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Updated: May 31, 2026

An Anesthesia, Surgery, and Harvest Method for the Evaluation of Transpedicular Screws Using an In Vivo Porcine Lumbar Spine Model

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Robotic-Assisted Muscle-Preserving (RAMP) Decompression in the Thoracic and Lumbar Spine: A Cadaveric Validation.

Giuseppe Loggia¹, Fedan Avrumova¹, Marco D Burkhard¹

¹Department of Spine Surgery, Hospital for Special Surgery, New York, NY, USA.

|March 3, 2026

Summary

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This study validates a new robotic-assisted muscle-preserving (RAMP) decompression technique in cadavers. The RAMP technique precisely removes bone while sparing muscle, showing promise for safer spinal decompression.

Area of Science:

Spinal surgery
Robotic surgery
Anatomical validation

Background:

Robotic-assisted (RA) platforms enhance spinal instrumentation precision.
RA integration into decompression procedures is limited.
Conventional decompression disrupts paraspinal muscles, necessitating tissue-sparing methods.

Purpose of the Study:

Evaluate the accuracy and feasibility of a novel robotic-assisted muscle-preserving (RAMP) decompression technique.
Validate RAMP decompression in human cadavers.

Main Methods:

Eight human cadavers underwent RAMP decompressions at 80 levels (T8-L5) using a robotic bone removal instrument.
A muscle-sparing approach involved unilateral laminotomy with contralateral "over-the-top" decompression.
Computed tomography (CT) assessed deviations and anterior cortical bone removal (ACBR).

Keywords:

cadaver decompression laminectomy minimally invasive surgical procedures robotics

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Main Results:

Median deviation at the posterior laminar bone removal site was 0.7 mm; at the anterior laminar cortex, it was 0.3 mm.
Substantial ACBR (>3 mm ipsilaterally or >7.5 mm contralaterally) occurred in only 1.3% of levels.
Contralateral ACBR (87.9%) had a median distance of 4.3 mm.

Conclusions:

This is the first cadaveric validation of RAMP decompression, proving its feasibility and precision.
The muscle-sparing RAMP approach may reduce surgical morbidity and preserve spinal stability.
This technique supports expanding robotic platforms into spinal decompression procedures.