History and trends of robot-assisted spine surgery_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HUANG Yi ¹ ,  WANG Yan ^1,2

1. Nankai University School of Medicine, Tianjin, 300071, P. R. China;
2. Senior Department of Orthopedics, General Hospital of Chinese PLA, Beijing, 100853, P. R. China;

Corresponding author：

WANG Yan, Email: yanwang301@163.com

Keywords：

Robotics; spine surgery; minimally invasive surgery; safety; computer navigation

DOI：

10.7507/1002-1892.202404109

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Spanning two decades since the 1st generation spinal robotics inception, the robot-assisted spine surgery (RSS) technology has evolved through generations, culminating in the 4th generation characterized by real-time visual navigation and wire-free screw placement. The fundamental principles of RSS technology include surgical planning, tracking, image registration, and robotic arm control technologies. Currently, RSS technology is maturely employed in thoracolumbar procedures and is progressively being applied in cervical surgeries, spinal tumor resections, and percutaneous operations, offering advantages in reducing tissue trauma and exposure to radiation, thereby improving patient outcomes. Emerging research also focuses on the cost-effectiveness of clinical applications and robot-specific complications. With the integration of artificial intelligence into surgical planning, RSS technology is poised to further incorporate emerging technologies and expand its application across a broader clinical spectrum.

Citation： HUANG Yi, WANG Yan. History and trends of robot-assisted spine surgery. Chinese Journal of Reparative and Reconstructive Surgery, 2024, 38(8): 904-910. doi: 10.7507/1002-1892.202404109 Copy

