Spinal robotics

Abstract

Contemporary robotics integrates sensory and advanced navigational hardware to provide advanced degrees of repeatability, accessibility, and speed. The virtues of robotics have been leveraged toward revolutionizing medical applications, including major surgical techniques [ 1 ]. Robotic guidance platforms are often characterized by advanced dexterity and accuracy, superb 3D visualization [ 2 ], and the capacity to hold tools for prolonged periods, factors which signifi - cantly support minimally invasive surgeries (MIS), and hence closely correlate with lower infection rates, less pain, blood loss and tissue trauma, shorter convalescence periods, and more rapid recovery rates [ 3 - 5 ]. Robotic guidance can be an advantageous complement to spinal surgeries at large and to minimally invasive spinal procedures, especially those involving fi ne manipulation of critical anatomical structures [ 6, 7 ], with high neurological risk. In the spinal arena, a robotic interface can signifi cantly improve microsurgical dexterity and accuracy, which are critical factors when manipulating a sensitive organ of this nature. In addition, accumulating data is suggesting that robot-assisted spinal procedures spare the patient and medical staff from a signifi cant degree of exposure to ionizing radiation. Radiation exposure times in spinal procedures, which from the outset involve 10-12-fold higher doses when compared to nonspinal procedures [ 8 ], are typically twofold longer in MIS versus computed tomography (CT)-based or computer-assisted procedures [ 9 ]. Thus, many spinal surgeons still opt for standard open approaches. In a retrospective review of 108,419 spinal surgeries, only 13.2 % were performed using a minimally invasive approach [ 10 ].