Spinal robotics continues to develop, but far from 'watershed moment': 7 spine surgeons discuss

Alan Condon -   Print  |

Seven spine surgeons discuss robotics in spine surgery and how the technology will develop in the field.

Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses.

Next week's question: What healthcare policies concern you the most?

Please send responses to Alan Condon at acondon@beckershealthcare.com by Wednesday, Feb. 26, 5 p.m. CST.

Note: The following responses were edited for length and clarity.

Question: What do you think about robotics in spine surgery? How do you see it developing in the next five years?

Christopher Blanchard, DO. Resurgens Orthopaedics (Atlanta): Robotics in spine surgery are still in their infancy compared to robotics in general surgery. Currently, the largest utility of a robot is with screw placement. This is rapidly changing with software and hardware updates. In the next five years, I think robotics will continue to evolve, allowing surgeons to perform surgery in a less invasive way to allow for quicker recovery. I believe as robotics develops, it may completely change how we think about and perform spinal procedures.  

Vladimir Sinkov, MD. Sinkov Spine Center (Las Vegas): Robotic-assisted spine surgery is an amazing emerging technology. It allows for more precise instrument and implant placement, with soft tissue disruption and more efficiency. This technology has evolved tremendously over the past several years.  Even greater enhancements and expansions of this technology will be coming in the near future. In five years, I anticipate that all steps of most common spine surgeries could be done with robotic assistance — from incision and exposure, to nerve decompression, hardware placement and deformity reduction. It will be done in the most minimally invasive way possible. The result will be more efficient, safe and accurate procedures that will help minimize postoperative pain, shorten postoperative recovery and result in superior outcomes for our patients.

Brian Gantwerker, MD. Craniospinal Center of Los Angeles: Spinal robotics is already a competitive field. In my mind, it is still a pedicle screw placement template. What I am looking for is a device that can help the actual 'surgery part' of the case. Something that can act like a Mako-type device and help with decompression or corpectomy, as well as assist in graft or interbody placement and finally, instrumentation. Right now, it is still very nascent. In its inevitable future iterations, it will be used more in general surgery, oncological surgery, urology and obstetrics, where it is truly an evolutionary next step. It has a long way to go until that watershed moment.

Fred Naraghi, MD. Klamath Orthopedic Clinic (Klamath Falls, Ore.): Robotics in spine surgery are used to aid in the accuracy of screw placement in complex cases. Robotics will continue to improve, although currently the cost is high for most centers. U.S. healthcare is rapidly transitioning from a fee-for-service payment model to a value-based reimbursement model. Value is defined as outcomes divided by cost. To remain successful, more evidence is needed to show improved outcomes as well as lowering the costs of this technology.

James Chappuis, MD. Spine Center Atlanta: I think the use of robotics is a very costly solution for procedures that today have relatively good outcomes without its use. In the outpatient setting, it's almost cost-prohibitive. As time goes on, I think there will be a role for that, particularly in more complicated instrumentation procedures, and that its use will continue to develop and flourish.

Issada Thongtrangan, MD. Microspine (Phoenix): Robotic-assisted spine surgery will continue to evolve, and I anticipate it will be part of the ultimate planning in spine surgery. The data on pedicle screw placement is already accepted in the spine community. It already expanded to the complex deformity reconstruction as it helps tremendously with preoperative planning. I expect it will also be utilized more in minimally invasive spinal fusion.

Harel Deutsch, MD. Rush University (Chicago): Robotics will continue to develop. Currently, I believe it will provide spine companies and representatives with another way to add value to their portfolio of products.

More articles on robotics:
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