1.	Subramanian P, Wainwright T W, Bahadori S, et al. A review of the evolution of robotic-assisted total hip arthroplasty. Hip Int, 2019, 29(3): 232-238.
2.	Bertelsen A, Melo J, Sánchez E, et al. A review of surgical robots for spinal interventions. Int J Med Robot, 2013, 9(4): 407-422.
3.	Zhang W, Li H, Cui L, et al. Research progress and development trend of surgical robot and surgical instrument arm. Int J Med Robot, 2021, 17(5): e2309. doi: 10.1002/rcs.2309.
4.	Sukovich W, Brink-Danan S, Hardenbrook M. Miniature robotic guidance for pedicle screw placement in posterior spinal fusion: early clinical experience with the SpineAssist. Int J Med Robot, 2006, 2(2): 114-122.
5.	王岩. 临床脊柱外科治疗的新兴技术发展前沿与展望. 中华外科杂志, 2024, 62(1): 16-21.
6.	Avrumova F, Morse KW, Heath M, et al. Evaluation of K-wireless robotic and navigation assisted pedicle screw placement in adult degenerative spinal surgery: learning curve and technical notes. J Spine Surg, 2021, 7(2): 141-154.
7.	Yang GZ, Cambias J, Cleary K, et al. Medical robotics—Regulatory, ethical, and legal considerations for increasing levels of autonomy. Sci Robot, 2017, 2(4): eaam8638. doi: 10.1126/scirobotics.aam8638.
8.	Good CR, Orosz L, Schroerlucke SR, et al. Complications and revision rates in minimally invasive robotic-guided versus fluoroscopic-guided spinal fusions: The MIS ReFRESH prospective comparative study. Spine (Phila Pa 1976), 2021, 46(23): 1661-1668.
9.	Sun WX, Huang WQ, Li HY, et al. Clinical efficacy of robotic spine surgery: an updated systematic review of 20 randomized controlled trials. EFORT Open Rev, 2023, 8(11): 841-853.
10.	McCormick B, Asdourian PL, Johnson DC, et al. 100 Complex posterior spinal fusion cases performed with robotic instrumentation. J Robot Surg, 2023, 17(6): 2749-2756.
11.	Diaz-Aguilar LD, Shah V, Himstead A, et al. Simultaneous Robotic Single-Position Surgery (SR-SPS) with oblique lumbar interbody fusion: A case series. World Neurosurg, 2021, 151: e1036-e1043.
12.	Pham MH, Diaz-Aguilar LD, Shah V, et al. Simultaneous robotic single position oblique lumbar interbody fusion with bilateral sacropelvic fixation in lateral decubitus. Neurospine, 2021, 18(2): 406-412.
13.	De Biase G, Chen S, Akinduro O, et al. Awake robotic minimally invasive L_4-5 transforaminal lumbar interbody fusion. World Neurosurg, 2021, 148: 93. doi: 10.1016/j.wneu.2021.01.005.
14.	Li Y, Chen L, Liu Y, et al. Accuracy and safety of robot-assisted cortical bone trajectory screw placement: a comparison of robot-assisted technique with fluoroscopy-assisted approach. BMC Musculoskelet Disord, 2022, 23(1): 328. doi: 10.1186/s12891-022-05206-y.
15.	Ho AL, Varshneya K, Medress ZA, et al. Grade Ⅱ spondylolisthesis: Reverse Bohlman procedure with transdiscal S₁-L₅ and S₂ alar iliac screws placed with robotic guidance. World Neurosurg, 2019, 132: 421-428.
16.	王岩. 后路经椎间隙截骨的临床分型及应用. 中国脊柱脊髓杂志, 2021, 31(11): 967-975.
17.	Menger RP, Savardekar AR, Farokhi F, et al. A cost-effectiveness analysis of the integration of robotic spine technology in spine surgery. Neurospine, 2018, 15(3): 216-224.
18.	Passias PG, Brown AE, Alas H, et al. A cost benefit analysis of increasing surgical technology in lumbar spine fusion. Spine J, 2021, 21(2): 193-201.
19.	Rampersaud YR, Simon DA, Foley KT. Accuracy requirements for image-guided spinal pedicle screw placement. Spine (Phila Pa 1976), 2001, 26(4): 352-359.
20.	Davidar AD, Jiang K, Weber-Levine C, et al. Advancements in robotic-assisted spine surgery. Neurosurg Clin N Am, 2024, 35(2): 263-272.
21.	Zhou LP, Zhang ZG, Li D, et al. Robotics in cervical spine surgery: feasibility and safety of posterior screw placement. Neurospine, 2023, 20(1): 329-339.
22.	Beyer RS, Nguyen A, Brown NJ, et al. Spinal robotics in cervical spine surgery: a systematic review with key concepts and technical considerations. J Neurosurg Spine, 2022, 38(1): 66-74.
23.	Sacino AN, Materi J, Davidar AD, et al. Robot-assisted atlantoaxial fixation: illustrative cases. J Neurosurg Case Lessons, 2022, 3(25): CASE22114. doi: 10.3171/CASE22114.
24.	Bederman SS, Lopez G, Ji T, et al. Robotic guidance for en bloc sacrectomy: a case report. Spine (Phila Pa 1976), 2014, 39(23): E1398-E1401.
25.	Petrov D, Spadola M, Berger C, et al. Novel approach using ultrasonic bone curettage and transoral robotic surgery for en bloc resection of cervical spine chordoma: case report. J Neurosurg Spine, 2019, 30(6): 788-793.
26.	李佳鸿, 林书, 唐六一, 等. 骨科机器人辅助下经皮固定小切口减压术治疗晚期胸腰椎转移瘤. 中国修复重建外科杂志, 2023, 37(9): 1113-1118.
27.	郭松, 付强, 杭栋华, 等. Mazor脊柱机器人辅助改良经皮椎体成形术治疗腰椎骨质疏松性骨折的疗效分析. 中国脊柱脊髓杂志, 2021, 31(9): 818-824.
28.	袁伟, 孟小童, 刘欣春, 等. 机器人辅助经皮椎体后凸成形术治疗单/双节段骨质疏松性椎体压缩骨折临床疗效. 中国修复重建外科杂志, 2021, 35(8): 1000-1006.
29.	郑山, 王博, 韩振川, 等. 机器人辅助经椎间孔入路脊柱内窥镜手术治疗单节段腰椎椎间盘突出症. 脊柱外科杂志, 2023, 21(4): 224-229.
30.	Scherer M, Kausch L, Ishak B, et al. Development and validation of an automated planning tool for navigated lumbosacral pedicle screws using a convolutional neural network. Spine J, 2022, 22(10): 1666-1676.
31.	Esfandiari H, Weidert S, Kövesházi I, et al. Deep learning-based X-ray inpainting for improving spinal 2D-3D registration. Int J Med Robot, 2021, 17(2): e2228. doi: 10.1002/rcs.2228.
32.	Abel F, Lebl DR, Gorgy G, et al. Deep-learning reconstructed lumbar spine 3D MRI for surgical planning: pedicle screw placement and geometric measurements compared to CT. Eur Spine J, 2024. doi: 10.1007/s00586-023-08123-3.
33.	Lee NJ, Leung E, Buchanan IA, et al. A multicenter study of the 5-year trends in robot-assisted spine surgery outcomes and complications. J Spine Surg, 2022, 8(1): 9-20.
34.	Fontalis A, Hansjee S, Giebaly DE, et al. Troubleshooting robotics during total hip and knee arthroplasty. Orthop Clin North Am, 2024, 55(1): 33-48.
35.	Rossi VJ, Wells-Quinn TA, Malham GM. Negotiating for new technologies: guidelines for the procurement of assistive technologies in spinal surgery: a narrative review. J Spine Surg, 2022, 8(2): 254-265.

