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. 2021 Oct;15(s2):S65-S73.
doi: 10.14444/8141.

History and Evolution of Spinal Robotics in Pediatric Spinal Deformity

Dennis P Devito  1 , Raymund Woo  2
Affiliations

History and Evolution of Spinal Robotics in Pediatric Spinal Deformity

Dennis P Devito et al. Int J Spine Surg. 2021 Oct.

Abstract

Robotic assistance in surgical procedures is a valuable tool that enhances the safety and efficacy of invasive surgeries. These devices are divided functionally into surgeon surrogates where the device operates under the direct control of an offsite surgeon, and surgeon adjuncts where the device is an intraoperative guidance tool used in a portion of the procedure. The current state of robotic spine surgery focuses on the latter, addressing the primary task of pedicle screw placement. We would like to share our experience with the Mazor Robotics devices to discuss the underlying concepts, strengths, weaknesses, and results as they pertain to pediatric spine deformity.

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Conflict of interest statement

Disclosures and COI: Dr Devito is on the Advisory Boards of Medtronic Spine and Stryker Spine; he is also a consultant for Astura Spine and SeaSpine. Dr Woo is a consultant for SeaSpine, Innovasis, and Implanet; he also receives royalties from SeaSpine and Innovasis.

Figures

Figure 1
Figure 1
(A) SpineAssist with 6 internal actuators. (B) Robot on spinous process–mounted platform, with arm and drill guide. (C) Hoover-T robot platform mounted on pelvis; with percutaneous drill guide placement.
Figure 2
Figure 2
(A) Robotic arm base connected to spinous process–linked clamps; connected to Thompson clamp back to the table. (B) Cephalad to caudal view showing stabilized spine.
Figure 3
Figure 3
(A) Adolescent with rigid neuromuscular scoliosis with pelvic obliquity induced by post–spinal cord tumor resection. (B) Computed tomography (CT) scan showing pelvic position for planning S2 alar-iliac (S2AI) screws. (C) Absent lamina in region of prior tumor resection. (D) Mazor software with planned screw size and trajectories. (E) Mazor X Stealth robotic alignment and observed navigated drilling of planned screws. (F) Example of thoracic robot-guided screw placement. (G) Accuracy of S2AI robotic screw position verified on postoperative CT scan. (H) Final postoperative alignment.
See this image and copyright information in PMC

References

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