The Robots Are Here to Stay

By Amin Amini, MD, MS, FAANS

Center for Brain & Spine

. https://www.centerbrainspine.com/

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The Robots Are Here to Stay

How Robotic Technology Is Improving Spine Care

Most people picture neurosurgeons working constantly through a microscope to remove brain tumors or treat dangerous aneurysms. In reality, modern neurosurgeons often spend far more time operating on the spine than on the brain. As a result, advances in spine surgery technology have had a major impact on both surgeons and patients. One of the most important recent advances is robot-assisted spine surgery.

Spinal fusion often uses titanium screws to stabilize the spine while bones heal together. Fusion may be necessary after certain fractures, because of severe wear and tear, or when relieving pressure on nerves requires removing enough bone that the spine would otherwise become unstable.

Traditionally, surgeons placed screws using anatomical landmarks and X-rays. In experienced hands, this technique is highly successful, but it can expose patients and surgical teams to radiation. Occasionally, a screw is later found to be in a less-than-ideal position and must be corrected.

The Center for Brain & Spine began using the pioneering Mazor robotic system as early as 2017. Published studies report that approximately 98–99% of robotically placed screws are in clinically acceptable positions, with revision rates below 1%. Our experience has matched or exceeded these results while also reducing blood loss, shortening hospital stays, and improving operating-room efficiency.

What Does the Robot Actually Do?

The robot does not replace the surgeon. Instead, it combines detailed 3-D imaging and surgical planning with a robotic arm that guides the surgeon along a precisely planned path.

Before placing a screw, the surgeon can select its size, starting point, angle, and final position. The robotic arm then provides a stable guide along the planned path. This can be particularly valuable for patients with small spinal bones, obesity, severe spinal deformity, prior surgery, or those requiring complex or multilevel procedures.

Importantly, robotics may help prevent the uncommon but significant screw-placement error. Traditional screw placement is already highly accurate in experienced hands, often achieving 95–97% accuracy. Increasing that to 98–99% may sound like a small improvement, but avoiding even one significantly misplaced screw can prevent nerve or blood-vessel injury or another operation.

Robotics also aligns naturally with our emphasis on minimally invasive surgery. Precise guidance enables screws to be placed through smaller incisions with less muscle disruption. For many patients, this can mean less blood loss and pain, a lower risk of infection, and a faster return to normal activities.

The brain and spine leave little room for error. Even a millimeter can matter. At the Center for Brain & Spine, robotic technology and minimally invasive techniques are important tools for making surgery more precise while reducing its physical impact on patients.

As imaging, planning software, and robotic technology continue to advance, spine surgery will become increasingly precise and less invasive, offering patients safer procedures and faster recoveries.