Robotic spine surgery: Technical note and descriptive analysis of the first 40 cases

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Medical Robotics

Background:

• Increasing global incidence of spinal pathologies due to aging populations.
• Transpedicular screw fixation is a standard for unstable spinal conditions.
• Robotic navigation represents a recent advancement in spinal surgery techniques.

Purpose of the Study:

• To describe the technical aspects and workflows of the ExcelsiusGPS® robotic navigation system.
• To evaluate the initial clinical outcomes of robotic-assisted spinal surgery in 40 patients.

Main Methods:

• Utilized the ExcelsiusGPS® robotic navigation system for screw implantation.
• Included 40 patients undergoing thoracic and lumbar spine procedures between July 2023 and February 2024.
• Procedures involved both minimally invasive surgery (MIS) and open surgery approaches.

Main Results:

• Successfully implanted 250 transpedicular screws with a 2.5% intraoperative malpositioning rate.
• Median surgery duration was 143 minutes, median hospital stay was 4 days, with 0% blood transfusion rate.
• Median intraoperative radiation dose was 899 mGy/cm², and median blood loss was 150 ml.

Conclusions:

• Robotic spine surgery enhances accuracy (96-100%) and reduces radiation exposure compared to conventional methods.
• The ExcelsiusGPS® system allows for larger screw implantation, potentially improving biomechanical strength.
• The system is versatile, applicable to the entire spinal axis and certain brain pathologies, with a manageable learning curve.