long searching to implement the optimal exact searching, and the dynamic strategy to reduce the iterations of our algorithm. Besides, we optimize the oracle circuit to reduce the number of gates by the simplified rules. The performance evaluation including the theoretical success rate and computational complexity shows that our algorithm has higher accuracy and efficiency than DHA algorithm. Finally, a simulation experiment based on Cirq is performed to verify its feasibility.
Grover algorithm is a quantum search algorithm that can find the target state efficiently. However, with the increase in the amount of searching data, the circuit of Grover algorithm is faced with ...complex gate decomposition problem. In today's NISQ era, resources are very limited, so the depth of circuit is an important metric. This paper introduces a two-stage quantum search algorithm based on divide-and-conquer, which can run quickly in parallel on a quantum computer. A circuit optimization method is proposed to reduce the number of iterations by using block-level oracle circuit. Combining this method with divide-and-conquer idea, it is defined as the 2P-Grover algorithm. The simulation experiment was carried out on the quantum computing framework Cirq and compared with Grover algorithm. The experimental results show that the 2P-Grover algorithm can reduce the depth of circuit by at least 1.2 times and maintain a high probability of search success.
To compare our experience with pedicle screw insertion of the thoracolumbar spine utilizing the Cirq robot assistance device compared with traditional paradigm using fluoroscopy.
We prospectively ...collected data of patients undergoing pedicle screw instrumentation in the thoracolumbar spine performed by a single surgeon at three different centers. One center took delivery of the Cirq robotic assistance device. Remaining two centers used C-arm fluoroscopy. Demographic information, diagnosis, total OR time, intraoperative complications, unexpected return to the operating room, and hospital readmissions within 90 days was compared between the two cohorts.
A total of 166 screws were placed during the study period. Forty percent were placed using the Cirq. Two thirds the patients had traumatic diagnoses with remaining degenerative spine disease. There were no misplaced pedicle screws in either group. While total OR time was longer in the Cirq cohort by 123 min (p = 0.04), actual procedural time was not statistically different (p = 0.11). Nonetheless there were also more hospital readmissions in the Cirq cohort compared with the C arm group (p = 0.04).
Thoracolumbar screws inserted using C-arm fluoroscopy utilize less total operating room time with similar accuracy compared with the Cirq robotic assistance device. Further studies are warranted.
Deep neural networks were previously used in the arena of image retrieval. Siamese network architecture is also used for image similarity comparison. Recently, the application of quantum computing in ...different fields has gained research interest. Researchers are keen to explore the prospect of quantum circuit implementation in terms of supervised learning, resource utilization, and energy‐efficient reversible computing. In this study, the authors propose an application of quantum circuit in Siamese architecture and explored its efficiency in the field of exudate‐affected retinal image patch retrieval. Quantum computing applied within Siamese network architecture may be effective for image patch characteristic comparison and retrieval work. Although there is a restriction of managing high‐dimensional inner product space, the circuit with a limited number of qubits represents exudate‐affected retinal image patches and retrieves similar patches from the patch database. Parameterized quantum circuit (PQC) is implemented using a quantum machine learning library on Google Cirq framework. PQC model is composed of classical pre/post‐processing and parameterized quantum circuit. System efficiency is evaluated with the most widely used retrieval evaluation metrics: mean average precision (MAP) and mean reciprocal rank (MRR). The system achieved an encouraging and promising result of 98.1336% MAP and 100% MRR. Image pixels are implicitly converted to rectangular grid qubits in this experiment. The experimentation was further extended to IBM Qiskit framework also. In Qiskit, individual pixels are explicitly encoded using novel enhanced quantum representation (NEQR) image encoding algorithm. The probability distributions of both query and database patches are compared through Jeffreys distance to retrieve similar patches.
Abstract
BACKGROUND
Accurate screw placement remains very challenging especially in the upper cervical spine.
OBJECTIVE
To present our first experience of a percutaneous posterior C1-C2 fixation for ...a traumatic fracture.
METHODS
This is a case report of a non-neurological patient, harboring a type II odontoid fracture. She underwent a posterior percutaneous fixation using Cirq® Robotic Assistance coupled to the AIRO® intraoperative computed tomography (iCT)-scan and BrainLab® navigation system (all by BrainLab AG). Routine CT was performed on postoperative day 2 to evaluate pedicle screw placement. The effective dose was calculated.
RESULTS
The C1-C2 posterior percutaneous fixation was performed with cannulated VERTEX® Reconstruction System (Medtronic). Overall, 4 screws were placed. All of them were rated as acceptable (100%). Radiation dose received by the patient was 4.13 mSv. Radiation dose received by the surgical staff was 0 mSv. Postoperative course was excellent.
CONCLUSION
Posterior percutaneous fixation using Cirq® Robotic Assistance coupled with iCT navigation system is a major innovation that can improve pedicle screw positioning's accuracy with acceptable patient radiation and reduced surgical team exposure.
PDF
