Advancements in robotic-assisted spine surgery: A literature review and technology comparison

Abstract

Background

Since the first spinal robotic system was developed in 2004, there have been many innovations in the field of neurosurgery including new robotic systems that utilize optical tracking systems (OTS) like the Mazor X Stealth Edition. OTS is an effective navigation system with high accuracy, yet it does have certain limitations like line-of-sight obstructions. Recently, alternative technology like electromagnetic navigation has been explored to address this challenge and shown promising results.

Methods

A comprehensive literature review was completed using databases such as PubMed, Google Scholar, and ScienceDirect to identify all current spinal robotic systems. Information regarding 8i Robotics was obtained directly from the manufacturer based on company-reported specifications.

Discussion

There are currently six spinal robotic systems available, all of which utilize OTS for navigation. One of the main challenges of this type of navigation is line of sight obstructions which can result in decreased accuracy and cause delays in time. Recent development involves the use of EM navigation which has not been done in spine surgery thus far. Since EM navigation eliminates the need for line of sight, it creates an efficient and flexible environment for the surgeon to work in. However, EM navigation is not without challenges, including electromagnetic interference from metallic objects, which can disrupt signals and decrease accuracy.

Conclusion

OTS remains the gold standard in robotic spine surgery due to its proven safety and accuracy. However, EM navigation presents a promising alternative by addressing line-of-sight limitations while maintaining high accuracy.