Advances in robotics and pediatric spine surgery

Abstract

Purpose of reviewRobotic-assisted surgical navigation for placement of pedicle screws is one of the most recent technological advancements in spine surgery. Excellent accuracy and reliability results have been documented in the adult population, but adoption of robotic surgical navigation is uncommon in pediatric spinal deformity surgery. Pediatric spinal anatomy and the specific pediatric pathologies present unique challenges to adoption of robotic assisted spinal deformity workflows. The purpose of this article is to review the safety, accuracy and learning curve data for pediatric robotic-assisted surgical navigation as well as to identify ''best use'' cases and technical tips. Recent findingsRobotic navigation has been demonstrated as a safe, accurate and reliable method to place pedicle screws in pediatric patients with a moderate learning curve. There are no prospective studies comparing robotically assisted pedicle screw placement with other techniques for screw placement, however several recent studies in the pediatric literature have demonstrated high accuracy and safety as well as high reliability. In addition to placement of pediatric pedicle screws in the thoracic and lumbar spine, successful and safe placement of screws in the pelvis and sacrum have also been reported with reported advantages over other techniques in the setting of high-grade spondylolisthesis as well as pelvic fixation utilizing S2-alar iliac (S2AI) screws. SummaryEarly studies have demonstrated that robotically assisted surgical navigation for pedicle screws and pelvic fixation for S2AI screws is safe, accurate, and reliable in the pediatric population with a moderate learning curve.

Postoperative Communication Volume Following Total Joint Arthroplasty Can Be a Precursor for Emergency Department Visits

“…Total hip arthroplasty (THA) and total knee arthroplasty (TKA) procedures are projected to increase in volume by 659% and 469%, respectively, by the year 2060 [ 1 ]. Technological advances, ranging from robotic-assisted TJA to electronic portals or text messages, have been integrated into the practice of medicine with goals to improve healthcare efficiency, surgical precision, safety, and quality [ [2] , [3] , [4] , [5] , [6] ]. As surgical case volume increases, so does the absolute communication volume from patients to physicians and support staff.…”