Dr. Robert Brady: Robotics in spinal fusion and how the trend will develop in spine

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Robert Brady, MD, is an orthopedic surgeon and spine specialist at Norwalk (Conn.) Hospital and part of Danbury-based OrthoConnecticut.

He specializes in spine surgery of the cervical and lumbar spine, minimally invasive surgery, scoliosis surgery and orthopedic trauma.

Dr. Brady completed fellowship training in spine surgery at the Spine Institute of New York at the Beth Israel Medical Center in New York City.

In late July, Dr. Brady used a new robotic guidance and navigation system in a spinal fusion surgery to alleviate the chronic pain that his 75-year-old patient was suffering from a herniated disc. 

Question: What robot did you use in this spinal fusion procedure? What was most challenging about the procedure?

Dr. Robert Brady: Norwalk Hospital uses Globus Medical's ExcelsiusGPS robotic navigation system. The procedure we performed is no more challenging than any of our other minimally invasive surgeries. The most important part of the surgery, however, is obtaining accurate anteroposterior and lateral intraoperative fluoroscopic views of the spine and merging with the preoperative CT scan. This provides the robot with vital information to guide us in inserting the pedicle screws safely into our patient's spine.

Q: How do you see robotics developing in spine?

RB: Currently, the ExcelsiusGPS system assists the surgeon in inserting pedicle screws in the cervical, thoracic, and lumbar spine, and sacroiliac joint. With this technology, we are able to limit the intraoperative radiation during pedicle screw insertion in a safer, faster fashion. I think the next advancement in robotics for spine will be software and instruments for navigation in inserting interbody cages, anterior instrumentation, and performing cranial surgery. This will allow us to virtually eliminate any significant intraoperative radiation.

Q: Outside of robotics, what do you see as the next big trend in spine?

RB: With the advent of robotic technology, minimally invasive spine surgery has become a safer and more viable alternative to traditional open surgery. Along those lines, minimally invasive spine surgery has allowed us to significantly reduce postoperative pain, expedite recovery, and decrease the length of hospital admissions. I predict that except for major spinal deformity surgeries, the majority of degenerative surgical cases will be performed in outpatient settings.

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