title: Spinal robotics:  current applications and future perspectives.
abstract: Even though robotic technology holds great potential for performing spinal surgery and advancing neurosurgical techniques, it is of utmost importance to establish its practicality and to demonstrate better clinical outcomes compared with traditional techniques, especially in the current cost-effective era. Several systems have proved to be safe and reliable in the execution of tasks on a routine basis, are commercially available, and are used for specific indications in spine surgery. However, workflow, usability, interdisciplinary setups, efficacy, and cost-effectiveness have to be proven prospectively. This article includes a short description of robotic structures and workflow, followed by preliminary results of a randomized prospective study comparing conventional free-hand techniques with routine spine navigation and robotic-assisted procedures. Additionally, we present cases performed with a spinal robotic device, assessing not only the accuracy of the robotic-assisted procedure but also other factors (eg, minimal invasiveness, radiation dosage, and learning curves). Currently, the use of robotics in spinal surgery greatly enhances the application of minimally invasive procedures by increasing accuracy and reducing radiation exposure for patients and surgeons compared with standard procedures. Second-generation hardware and software upgrades of existing devices will enhance workflow and intraoperative setup. As more studies are published in this field, robot-assisted therapies will gain wider acceptance in the near future.
authors.affiliation: Spine Unit, Department of Neurosurgery, University of Tübingen, Tübingen, Germany. f.roser@gmx.de
authors.forename: Florian
authors.initials: F
authors.lastname: Roser
authors.forename: Marcos
authors.initials: M
authors.lastname: Tatagiba
authors.forename: Gottlieb
authors.initials: G
authors.lastname: Maier
mesh_terms: D000328:Adult; D001863:Bone Screws; D003201:Computers / Q000639:trends; D005471:Fluoroscopy; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000639:trends*; D038361:Neuronavigation / Q000295:instrumentation / Q000639:trends; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000639:trends*; D010865:Pilot Projects; D011446:Prospective Studies; D011829:Radiation Dosage; D012371:Robotics / Q000295:instrumentation / Q000639:trends*; D012985:Software Design; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000639:trends; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000639:trends*