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Improving Patient Outcomes Using Robotic Spine Surgery

In recent years, there has been a trend towards minimally invasive spine surgery instead of traditional open spine surgery which included a rather long surgical incision, often unnecessary tissue damage, and a lengthy residual scar. The trend towards minimizing the surgical incision avoids damage to the muscles and ligaments that surround the spinal structures. This decreases a patient’s postoperative pain significantly and further reduces infection rates, blood loss, and wound healing complications.

The use of robotics in spine surgery is especially helpful in patients with severe scoliosis or other spinal deformities that may make traditional implant placement more difficult, as well as those who have had prior spine surgery that failed (pseudoarthrosis or what can be referred to as Failed Back Syndrome). Even when anatomic landmarks are obscured or prior implants are not in the right location, the surgeon can use the robotic arm to place new implants in a perfect position that creates better outcomes for the patient.

The use of robotic arms to assist surgeons with abdominal surgery started in 2000 with the Da Vinci robot. Since that time, robotic surgery has become utilized in gynecologic and urologic surgery as well as open heart surgery.    Since 2004, robots specifically designed for spine surgery have been tested and proven to  increase surgical accuracy in the placement of implants with greater accuracy and precision.  The use of intra operative radiographic imaging or a CT prior to surgery allows the surgeon to map out exactly where the implant needs to be placed using a 3D computer image.  The trajectories of the implants are mapped to a very fine detail before the surgery takes place, allowing for more accurate placement and smaller incisions leading to faster recovery time and less pain after surgery.  During the surgery, the robotic arm carries out placement of the implant with the surgeon’s guidance which is further enhanced by the 3D images.

There are multiple advantages of robotic surgery including potential less radiation exposure, highly accurate placement of implants, lower rates of neurological complications, and lower infection rates as larger open incisions are not necessary. While studies are still being done to further evaluate the utility of robotics and navigation in spine surgery, these techniques have already been shown to be safe and effective and patients can be evaluated by our highly trained and skilled CNSO surgeons to determine if they are a candidate.
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