Types of Cases for Robotics
Minimally invasive spine (MIS) surgery has become more and more popular over the past 10 years due to advances in technology that have made it better and more effective, as well as the improvements in patient outcomes especially in the first few months after surgery when they are trying to return to work and physical activity. Instead of using larger incisions down the middle of the spine which require moving and damaging all of the muscles that attach there, in MIS surgery, smaller 1-2 cm incisions can be made off the sides of the spine to place stabilizing screws and rods as well as to remove pressure from the spinal nerves and place implants in the disc space if needed (anterior, lateral, or posterior interbody fusion). Robotics and navigation allow CNSO surgeons to place these implants and decompress the spinal nerves through small incisions and accomplish even more accurate placement despite the fact that the muscles are not moved out of the way, and recovery is faster in most cases. Through preoperative planning software, the surgeons at CNSO can plan ideal trajectories of the implants to minimize incision size, allow easier passage of the rods and interbody cages, and even place implants in small or difficult to access pedicles without the need to open the spine and directly visualize those structures. In addition, it is possible to do “front and back” surgeries that were traditionally done through different positions requiring positioning the patient on their back or side and then moving them during surgery to “single position” surgery now which decreases operative time and therefore risk of certain complications.
Preoperative planning using CT scan uploaded to robotic platform (Image Courtesy of Globus, Inc).
Images show before and after images of transforaminal lumbar interbody fusion (TLIF) done using robotic guidance with restoration of normal alignment.