Pros and Cons of Robot-Assisted Spine Surgery

Surgical procedures have become more and more efficient with the advancement of technology. Spinal surgery is one of the most advanced surgical procedures available using robotic systems that help improve outcomes. Here we look at the pros and cons of robot-assisted spine surgery to help you understand why it might be recommended for you. 

PROS OF ROBOT-ASSISTED SPINAL SURGERY 

First, let’s look at the pros: 

Precision for Improved Accuracy 

One of the biggest benefits of robot-assisted surgery is that it uses accurate image guidance. As a result, the surgeon can find and target the exact position and trajectory to improve their stability and placement. Some of the challenges spinal surgeons face include the proper placement of screws to avoid instability and risk for neurological, vascular, and visceral injuries. Robots use guide tubes on targets to improve precision and offer stability for improved screw insertion. 

Less Invasive 

Robot-assisted spinal surgery makes it easier for surgeons to perform surgery on patients with challenging anatomies. It also allows for smaller incisions making the procedure less invasive than traditional methods. The use of small cameras and “manipulators” improve capabilities while reducing the risk of infection due to smaller incisions and less muscle retraction. 

Better Post Operative Experience 

Less retraction reduces postoperative pain while allowing for shorter hospital stays. Along with a reduced risk of infection, there is also less scarring thanks to the smaller incisions. Also, because of the improved accuracy, the need for revision surgery is reduced. 

Less Bleeding 

Using robotics allows surgeons to gently push aside soft tissue instead of cutting it. As a result, there is less blood loss. 

Reduced Radiation Exposure 

Robotics can reduce radiation exposure as surgeons can avoid the use of intraoperative fluoroscopy and x-rays.   

Quicker Procedures 

In some cases, surgeons can perform procedures more quickly as robots improve accuracy. However, robotic-assisted spinal surgery can also take more time for set up which can offset the benefits of time reducing accuracy.   

CONS OF ROBOT-ASSISTED SPINAL SURGERY 

You also have to weigh the cons of robot-assisted spinal surgery. For the most part, robotic guided spine surgery is not as readily available as it requires special training. It is also more expensive than traditional surgical procedures as the high-tech equipment in hand with specialized medical training can impact costs.  

There is also a delay time between the surgeon’s instructions and the robot’s reaction which can make it more difficult to match up the “real-time” anatomy of the patient to the three-dimensional images of the robotics. Therefore it is important to seek experienced surgeons who have developed the skills required to understand these delays. 

HOW ARE ROBOTIC SYSTEMS USED IN SPINAL SURGERY? 

 The most common use of robotic systems is to assist in the accuracy of screw and implant placement. However, they can also be used for the following procedures: 

  • Tumor resections 

  • Vertebroplasties 

  • Anesthetic blocks 

  • Revision surgery 

  • Spondylolisthesis 

  • Stenosis 

  • Spondylolysis 

  • Ankylosing spondylitis 

  • Vertebral fractures 

  • Osteomyelitis 

Your surgeon will discuss your options and the type of surgery required to correct your spine issues. 

WHAT TYPES OF ROBOTS ARE USED FOR SPINE SURGERY? 

 There are two types of surgical robots used for spine surgery: 

1.  Master-Slave Systems: Surgeons control and manipulate a master-slave system that provides a video screen to follow the procedure. It uses mechanical actuators that allow the surgeon to maintain control and direct the robot’s movements. These systems can have as many as six “arms” allowing the surgeon complete freedom and views using three-dimensional visual cues. The surgeon has better movement, bleeding, and tremor control in hand with excellent visualization with increased magnification and illumination. 

2.  Trajectory Assistance Robots: These robots are used for insertion procedures improving planning using preoperative images. This allows surgeons to better understand the trajectory and also avoid critical regions. They can make changes to suit the needs of the patient, while the robot ensures the path is followed. The surgeon maintains manual control of their surgical instruments but gains accuracy and precision thanks to planning and tremor control.

There are also robotic systems used for diagnostic and imaging applications. 

Despite the cons, robotic-assisted spine surgery has shown favorable outcomes. It offers leading-edge technology in hand with human interventions to ensure patients experience the benefits of their surgery, with fewer postoperative complications and discomfort.


By the Brain and Spine Neurosurgical Institute of Rhode Island


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