Jean-Philippe Langevin, MD, is a fellowship-trained neurosurgeon at Pacific Neuroscience Institute in Santa Monica, Calif., and chief of neurosurgery at Greater Los Angeles Veteran Affairs Healthcare System. He specializes in the surgical treatment of movement disorders, epilepsy and psychiatric conditions.
Here, Dr. Langevin describes how he sees robotics developing in spine:
1. Minimalistic design with reduced OR footprint and improved workflow. Future robots will be less bulky and will ideally just replace other instruments such as a drill guide or the tubular retractor holder.
2. Easier integration in the OR. With improved software capabilities, the activation of the robot should become simpler. We have seen, for example, newer robots allowing fluoroscopy to CT match for registration. In this view, robotic spine surgery is simply the evolution of image-guidance spine surgery. Furthermore, with the evolution of intraoperative imaging, I expect that CT will eventually replace fluoroscopy therefore allowing for automatic registration in most cases.
3. Development of preoperative planning software. Robotic surgery allows surgeons to plan the entire surgery. Currently, pedicular screw placement can be pre-planned, but in the future laminectomy and bone resection could be planned and carried out by robotic drills.
4. With further development of the technology, robotic integration and image guidance will become ubiquitous in spine surgery. Most instruments used will eventually possess robotic attachments with an emphasis on preoperative planning and less reliance on freehand surgery.