Robotic spine surgery offers big benefits

8:03 AM, Apr 25, 2019

A pervasive problem in the U.S., back pain is the No. 1 cause of job-related disability and a leading contributor to missed workdays. Outside of work, chronic back pain tends to leach into other aspects of day-to-day life and missed activities with family and friends.

Specialists often treat spinal issues with non-surgical methods first — steroid injections or physical therapy. But if they don’t work, it may be time to consider surgery.

“We tell people to look at their quality of life,” said Louis Rappoport, MD, an orthopedic spine surgeon who’s an independent member of the HonorHealth medical staff. “You only live once, and you don’t want to throw good years away.”

With technological advances in robotics, spinal surgery has become more accurate than ever before. Available since the 1990s, minimally invasive spinal surgery was a big improvement to the open procedures previously used and the resulting long recoveries. The next leap in technology is robotic spine surgery, which offers four major advantages:

1. Greater accuracy

2. Smaller incisions

3. Less tissue trauma

4. Faster recovery

“You can do minimally invasive spinal surgery without the robot, but you lose that accuracy,” Dr. Rappoport said.

Another benefit to general robotic surgery is reducing radiation exposure for not only the patient but also for surgeons and staff in the operating room.

“Without robotic guidance, we need to take a lot of X-rays to see where we were,” Dr. Rappoport said. “There’s a higher rate of thyroid cancer in spine surgeons because of the scatter radiation. We have much less radiation exposure in robotic-assisted surgery, so it’s a win-win.”

Dr. Rappoport and his team at HonorHealth John C. Lincoln Medical Center use general robotic surgery to plan placement of screws to hold the spine in place. While this technology has improved accuracy for a typical spine surgery, Dr. Rappoport said it’s a major advantage when a patient has a spinal abnormality such as scoliosis or has had previous back surgery.

“When there is atypical anatomy in the curve of the spine, or when the patient has had spine surgery before, the landmarks we use for placing screws can be disrupted,” he said. “If you have difficult anatomy, the surgeon can plan the surgery on a tablet and decide on all the screw trajectories before the operation. That information for screw placement can then be transferred to the robot.”

The spine robot at John C. Lincoln Medical Center is FDA approved only for spine surgery, but robotic assistance has drawn the attention of other orthopedic surgeons, especially those who repair pelvic and long bone trauma.

“I think this is just the tip of the iceberg for what robots are capable of doing,” Dr. Rappoport said. “Robotic guidance in the operating room is going to be the mainstay of treatment in the future and the generation to come.”

If you’re dealing with chronic back pain, find an orthopedic spine surgeon at HonorHealth.

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