Robot-assisted pedicle screw placement

With new technological advancements in spine surgery, come accompanying expectations regarding the association between the incremental improvements of the surgical technique and its ability to provide superior patient outcomes and more efficient surgical workflows at lower cost. In many surgical fields, robots are still being tested on an experimental level. In others, such as urological surgery and gastrointestinal surgery, robots are a routine part of subspecialty practice. Spinal surgeons have begun to adopt the available robotic systems into their daily workflow. Yet, despite the majority of clinical results showing equally high or even higher accuracy for robot-assisted pedicle screw instrumentation and reduced radiation exposure, the evidence for long-term clinical outcome is still scarce. The chapter provides an overview of the existing robotic platforms and the workflow in spine surgery, with an emphasis on minimal invasive fusion procedures, where integration of robotic systems might be especially beneficial. Future technological improvements in these robotic systems specific to spine surgery, the integration of intraoperative imaging modalities, and the awareness of a significant learning curve will provide a cost-effective surgical tool that facilitates better clinical results with decreased surgical time.