Image-guidance, Robotics, and the Future of Spine Surgery

Abstract

Spine surgery has seen considerable advancements over the last 2 decades, particularly in the fields of image-guidance and robotics. These technologies offer the potential to overcome the various technical challenges in spinal surgery, such as physical and mental fatigue, hand tremor, difficulties with manual dexterity, and surgical precision. This review provides an overview of the image-guidance and robotics systems currently available. It will also provide an insight into the emerging technologies in development in the field of spine surgery. Image-guided and robotic-assisted surgical systems have been demonstrated to be safe, accurate, and time-efficient. Future advancements in the field include “augmented reality” systems, which build on these navigation platforms, but are yet to come to market. These developing technologies have considerable potential to improve the field of spine surgery. Further research is required in this area to determine superiority of these developing technologies over conventional techniques before widespread use should be adapted.

Research on Accuracy of Augmented Reality Surgical Navigation System Based on Multi-View Virtual and Real Registration Technology

“…From the perspective of the research and development of the accuracy of spinal puncture navigation system, it is one of the development trends of spinal surgical navigation system in the future to introduce augmented reality technology to monitor the surgical process and allow physician to observe the position of surgical tools and focal points of pathogenesis in real time. The introduction of robots to replace physician to complete tasks like spinal puncture is also one of the future development trends [48,49]. The development of navigation systems for spinal puncture is not limited to these.…”

Zukunft der operativen Therapie degenerativer Wirbelsäulenerkrankungen: Kontra: Die Operationszahl wird zunehmen aufgrund technischer Verbesserungen und Fortschritte

“…Bei komplexeren Verfahren wie Rekonstruktionen/Instrumentationen scheint dabei die Robotik nur eine logische Konsequenz und Weiterentwicklung, hervorgehend aus der Navigation, darzustellendie sowohl schneller als auch sicherer agieren und dabei keine jahrelange Lernkurven durchlaufen bis die Fähigkeiten eines fundierten Operateurs erreicht sind [14,15].…”

Robotic Technology

“…According to a 2019 market analysis, the average upfront cost of a spine surgical robot can be anywhere from 600,000-1,300,000 dollars depending on the model and purchasing agreement for a health system. Additionally, there is typically an annual service contract that can cost as much as $100,000 to service and maintain the robot (Ahern et al 2020). Over time the total costs to operate, service, and maintain each robot accumulate and thus increase the total cost of each surgical procedure in which the robot is used.…”

“…As such, the added upfront costs, added surgical time, and training of the surgeon, and OR staff must be considered and weighed against the potential benefits of robotic-assisted surgery. According to a review by Ahern et al, these added upfront costs could be offset if robotic-assisted spine surgery can continue to decrease operating room time, hospital length of stay, and rates of revision surgery (Ahern et al 2020). Although the learning curve for robotic-assisted surgery is steep and volume dependent, once surgeons become familiar with their use, operating room times may decrease leading to more operating room efficiency (Ahern et al 2020).…”

“…According to a review by Ahern et al, these added upfront costs could be offset if robotic-assisted spine surgery can continue to decrease operating room time, hospital length of stay, and rates of revision surgery (Ahern et al 2020). Although the learning curve for robotic-assisted surgery is steep and volume dependent, once surgeons become familiar with their use, operating room times may decrease leading to more operating room efficiency (Ahern et al 2020). Additionally, costs may be recouped by capturing a greater portion of patients who desire robotic-assisted procedures.…”