Workflow and Recommendations for Lateral Position Spinal Surgery With Robotics and Navigation

Recent decades have seen numerous significant advancements in the field of spinal and lumbar fusion surgeries, including the augmentation of surgical precision with robotic navigation. Use of robotic navigation in single-position lumbar fusion surgery (SPLS), which utilizes a lateral approach and requires no mid-procedure repositioning of the patient, has been shown to improve outcome measures and overall operative efficiency in addition to reducing patient time under anesthesia. Despite indications that robotically-assisted SPLS is superior to more traditional approaches in terms of cost and outcomes, relatively few surgeons currently utilize this innovative combination. This is largely attributed to the well-documented learning curve associated with robotically assisted surgery. In an attempt to mitigate this and reduce the barrier to entry for robotically-assisted spinal surgery, this report will give a detailed description of the workflow for SPLS procedures using robotic navigation. The authors will also give best-practice recommendations applicable for spine surgeons and surgical residents unfamiliar with surgical robotics systems.