1. Subramanian P, Wainwright T W, Bahadori S, et al. A review of the evolution of robotic-assisted total hip arthroplasty. Hip Int, 2019, 29(3): 232-238.
2. Bertelsen A, Melo J, Sánchez E, et al. A review of surgical robots for spinal interventions. Int J Med Robot, 2013, 9(4): 407-422.
3. Zhang W, Li H, Cui L, et al. Research progress and development trend of surgical robot and surgical instrument arm. Int J Med Robot, 2021, 17(5): e2309. doi: 10.1002/rcs.2309.
4. Sukovich W, Brink-Danan S, Hardenbrook M. Miniature robotic guidance for pedicle screw placement in posterior spinal fusion: early clinical experience with the SpineAssist. Int J Med Robot, 2006, 2(2): 114-122.
5. 王岩. 临床脊柱外科治疗的新兴技术发展前沿与展望. 中华外科杂志, 2024, 62(1): 16-21.
6. Avrumova F, Morse KW, Heath M, et al. Evaluation of K-wireless robotic and navigation assisted pedicle screw placement in adult degenerative spinal surgery: learning curve and technical notes. J Spine Surg, 2021, 7(2): 141-154.
7. Yang GZ, Cambias J, Cleary K, et al. Medical robotics—Regulatory, ethical, and legal considerations for increasing levels of autonomy. Sci Robot, 2017, 2(4): eaam8638. doi: 10.1126/scirobotics.aam8638.
8. Good CR, Orosz L, Schroerlucke SR, et al. Complications and revision rates in minimally invasive robotic-guided versus fluoroscopic-guided spinal fusions: The MIS ReFRESH prospective comparative study. Spine (Phila Pa 1976), 2021, 46(23): 1661-1668.
9. Sun WX, Huang WQ, Li HY, et al. Clinical efficacy of robotic spine surgery: an updated systematic review of 20 randomized controlled trials. EFORT Open Rev, 2023, 8(11): 841-853.
10. McCormick B, Asdourian PL, Johnson DC, et al. 100 Complex posterior spinal fusion cases performed with robotic instrumentation. J Robot Surg, 2023, 17(6): 2749-2756.
11. Diaz-Aguilar LD, Shah V, Himstead A, et al. Simultaneous Robotic Single-Position Surgery (SR-SPS) with oblique lumbar interbody fusion: A case series. World Neurosurg, 2021, 151: e1036-e1043.
12. Pham MH, Diaz-Aguilar LD, Shah V, et al. Simultaneous robotic single position oblique lumbar interbody fusion with bilateral sacropelvic fixation in lateral decubitus. Neurospine, 2021, 18(2): 406-412.
13. De Biase G, Chen S, Akinduro O, et al. Awake robotic minimally invasive L_4-5 transforaminal lumbar interbody fusion. World Neurosurg, 2021, 148: 93. doi: 10.1016/j.wneu.2021.01.005.
14. Li Y, Chen L, Liu Y, et al. Accuracy and safety of robot-assisted cortical bone trajectory screw placement: a comparison of robot-assisted technique with fluoroscopy-assisted approach. BMC Musculoskelet Disord, 2022, 23(1): 328. doi: 10.1186/s12891-022-05206-y.
15. Ho AL, Varshneya K, Medress ZA, et al. Grade Ⅱ spondylolisthesis: Reverse Bohlman procedure with transdiscal S₁-L₅ and S₂ alar iliac screws placed with robotic guidance. World Neurosurg, 2019, 132: 421-428.
16. 王岩. 后路经椎间隙截骨的临床分型及应用. 中国脊柱脊髓杂志, 2021, 31(11): 967-975.
17. Menger RP, Savardekar AR, Farokhi F, et al. A cost-effectiveness analysis of the integration of robotic spine technology in spine surgery. Neurospine, 2018, 15(3): 216-224.
