Robotics in Spinal Surgery : The Future is Here

A spinal surgery has evolved, new techniques have been developed to address complex pathologies through smaller anatomical corridors, leading to better outcomes. Surgical procedures of the spine benefit from fine motor coordination, a highly experienced surgeon, and the best available technology,5,9,45 and it is clear that surgical robotic systems have established a foothold in medicine as an enabling technology.15 The rationale for using robotic systems started with the idea that robots would improve surgical dexterity by motionscaling and tremor-filtering and that they would also eliminate fatigue-related errors.39,44 Furthermore, robots should have superior precision and nearly unlimited endurance and should be able to execute repetitive tasks without decreased performance.50 In recent years, robotic systems have been used in many surgical disciplines, including gynecology, urology, cardiothoracic surgery, vascular surgery, and general surgery,45 whereas robotassisted spinal procedures have only become commercially available relatively recently.7,12 We present an English-language literature review of articles published in the last 15 years that are related to robotic systems used in spinal surgery; articles related to imaging and diagnostic devices were excluded. The objective of this review is to present the current state of robotic-assisted spinal surgery, including the advantages and disadvantages of robotic systems, most common applications, and different types of robots used. Surgical procedures of the spine benefit from fine motor coordination, a highly experienced surgeon, and the best available technology. Robotic systems have been used in many surgical disciplines, including spinal surgery. This review will present the advantages and disadvantages of robot-assisted spinal surgery, as well as the most common applications and different types of robots used for spinal surgery. The robotic systems most often used in spinal surgery are masterslave systems and trajectory assistance robots. To date, robotic systems have been used with favorable outcomes in several types of spinal surgery, including posterior instrumentation, tumor resection, and vertebroplasty. Robot-assisted spinal surgery is an ongoing investigational field, and new research directions may lead to the development of very different robotic surgical devices in the future.

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