Robotics for spinal operations: reality or Alice in Wonderland?

Accuracy of pedicle screw placement comparing robot-assisted technology and the free-hand with fluoroscopy-guided method in spine surgery

“…Additional benefits include image-based semi-active guidance for screw insertion, the ability to hold tools for long periods of time and for repetitive motions, quick response to change in commands, excellent three-dimensional visualization, and reduction of intraoperative dosage of radiation exposure. [23]…”

Comparison of Accuracy of Pedicle Screw Insertion Among 4 Guided Technologies in Spine Surgery

“…The SpineAssist™ system consists of 2 units: a cylindrical miniature robot with an end-effector that can be moved in 6 degrees of freedom, and a connected workstation that runs graphic user interface software responsible for intraoperative real-time robot motion monitoring and control, preoperative planning, image acquisition, registration for matching, and calculations [ 13 ]. The miniature robot has characteristics of ergonomics, great dexterity that eliminates physiological tremor of surgeons, image-based semi-active guidance for screw insertion, ability to hold tools for long times and make repetitive motions, quick response to change in commands, excellent three-dimensional visualization, and reduction of intraoperative radiation exposure [ 17 ]. The SpineAssist™ platform uses a computerized mechanical positioning system that assists surgeons insert implants along the planned trajectory, with 2 advantages: 1) Registration does not require using bony landmarks and it can be applied even for difficult insertions and on deformed spines; and 2) The robot system works without relying on a camera tracking mechanism, thereby avoiding all the problems of reconnaissance between the camera and navigation instruments or targets [ 18 ].…”