18. Passias PG, Brown AE, Alas H, et al. A cost benefit analysis of increasing surgical technology in lumbar spine fusion. Spine J, 2021, 21(2): 193-201.
19. Rampersaud YR, Simon DA, Foley KT. Accuracy requirements for image-guided spinal pedicle screw placement. Spine (Phila Pa 1976), 2001, 26(4): 352-359.
20. Davidar AD, Jiang K, Weber-Levine C, et al. Advancements in robotic-assisted spine surgery. Neurosurg Clin N Am, 2024, 35(2): 263-272.
21. Zhou LP, Zhang ZG, Li D, et al. Robotics in cervical spine surgery: feasibility and safety of posterior screw placement. Neurospine, 2023, 20(1): 329-339.
22. Beyer RS, Nguyen A, Brown NJ, et al. Spinal robotics in cervical spine surgery: a systematic review with key concepts and technical considerations. J Neurosurg Spine, 2022, 38(1): 66-74.
23. Sacino AN, Materi J, Davidar AD, et al. Robot-assisted atlantoaxial fixation: illustrative cases. J Neurosurg Case Lessons, 2022, 3(25): CASE22114. doi: 10.3171/CASE22114.
24. Bederman SS, Lopez G, Ji T, et al. Robotic guidance for en bloc sacrectomy: a case report. Spine (Phila Pa 1976), 2014, 39(23): E1398-E1401.
25. Petrov D, Spadola M, Berger C, et al. Novel approach using ultrasonic bone curettage and transoral robotic surgery for en bloc resection of cervical spine chordoma: case report. J Neurosurg Spine, 2019, 30(6): 788-793.
26. 李佳鸿, 林书, 唐六一, 等. 骨科机器人辅助下经皮固定小切口减压术治疗晚期胸腰椎转移瘤. 中国修复重建外科杂志, 2023, 37(9): 1113-1118.
27. 郭松, 付强, 杭栋华, 等. Mazor脊柱机器人辅助改良经皮椎体成形术治疗腰椎骨质疏松性骨折的疗效分析. 中国脊柱脊髓杂志, 2021, 31(9): 818-824.
28. 袁伟, 孟小童, 刘欣春, 等. 机器人辅助经皮椎体后凸成形术治疗单/双节段骨质疏松性椎体压缩骨折临床疗效. 中国修复重建外科杂志, 2021, 35(8): 1000-1006.
29. 郑山, 王博, 韩振川, 等. 机器人辅助经椎间孔入路脊柱内窥镜手术治疗单节段腰椎椎间盘突出症. 脊柱外科杂志, 2023, 21(4): 224-229.
30. Scherer M, Kausch L, Ishak B, et al. Development and validation of an automated planning tool for navigated lumbosacral pedicle screws using a convolutional neural network. Spine J, 2022, 22(10): 1666-1676.
31. Esfandiari H, Weidert S, Kövesházi I, et al. Deep learning-based X-ray inpainting for improving spinal 2D-3D registration. Int J Med Robot, 2021, 17(2): e2228. doi: 10.1002/rcs.2228.
32. Abel F, Lebl DR, Gorgy G, et al. Deep-learning reconstructed lumbar spine 3D MRI for surgical planning: pedicle screw placement and geometric measurements compared to CT. Eur Spine J, 2024. doi: 10.1007/s00586-023-08123-3.
33. Lee NJ, Leung E, Buchanan IA, et al. A multicenter study of the 5-year trends in robot-assisted spine surgery outcomes and complications. J Spine Surg, 2022, 8(1): 9-20.
34. Fontalis A, Hansjee S, Giebaly DE, et al. Troubleshooting robotics during total hip and knee arthroplasty. Orthop Clin North Am, 2024, 55(1): 33-48.
35. Rossi VJ, Wells-Quinn TA, Malham GM. Negotiating for new technologies: guidelines for the procurement of assistive technologies in spinal surgery: a narrative review. J Spine Surg, 2022, 8(2): 254-265.

Chinese Journal of Reparative and Reconstructive Surgery

History and trends of robot-assisted spine surgery

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content