Advancing the Adoption of Robot-Assisted Surgery as the Routine Minimally Invasive Approach in Spinal Procedures: Commentary on “Floor-Mounted Robotic Pedicle Screw Placement in Lumbar Spine Surgery: An Analysis of 1,050 Screws”

Neurospine, 2023 · DOI: https://doi.org/10.14245/ns.2346814.407 · Published: September 1, 2023

Simple Explanation

Robot-assisted (RA) techniques in spinal surgery offer enhanced safety, accuracy, and reduced invasiveness compared to traditional methods. The accuracy of pedicle screw placement in RA methods was 96.4%, with low violation rates. Currently, RA systems are mainly used for pedicle and translaminar screw instrumentation, with conventional techniques dominating clinical practice. Significant progress is needed for RA spinal surgery to become routine. To promote routine use of RA techniques, innovation in robot systems, surgeon training, economic support, patient awareness, and large-scale data collection are essential.

Study Duration

Not specified

Participants

229 patients (in the referenced study)

Evidence Level

Commentary

Key Findings

1
Robot-assisted techniques offer high accuracy in pedicle screw placement (96.4%) and minimal screw-related complications.
2
The implementation of RA techniques in cervical spinal surgery is still limited due to the complexed cervical anatomy and vulnerability to catastrophic complications from malposition.
3
Effective training empowers surgeons to enhance technical skills, develop surgical strategies, and master management of safety and risk during the use of orthopedic robots.

Research Summary

This commentary discusses the advancements in robot-assisted (RA) spinal surgery and its potential to become a routine minimally invasive approach. It highlights the enhanced safety, accuracy, and minimal invasiveness of RA techniques compared to conventional methods. The authors emphasize the need for innovation and upgrades in robot systems, including achieving safe screw placement throughout the entire spinal segments and for different types of screws. They also discuss the importance of remote interactions and improving related policies and regulations. The commentary concludes that the routine implementation of RA techniques in spinal procedures is an inevitable trend, supported by artificial intelligence and communications technology, with spinal robots potentially serving as main or independent surgical operators.

Practical Implications

Technological Advancement

Continuous innovation and upgrades in robot systems are necessary to meet diverse surgical requirements and enhance safety and accuracy.

Surgeon Training

Comprehensive training programs are crucial to empower surgeons with the technical skills and risk management strategies required for RA surgery.

Policy and Economic Support

Increased investment, healthcare reforms, and insurance coverage are needed to promote the widespread adoption of RA surgery.

Study Limitations

1
RA systems are currently in early stages.
2
Implementation of RA techniques in cervical spinal surgery is limited.
3
Lack of detailed rules for determining liability in cases of Internet medical accidents.

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