Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Apr;10(2 Suppl):34S-40S.
doi: 10.1177/2192568219878131. Epub 2020 May 28.

Robotic Spine Surgery: Current State in Minimally Invasive Surgery

Chau D Vo  1 , Bowen Jiang  1 , Tej D Azad  2 , Neil R Crawford  3 , Ali Bydon  1 , Nicholas Theodore  1
Affiliations

Robotic Spine Surgery: Current State in Minimally Invasive Surgery

Chau D Vo et al. Global Spine J. 2020 Apr.

Abstract

Study design: Narrative review.

Objectives: Robotic systems in spinal surgery may offer potential benefits for both patients and surgeons. In this article, the authors explore the future prospects and current limitations of robotic systems in minimally invasive spine surgery.

Methods: We describe recent developments in robotic spine surgery and minimally invasive spine surgery. Institutional review board approval was not needed.

Results: Although robotic application in spine surgery has been gradual, the past decade has seen the arrival of several novel robotic systems for spinal procedures, suggesting the evolution of technology capable of augmenting surgical ability.

Conclusion: Spine surgery is well positioned to benefit from robotic assistance and automation. Paired with enhanced navigation technologies, robotic systems have tremendous potential to supplement the skills of spine surgeons, improving patient safety and outcomes while limiting complications and costs.

Keywords: ExcelsiusGPS; Mazor; ROSA; minimally invasive surgery; navigation; pedicle screw; robotics; spine surgery.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The Excelsius GPS robot described in this presentation was invented by Drs Theodore and Crawford and is manufactured by Globus Medical. They are both entitled to royalty payments on sales of the robot. Dr Theodore is also a paid consultant to Globus Medical and owns Globus Medical stock. Dr Crawford is an employee of Globus Medical.

Figures

Figure 1.
Figure 1.
Representative case of minimally invasive surgery (MIS) for a transforaminal lumbar interbody fusion (TLIF). A man with history of right L4-L5 disc herniation and right L5 radiculopathy status-post 3 prior right-sided microdiscectomies who presented with recurrence of radicular pain. He underwent a right L4-L5 MIS TLIF with robotic guidance using the Globus ExcelsiusGPS system. (A) Lateral magnetic resonance image shows re-herniation of the right L4-L5 disc with significant lateral recess and foraminal stenosis. (B) Axial postoperative computed tomogram shows ideal placement of a transpedicular screw. (C) Postoperative frontal radiograph of L4-L5 instrumented TLIF. (D) Postoperative lateral radiograph.
Figure 2.
Figure 2.
Representative case of percutaneous instrumentation for traumatic burst fracture of the thoracic spine. A man presented with back pain after significant trauma and was found to have a traumatic burst fracture of the T8 vertebral body. He underwent percutaneous T6-T10 segmental pedicle screw fixation with robotic guidance using the Globus ExcelsiusGPS system. (A) Lateral computed tomogram (CT) shows traumatic burst fracture of the T8 vertebral body. (B) Lateral postoperative CT shows T6-T10 instrumentation. (C) Axial postoperative CT shows transpedicular screw placement at the T8 vertebral body. (D) Postoperative frontal radiograph. (E) Postoperative lateral radiograph.
See this image and copyright information in PMC

References

    1. Childers CP, Maggard-Gibbons M. Estimation of the acquisition and operating costs for robotic surgery. JAMA. 2018;320:835–836. doi:10.1001/jama.2018.9219 - PMC - PubMed
    1. Roser F, Tatagiba M, Maier G. Spinal robotics: current applications and future perspectives. Neurosurgery. 2013;72(suppl 1):12–18. doi:10.1227/NEU.0b013e318270d02c - PubMed
    1. Overley SC, Cho SK, Mehta AI, Arnold PM. Navigation and robotics in spinal surgery: where are we now? Neurosurgery. 2017;80(3 suppl):S86–S99. doi:10.1093/neuros/nyw077 - PubMed
    1. Marcus HJ, Cundy TP, Nandi D, Yang GZ, Darzi A. Robot-assisted and fluoroscopy-guided pedicle screw placement: a systematic review. Eur Spine J. 2014;23:291–297. doi:10.1007/s00586-013-2879 -1 - PMC - PubMed
    1. Joseph JR, Smith BW, Liu X, Park P. Current applications of robotics in spine surgery: a systematic review of the literature. Neurosurg Focus. 2017;42:E2 doi:10.3171/2017.2.FOCUS16544 - PubMed

LinkOut - more resources