Robot Turns Spinal Surgery Into A Flight Simulator Game

Conducting surgery using robots with tiny arms cuts the risk of infection, reduces hospital stay time, and could revolutionize spinal surgery. And it makes the whole process feel a bit like a game.

From the interesting advances in medicine file: An Israeli company has created small robots for spinal surgery that appear to reduce pain and complication risk for patients. Mazor Robotics' SpineAssist robots are currently in use in the United States, Germany, Russia, Israel, South Korea and several other countries.

SpineAssist is a small robotic arm coupled with a workstation unit that allows surgeons to map out a patient's spinal anatomy in advance (pictured). The package also includes a clamping fixation device and special software to control the robot. These are currently the only robots specifically created for spinal surgery.

One of the robot's most interesting features, Mazor CEO Ori Hadomi tells Fast Company, is how it helps surgeons avoid making deep incisions while repairing the spine. Here is how he described the creation process:

When we were founded, we were thinking that the technology we developed would be able to be implemented in a very wide range of applications—everything from the brain to the spine to the knee. But we acknowledged that, being a small company, we must be very focused. So we decided to focus on the area where we thought we had the greatest potential—the spinal cord.

So far, spinal implants have been inserted in 2,000 different surgeries using SpineAssist. There have been no cases of nerve damage, Mazor says. A newly released study in the medical journal Spine indicates a 98% success rate in implant accuracy via SpineAssist. And a presentation at a 2010 spinal surgery conference says use of the robots reduced patients' hospital stay by a third and led to a 70% reduction in misplaced implants.

Mazor's robotics system are primarily used in cases of scoliosis and severe spinal deformities. The Dallas Morning News recently wrote on the use of SpineAssist on scoliosis patients in Texas:

"Like a pilot in a flight simulator, I can map out the patient's spinal anatomy and perform the entire procedure before the patient even arrives for surgery," [SpineAssist co-creator Dr. Isadore]Lieberman said. "I contribute the basic carpentry, just putting the screws in the right spot."

In addition to increasing precision, Lieberman said SpineAssist reduces a patient's radiation exposure during surgery. Lieberman said that with SpineAssist there's less chance of an infection, less pain after surgery, fewer complications, shorter hospital stays and quicker recovery.

"We envision this technology as ushering in a new era in spine surgeries, the same way laparoscopies transformed general surgery in the 1990s," said Sara Misuraca, program director of the Scoliosis & Spine Tumor centre at Texas Health Plano."

Hadomi also compares SpineAssist to a sort of "GPS system" for surgeons to use while inserting spinal implants.

The use of robotics for spinal surgery is, naturally, a new field. Hospitals will need to be sold on purchasing SpineAssist systems and on arranging training sessions for surgeons. Mazor is currently selling SpineAssist to hospitals for $US660,000, along with an annual $US66,000 service fee. Spinal implants marketed by the firm are also proprietary. Given the inflated costs of just about everything in healthcare, that seems a small price to pay for empirically faster and easier surgery.

[Photo courtesy Mazor Robotics]

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