The use of robotics in the medical field has been gaining ground over the last 10 years. In particular, in spine surgery, its greatest use at present seems to be the application of screws. Traditionally, they have been placed via an open-handed technique in which a surgeon will rely on his knowledge of anatomy and the appearance of the vertebral bones as they lie on the operating room table to attempt to accurately place screws. This is very common, particularly for fusion surgery. In addition, the use of fluoroscopic or x-ray helps guide the accuracy of screw placement. However, despite best attempts, accuracy often suffers and some studies show that up to five percent of screws placed need to be revised or are placed in an inappropriate fashion.
The use of robotics in spine surgery, both in practice and in theory, enables a higher degree of accuracy of instrument and screw placement. This is done via a CAT scan image of the preoperative spine, which is then matched to the on-the-table appearance of the patient in question. With the use of this type of technology, some studies are showing a greater than 98 percent accuracy in the placement of screws. An additional benefit is that, given the technology, the use of radiation within the operating room field is reduced.
As of now, only a small percentage of spinal surgeons as well as hospitals have the training, facility and equipment to engage in robotic spine surgery. New Jersey, as an example, has only two such institutions. An article in Becker’s Spine Review noted that as of January 2015, there were approximately 70 spinal surgeons who were trained and currently using robotics. As with all new technologies, its appropriateness needs to be evaluated on a case-by-case basis as well as on a pathology- by-pathology basis so that, for example, a simple sciatica discectomy–type surgery, in all probability, does not necessitate the use of robotics whereas a spine that is curved or in an attempt to minimize the surgical invasion, robotics could be of great help.
Here, at the Center of Spinal Disorders, we attempt to appropriately utilize this as well as other new technologies on an individualized basis so as to best suit your particular needs.
Please do not hesitate to contact us with questions and/or concerns. We look forward to seeing you and wish you the best of spinal health.
Dr. Jonathan Lewin is a Board-Certified Orthopedic Spinal Surgeon at The Center for Spinal Disorders, providing services for back pain & spinal disorders. Dr. Lewin is one of the few doctors in the states of New York and New Jersey who is experienced in performing Endoscopic Fusion Surgery. He can be reached at The Center for Musculoskeletal Disorders
By Dr. Jonathan Lewin