In 2004, Mazor SpineAssist became the first robot approved by the FDA to guide the placement of pedicle screws during spine surgery.
Since then, robotic spine surgery has developed rapidly. Medical device companies are investing heavily in the technology, with many spine surgeons projecting robots to develop far greater autonomy in the operating room in the future.
What you need to know about robotic spine systems at Medtronic, Globus Medical, Zimmer Biomet and NuVasive:
Medtronic
In a $1.7 billion deal in December 2018, Medtronic acquired Mazor Robotics as part of its plan to combine its spinal implants, navigation and 3D imaging technology with the Mazor X robotic guidance system.
In January 2019, Medtronic launched the Mazor X Stealth Edition for spine surgery. The technology enables surgeons to create personalized preoperative 3D surgical plans and holds instrumentation in place with a robotic arm during spine surgeries.
The Mazor X costs about $850,000 with each surgery resulting in around $1,500 in disposable sales.
Globus Medical
In 2014, Globus Medical acquired Excelsius for an estimated $40 million. The company's flagship spine product, ExcelsiusGPS, earned CE Mark approval and FDA clearance in 2017.
ExcelsiusGPS combines a robotic arm with navigation to improve accuracy in the placement of screws during spine surgery and reduce radiation exposure for the surgical team.
The platform is priced at about $1.5 million and supports screw placement in several approaches including posterior cervical, posterior thoracic sacroiliac and posterior lumbar.
Zimmer Biomet
Zimmer Biomet acquired Medtech SA for at least $132 million in 2016. Medtech SA developed the Rosa Brain and Rosa Spine robotic-assisted surgery systems, which cost about $700,000 each.
Rosa Spine was cleared by the FDA in 2016, but the company's new technology — the Rosa One Spine System — received FDA approval in March 2019.
Rosa One Spine also combines robotics and navigation with real-time patient tracking capability, assisting surgeons in minimally invasive and complex thoracolumbar spine procedures.
NuVasive
NuVasive is developing its Pulse robotic system for spine surgery, which it expects to compete with the Mazor X, ExcelsiusGPS and Rosa Spine systems.
The Pulse system is an open imaging platform integrated with Siemens' 3D mobile C-arm, the Cios Spine. Due to hardware and software updates following beta testing, as well as challenges brought by the pandemic, the timeline for the technology has been pushed back.
NuVasive plans to finish testing and receive FDA clearances in the summer of 2021, rather than the previously communicated first half of 2021. The first-in-human use of the Pulse system is expected to take place in 2022.