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Robotic Spine Surgery: Past, Present, and Future

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Robotic Spine Surgery: Past, Present, and Future


Abstract and Introduction

Abstract

Study Design: Systematic review.

Objective: The aim of this review is to present an overview of robotic spine surgery (RSS) including its history, applications, limitations, and future directions.

Summary of Background Data: The first RSS platform received United States Food and Drug Administration approval in 2004. Since then, robotic-assisted placement of thoracolumbar pedicle screws has been extensively studied. More recently, expanded applications of RSS have been introduced and evaluated.

Methods: A systematic search of the Cochrane, OVID-MEDLINE, and PubMed databases was performed for articles relevant to robotic spine surgery. Institutional review board approval was not needed.

Results: The placement of thoracolumbar pedicle screws using RSS is safe and accurate and results in reduced radiation exposure for the surgeon and surgical team. Barriers to utilization exist including learning curve and large capital costs. Additional applications involving minimally invasive techniques, cervical pedicle screws, and deformity correction have emerged.

Conclusion: Interest in RSS continues to grow as the applications advance in parallel with image guidance systems and minimally invasive techniques.

IRB Approval: N/A.

Introduction

The first robotic spine surgery (RSS) platform received US Food and Drug Administration (FDA) approval in 2004. Interest in the technology continues to grow as the applications advance in parallel with image guidance systems and minimally invasive techniques[1–3] (Figure 1). The primary goal of this enabling technology is to improve the surgeon’s ability to provide predictable and safe outcomes. However, similar to other new technologies, robot-assisted spine surgery has a clear learning curve.[4] As a result, it is imperative for spine surgeons to understand the nuances of the different platforms and their clinical applications. Furthermore, the growing utilization and capabilities of robotic technology has prompted some to ask if it will eventually become the standard of care in spine surgery.[5] In this review, we discuss the history of robotic-assisted spine surgery, the available evidence, and emerging applications of robotic guidance for spine surgery.

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Figure 1.

Search conducted at pubmed.ncbi.nlm.nih.gov on Nov. 22, 2021. Search inclusive of words “robotic,” “spine,” and “surgery” in any search field reveals a rise in articles over time.