Robotic spine surgery: what it is and what results it offers

In this post, we'll explain how robotic spine surgery represents a significant advancement in the field of neurosurgery, offering improved precision and safety compared to traditional procedures. This cutting-edge technology allows surgeons to perform complex interventions with millimetre accuracy, resulting in better patient outcomes and a faster recovery. The integration of robotics in spine surgery not only optimises the surgical process but also minimises the impact on the patient, marking a milestone in the evolution of spinal treatments.

Robotic spine surgery is a minimally invasive surgical technique that uses robotic arms controlled by a surgeon to perform spinal procedures.

Robotic spine surgery involves the use of a computer-assisted robotic system that guides surgical instruments during the procedure. Contrary to the popular image of a robot operating autonomously, in reality, the surgeon maintains full control at all times. The robot acts as a high-precision tool, providing increased stability and accuracy in placing implants, performing osteotomies, or navigating delicate anatomical structures of the spine. Before surgery, a detailed three-dimensional plan of the patient is created using medical imaging (CT scans or MRIs). During the operation, the robotic system uses this plan to guide the surgeon's instruments with sub-millimetre accuracy, ensuring that each movement is performed exactly as designed.

The key components of a robotic spinal surgery system typically include:

• Robotic arm: an articulated arm that holds and positions surgical instruments with extreme precision.
• Navigation system: an optical or electromagnetic tracking system that monitors the position of instruments and patient anatomy in real-time.
• Surgeon Console: where the surgeon controls the robot and visualises the surgical field in 3D and high definition.
• Planning software: allows the surgeon to plan the exact trajectory of instruments and the placement of implants before surgery.

Differences compared to traditional surgery

The differences between robotic spinal surgery and traditional surgery are substantial and manifest in several key aspects:

• Incision size Traditional surgery often requires larger incisions to allow the surgeon direct visualisation and manual access to the spine. In contrast, robotic surgery is minimally invasive, meaning much smaller incisions are made (often just a few centimetres). This reduces surgical trauma and damage to surrounding muscles and tissues.
• Accuracy whereas traditional surgery relies heavily on the manual skill and experience of the surgeon, robotic surgery adds a layer of computer-assisted precision. The robot can maintain an exact position and trajectory, which is especially critical in the placement of pedicle screws or performing decompressions near vital neural structures. This minimises the risk of errors and improves patient safety.
• Display In traditional surgery, visualisation can be limited. Robotic systems, however, offer an enlarged, three-dimensional view of the surgical field in real-time, allowing the surgeon greater clarity and control throughout the procedure.
• Blood loss Due to smaller incisions and greater precision, robotic spine surgery is generally associated with less intraoperative blood loss compared to open procedures.
• ERadiation exposure: although both types of surgery may require the use of fluoroscopy (real-time X-rays), robotic surgery often allows for a reduction in radiation exposure for both the patient and surgical staff, as the robotic system can guide instruments with less need for repeated imaging.

Patient advantages

The advantages of robotic spinal surgery for patients are numerous and translate directly into an improved postoperative experience and outcomes. At the Arráez Institute, we have found them to include:

• Faster recovery: As it is a minimally invasive procedure, the trauma to the tissues is less, allowing patients to recover more quickly and return to their daily activities in a shorter period of time.
• Shorter hospital stay Accelerated recovery often means patients can be discharged from hospital in less time, reducing costs and the risk of healthcare-associated infections.
• Significant reduction in post-operative pain: The smallest incisions and least tissue damage are associated with less post-operative pain, which reduces the need for strong painkillers and improves patient comfort.
• Lower risk of complications The robot’s millimetre-level precision reduces the risk of damaging adjacent nerve or blood vessel structures, resulting in a lower rate of intraoperative and postoperative complications.
• Less blood loss: As previously mentioned, the robot's precision helps to minimise bleeding during surgery.
• Smaller, more aesthetically pleasing scars Minimal incisions result in less visible scars, which is a significant aesthetic benefit for many patients.
• Greater confidence in the outcome Detailed pre-operative planning and precise robot-assisted execution enhance the confidence of both the surgeon and the patient in the success of the procedure.

Latest clinical results

Recent clinical studies and accumulated experience from leading centres demonstrate that robotic spine surgery offers promising results in the treatment of various spinal conditions. Its efficacy has been demonstrated in:

• Slipped discs Robotic precision facilitates minimally invasive microdiscectomy.
• Spinal stenosis decompression is performed more safely and accurately.
• Scoliosis and other spinal deformities: Robotic assistance is of great benefit when it comes to the precise placement of screws and the correction of curvature.
• Vertebral fractures: Stabilisation with implants is performed with greater accuracy.
• Spinal tumours: Tumour resection and spinal stabilisation benefit from robotic precision.

Patients treated with robotic spinal surgery experience a significant improvement in function, a reduction in pain and greater overall satisfaction. The trend is towards increasing adoption of this technology, as more surgeons are trained in its use and systems become more accessible and sophisticated.

Accuracy and safety

Precision is undoubtedly one of the main advantages of robotic surgery. The robotic system allows for detailed preoperative planning and precise execution of the surgery, minimising the risk of errors and improving patient safety. The ability to perform movements with sub-millimetric accuracy is crucial in a region as delicate as the spine, where proximity to the spinal cord and nerves requires the utmost caution.

Faster recovery

Thanks to the minimally invasive nature of robotic surgery, patients experience a faster and less painful recovery. This translates into reduced use of painkillers, early mobilisation, and an earlier return to daily and work activities. Reduced downtime is a significant benefit for the patient's quality of life and for their social and work reintegration.

At the Arráez Institute, we are at the forefront of neurosurgery, and we invite you to request a consultation with our robotic surgery specialists to evaluate your case and offer you the most advanced and safe solutions for your spinal health.