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NEW SPINE ROBOT TO SERVE AS BACKBONE FOR ORTHOPAEDIC INNOVATIONS IN PERSONALIZED
MEDICINE


Posted Today

As personalized medicine continues to garner more importance in the field of
health care, orthopaedic surgeons use advances in imaging technology coupled
with the latest robotics capabilities to improve the likelihood of achieving
successful outcomes for patients undergoing spinal surgery.

Image credit: Yale University (still image from the YouTube video)

The Mazor X Stealth Edition™, a new surgical robot from Medtronic, is coming to
the Yale-New Haven Hospital, Saint Raphael Campus, and the first surgeries using
this technology will be performed in May of 2022.



Peter Whang, MD, associate professor of orthopaedics & rehabilitation, works
extensively with this technology to perform robotic-assisted spinal fusions. “I
like to think of it as a co-bot rather than a robot,” Whang says. “Robots like
this, while not autonomous, function more as an extension of a skilled surgeon.
They create more opportunities for increasing the safety, reproducibility, and
efficiency of these procedures, and also fully leverage the benefits of
preoperative planning.”

With this type of novel technology, orthopaedic surgeons such as Whang are able
to upload preoperative CT scans of patients into the robotic platform to plan
out the procedure in advance and calculate trajectories of implants for spinal
operations like fusions, which allows for the placement of screws more safely
and accurately.

By utilizing robotic systems and other advanced technologies, many spine
surgeries may be performed in a minimally invasive fashion, which is associated
with numerous advantages including: less damage to muscles, reduced blood loss
and operative time, decreased complication rates, quicker recoveries, and
ultimately better clinical outcomes.

“Currently, the new robot will be used primarily for spinal fusions, which
involve stabilizing two or more levels of the spine using implants such as
screws and cages to alleviate back pain address symptoms of nerve compression,”
Whang says. “However, we will also be able to use the robot to address patients
with a wide range of conditions such as degenerative arthritis, spinal
deformities, and traumatic injuries.”

In fact, at a time when medical technology is advancing at an increasingly rapid
pace, robots like the one at Yale enable orthopaedic surgeons to perform even
more complex cases. For instance, their technological capabilities can also be
integrated with artificial intelligence and offer a range of patient-specific
treatment options necessary to provide personalized care.

Daniel Rubio, MD, assistant professor of orthopaedics & rehabilitation, focuses
many of his surgical efforts on scoliosis and other spinal deformity cases.
Scoliosis refers to a sideways curvature of the spine that can require surgery
to correct the patient’s alignment.

To illustrate how imaging technology and surgical navigation used in conjunction
with this new robot will further advance personalized medicine, Rubio discusses
a case where a patient may require surgical intervention.

“When I see the patient and review their x-rays, I can manipulate renderings of
their spine using our 3D imaging technology,” Rubio says. “This allows me to
show a representation or a model of what their optimal surgery would involve in
real-time with extremely precise detail.”

“Before patients even commit to surgery, I can clearly show them where the
incisions will be, the cages and rods that will be designed specifically for
their operation, and the improvements in their alignment with a high degree of
accuracy,” he says as he manipulates a 3D rendering of a patient’s spinal
column.

If a patient chooses surgery, the innovations in personalized medicine and
preoperative planning are where this new robot and other cutting-edge technology
truly shine.

“In many cases, surgery is a very personal decision for patients,” Rubio said.
“As their health care provider, it is my responsibility to steward the trust
they place in me to explain all the risks and benefits associated with these
procedures. If a patient decides to move forward, I will then use their imaging
to have custom implants designed specifically for them.”

Cages, screws, and rods are essential for an orthopaedic surgeon treating
conditions such as scoliosis. With rods, the material becomes much less stable
as more bends and adjustments are made manually during surgery. With the use of
this imaging technology that produces components that are designed precisely for
each patient’s anatomy, the need to reshape the rods is vastly reduced or even
eliminated and these custom-shaped rods are on hand before Rubio makes the first
incision.

When these personalized implants are coupled with the new robotic system, it
results in shortened recovery times, enhanced precision, and greater consistency
while also offering valuable real-time feedback in the operating room so
surgeons like Whang and Rubio can implement this data in a manner that is most
beneficial for each individual patient.

“As a research institution, Yale is often on the cutting edge when it comes to
surgical innovations and advanced technologies,” Whang concludes. “We understand
that there is a considerable capital cost to incorporate these novel platforms
into our spine service line. Nevertheless, we believe that they will afford us
wide-ranging opportunities to not only provide better care to our patients but
also perform studies that investigate the diverse benefits of robotics and other
innovations in spine surgery. As a result, we are much better positioned to help
our patients today while simultaneously preparing to integrate the technologies
of tomorrow into our own practices.”

Source: Yale University




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