The Future of Spinal Surgery: Robotic Navigation  


Spinal surgery is usually only considered after more conservative treatment methods like physical therapy and medications have already been tried. This is because surgery of the spine can be very risky, with even minor errors creating serious problems for the patient. For this reason, spinal surgery requires an especially high level of instrument positioning and control. The surgeon must also have access to the part of the spine that needs to be corrected. Traditional open spine surgery requires an incision large enough to expose the entire surgical site. Larger incisions are associated with greater tissue damage and more severe postoperative pain.

Robot-Assisted Minimally Invasive Surgery

Over the last few years, new developments in minimally invasive spinal surgery have sought to fix these problems. In minimally invasive surgery, a tiny endoscope—a flexible tube with a light and camera on one end often accompanied by a surgical tool—is inserted through a very small incision near the area of the spine to be operated upon. The surgeon must then navigate the tool to the problem area itself, avoiding major blood vessels, nerves, and other important internal structures.

Now, spinal surgeons are using even more advanced three-dimensional image-guided therapy to further improve upon minimally invasive spinal surgery techniques. Image-guided therapy includes all medical procedures that use generated pictures to target a medically relevant site. What started with the x-ray in the 19th century has now merged with the world of robotics.

These robot-assisted surgeries are planned with the aid of specialized software long before the first incision. The surgeon uploads a CT scan of the patient into the robotic system’s 3D-planning software. The surgeon then uses these highly accurate 3D images to plan out the surgery in detail. Once surgery begins, the surgeon then uses the system to help guide his or her hand to complete what was mapped out in the planning stage. In addition to navigation, these systems also reduce even minor tremors for greatly improved dexterity.

Benefits of Robotic Navigation

While these robot-assisted systems may be new to most surgical practices, years of research have revealed many advantages over traditional surgery:

  • Accuracy improved by up to 70%.
  • Greater consistency with screw placement.
  • Reduced chance of complications.
  • Less pain.
  • Minimal tissue damage thanks to smaller incisions and better accuracy. One dramatic example found significant medial breach to be eight times more likely to happen without robotic navigation. Another is that only 0.6% of screws placed with the aid of robotic navigation had to be removed during surgery compared to 4.9% in traditional surgery.
  • Better outcomes for complicated cases. Many spinal surgeries are performed on tissue that is distorted from problems like scoliosis or bone-destroying tumors. Direct real-time imaging is especially important when treating patients with these issues.
  • Reduces radiation exposure by 56%. Traditional spinal surgery requires a large number of x-rays to compensate for the lack of direct imaging.
  • Faster recovery time. Patients undergoing robot-assisted spinal surgery spent an average of 27% less time in the hospital.

Experienced Spinal Surgeons

One thing to keep in mind about spinal surgery with robotic navigation is that it in no way replaces the need for an experienced spinal surgeon to perform the procedure. Robotic navigation systems can only make skilled surgeons even better. If you’re considering spinal surgery or other related treatments, consider contacting us at the Colorado Brain & Spine Institute.