Navigation and Robotics in Spine Surgery: Why They Improve Accuracy and Safety

I always joke about this with my orthopedic fellows. I've had an orthopedic training program for the last 13 or 14 years, and not even one of them has opted for spine surgery as a career — they're very happy doing a knee replacement, arthroscopy, or a fracture nail instead. Spine surgery has evolved so much that the moment they look into the scope, everything is very tiny, and that can be discouraging — it looks very uphill. It takes a little while to enter the system and understand what's going on through keyholes; one has to be patient, because it has a steep learning curve and the margin of error is not there. So for the last four years I've run a dedicated fellowship national training program for spine fellows — once they're selected and come to me, they don't have the option to go to any other theatre, because they're now committed to spine surgery for the rest of their life.

We feel privileged to be treating your patient, and I hope we have done justice to you, your practice and of course the patient. I think at the end of the day we all have one common goal — we want to see our patients happy. Otherwise you, me and Jivo would not be here on a Sunday evening, leaving our families aside, if we did not have this goal.

In Dr. Puneet Girdhar's own data at BLK-Max Super Speciality Hospital, the last 350 cases using robotics achieved 100 percent accuracy in hardware placement, to within about 1 millimetre.

Radiation exposure is limited to a single 3D CT scan at the start of the procedure, making it a one-time exposure for the patient and radiation-free for the surgical team during the rest of the operation.

A frame is anchored to the pelvis and a 3D CT scan builds sagittal, coronal, axial and 3D images. The surgeon plans screw entry point, trajectory, diameter and length directly on this 3D model before the robotic arm aligns to the planned trajectory.

No. Robotics and navigation handle the objective work of screw and cage placement, but skill and experience are still required for decompression, reducing a spinal slip, and achieving good spinal balance.

Data shows that navigation and robotics, used daily with good backup, produce safer, more consistent outcomes regardless of the individual surgeon's years of experience, similar to how technology makes air travel statistically safer than car travel despite the driver's sense of control.