What to Know About Robotic Spine Surgery (video/podcast)

Your spine serves as the “control center” for your entire body. In addition to allowing you to stand, walk and move, the spine houses and protects the spinal cord, the intricate network of nerves that connects your brain to the rest of your body.

Understandably, surgery on the spine requires flawless precision and control. Robotic spine surgery allows surgeons to operate with greater dexterity than human hands alone and, in many cases, means less time in the operating room and a faster recovery.

In this video, San Diego Health host Susan Taylor talks with Stephen Stephan, MD, an orthopedic surgeon at Scripps Clinic, about how robotic spine surgery works and the benefits it offers.

Traditional spinal surgery has used what doctors call the “freehand” technique, which means they use their hands to place the necessary hardware into the spine. While this technique has been successful, robotic spine surgery combines the expertise of a skilled spine surgeon with the precision of robotic technology.

Robotics allows for more precise planning of what will happen during surgery. Based on data from imaging exams such as X-rays, CT scans and MRIs, the technology creates a 3D model of the spine. This model helps the surgical team plan the optimal approach, including the exact placement of screws or other hardware.

During the procedure, a robotic arm assists the surgeon by guiding instruments according to the plan and providing real-time feedback to the team. Unlike the human hand, the robotic arm can turn in any direction and angle, allowing for greater dexterity. However, it’s important to note that the arm never moves on its own; using a control panel, the surgeon controls every movement the robot makes.

“We input our data, and then we’re able to plan the screws and alignment down to the half millimeter,” says Dr. Stephan. “The robot arm goes exactly into the right spot, docks into a certain location, and we use that as a targeting guide to place our screws. It gives us a more accurate ability to perform the surgery and that gives us better outcomes.”

In addition to more precise placement, robotic spine surgery offers other valuable benefits.

As a type of minimally invasive surgery, robotic surgery uses very small incisions to pass tiny surgical instruments and a video camera into the area of surgery ― in this case, the spine. The incisions are smaller than with traditional open surgery, which usually means less bleeding, lower risk of complications, faster recovery and smaller scars. Most patients need less anesthesia than with freehand surgery and have shorter hospital stays, both of which increase safety. In many cases, patients can go home the next day.

Robotic spine surgery can be a treatment option when the spine needs to be realigned through the placement of hardware. Typically, these patients have diagnoses, such as scoliosis, which is an abnormal sideways curvature of the spine, degenerative disc diseases that affect alignment and spinal fractures.

“Non-operative management should always be the first thing for spinal realignment, with physical therapy, with time, with injections,” says Dr. Stephan. “And when you get to the point where you’re thinking about spine surgery, I always recommend finding a spine surgeon you trust.”

Robotic surgery is currently not appropriate to treat muscular pain or compressed nerves in the spine; however, other treatments are available for such conditions.

If non-surgical treatments are not effective in relieving back pain caused by spinal misalignment, it may be time to consult a spine surgeon.

Ask for recommendations from trusted family members or friends who have had similar procedures. If your health care provider offers a physician referral service, that may be a good place to start. Consider the surgeon’s education, experience and how comfortable you feel with their approach. Ask what specialized training they have and how many of these surgeries they have done.

“It’s important for patients with back pain to understand that there are a lot of people looking to help you," says Dr. Stephan. “Wherever the pain is coming from, talking to your primary care physician or an orthopedic specialist is the first step to figure out how to go forward. Robotic technology is only expanding and it’s going to be doing so much more in the future.”

U.S. News consistently ranks Scripps in San Diego among the nation’s best for orthopedics. Orthopedic surgeons use robotic spine surgery that combines surgeon skill with digital navigation to improve precision and patient outcomes