Dr. Terrence Kim, Cedars-Sinai see robotic spine surgery as the way of the future

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The Cedars-Sinai Spine Center in Los Angeles recently purchased a Mazor X Stealth Edition and completed its first spine procedure with the device Dec. 16.

Three spine surgeons — Terrence Kim, MD, J. Patrick Johnson, MD, and Robert Pashman, MD — performed the debut surgery with another three surgeons training in the robotic guidance system.

Cedars-Sinai has been using 3D-CT image guidance navigation in spine surgery, commonly referred to as "GPS Spine," for more than a decade, which provides a real-time map for surgeons to accurately assess the deep bony anatomy of the patient.

With robotics expected to play a significant role in the future of spine surgery, the hospital invested in the Medtronic system to train the next generation of spine surgeons in the emerging technology.

"Robotic spine surgery has been the natural evolution from image guidance navigation. From mapping the spine, the next steps have been to accurately maneuver within the spine," Dr. Kim said. "With such a diversity in spine patient conditions, bony anatomy, spinal disorders and surgical solutions, robotics represents a critical attempt to standardize the delivery of spinal instrumented surgical care."

As a teaching center, Cedars-Sinai ensures it is up to date with the latest in minimally invasive spine technology and places a strong emphasis on how to safely incorporate new devices into future practices.

Robotic spine surgery demands strict patient selection, considerable preoperative training and planning, and a dedicated robotic support team to achieve successful outcomes, according to Dr. Kim.

"In the literature, robotic performance is demonstrating continued patient safety with regards to high accuracy of instrumentation placement and decreased need for clinical revision surgery — all in attempts to improve overall patient outcomes," Dr. Kim added.

Although the technology is still in its infancy, several major academic institutions across the country have adapted robotic platforms and he believes its future looks bright.

Fully autonomous, multitasked spinal robots may be on the horizon, but they are not currently present. Dr. Kim sees cooperation between spine surgeons and robotic engineers as crucial for the technology to reach the level of robotics in other areas of healthcare. 

"I'm not worried about where the future takes us," he said. "Because if we are creative, careful and responsible at each step along the way, we will get to the right final destination."

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