Spine Surgery: Lights! Camera! Robots?

Professional using a robotic surgery system.
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Over the years technology has not just advanced, but catapulted to new heights. The quality and intricacy of today's technologies are at a level that makes us pause for a moment to think about the possibilities of tomorrow. Computers are no longer a wish list item, they are a necessity in most businesses and homes. Healthcare is no exception.

You have navigation on your phone, you have navigation in your car, and today you even have navigation in the operating room. Navigation technologies are assisting surgeons in a wide range of specialties, including spine surgery. There are various terminologies being referenced when discussing surgical navigation. Computer guided, image guided, and fluoroscopy guided are among those most commonly used. Robotics is another term currently being highlighted as a revolutionary development in surgical navigation solutions.

What does it all mean? Surgical computer navigation technologies create an easy to follow road map for surgeons to more accurately perform the procedure while minimizing the trauma to surrounding tissues. In spine surgery, navigation has been shown to exhibit increased accuracy and safety. A literature review concluded that CT navigation had the highest accuracy among the techniques studied including free hand and fluoroscopy.

A surgical robotic system goes one step further using advanced images while deploying a robotic component. This technology is controlled by the surgeon through use of a console panel or other equipment. The benefits of current robotic systems approved for, and used in spine surgery is still unclear. Clinical research is producing varied conclusions. The initial trial indicated that robotics may be superior in surgical precision. A recent publication shows that when the robot was actually tested against the traditional technique, the accuracy of the robot was inferior to the traditional surgical technique.

Not all technology is created equally. It has been established that navigation in itself is an effective tool for spine surgery. The need for technologies that can improve both surgical precision and surgical outcomes is what will continue to drive research and development. It is the collaborative effort between industry and medical experts that has brought this new phase of minimally invasive surgery to life. New software and hardware may emerge as time progresses, but the vision to improve the patient experience will remain an unchanged constant.

References

Gelalis, I., Paschos, N., Pakos, E., Politis, A., Arnaoutoglou, C., Karageorgos, A., et al. (2012). Accuracy of pedicle screw placement: a systematic review of prospective in vivo studies comparing free hand, fluoroscopy guidance and navigation techniques. European Spine Journal , 21, 247-255.

Devito, D., Kaplan, L., Pfeiffer, M., Horne, D., Silberstein, B., Hardenbrook, M., et al. (2010). Clinical acceptance and Accuracy Assessment of Spinal Implants Guided With SpineAssist Surgical Robot: Retrospective Study. Spine , 35 (24), 2109-2115.

Ringel, F., Stuer, C., Reinke, A., Preuss, A., Behr, M., Auer, F., et al. (2012). Accuracy of Robot-Assisted Placement of Lumbar and Sacral Pedicle Screws. Spine , 37 (8), E496-E501.

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