Robotic Spine Surgery for Complex and Revision Cases

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.

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.

In patients who have already had surgery elsewhere, finding safe anatomical landmarks can be difficult and risks entering the dura in scarred tissue. Robotics allows the surgeon to pre-plan screw placement on a 3D image using safe zones identified before the operation, rather than navigating live during surgery.

Yes. It has been used to correct grade two spinal listhesis with an expandable cage, restoring disc height and achieving good sagittal, segmental and overall spinal balance, including in multi-level cases.

Dr. Puneet Girdhar performed India's first C1-C2 transarticular screw fixation using robotic technique for a fracture at the top of the spine, an area previously fixed freehand under C-arm imaging.

The C1-C2 bony elements are small, and a drill can skid across them during freehand placement under C-arm imaging.

The robotic procedure, planned entirely on screen in advance, was completed in about 30 minutes, compared with two to three hours for the open, freehand technique.