Robotics and navigation in spine surgery: A narrative review

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Medical Technology

Background:

• Minimally Invasive Spine Surgery (MIS) offers improved quality of life but presents challenges in adaptation and increased radiation exposure.
• The evolution of computer-assisted surgery (CAS) integrated CT imaging into spinal procedures, leading to robotic-assisted techniques.
• Technological advancements aim to enhance safety and efficacy in complex spinal interventions.

Purpose of the Study:

• To review the historical development of computer-assisted techniques in spine surgery.
• To provide an overview of the benefits associated with CAS in spinal procedures.
• To analyze comparative studies evaluating the efficacy of CAS.

Main Methods:

• A systematic literature search was conducted using PubMed, Embase, and Scopus.
• Search terms included "Robotics," "Navigation," "computer assisted," "3D navigation," "Freehand," "O-Arm," and "spine surgery."
• Sixty-eight articles were included, excluding reviews, meta-analyses, and systematic literature reviews.

Main Results:

• Increased precision in pedicle screw insertion was reported in 49 out of 68 studies.
• Reduced radiation exposure was noted in 10 out of 19 studies.
• Decreased operative time, reduced hospital stay, and fewer complications (infections, neurological deficits, revision surgeries) were observed.

Conclusions:

• Computer-assisted spine surgery demonstrates superior accuracy in pedicle screw placement.
• CAS techniques lead to reduced blood loss, shorter operative times, and decreased radiation exposure.
• Improved functional outcomes and a lower incidence of complications are key benefits of computer-assisted spinal surgery.