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Advancements in Robotic Spine Surgery

May 13, 2025

Virtual Global Spine Conference - Robotic Applications in Spine Surgery

Introduction

  • Speaker: Dr. Carlos Gouard
  • Background:
    • Medical school in Brazil
    • Co-residency with host at SUNY Upstate in Syracuse
    • Current: Complex spine surgeon in Duluth, Minnesota
  • Focus: Robotic applications in spine surgery

Transitioning to Practice

  • Institution: Essentia Health in Duluth, Minnesota
    • Level 1 Trauma Center
    • New hospital tower as part of expansion project
  • Robot Introduction: Fall 2022
  • Initial Hesitation: Started with traditional techniques before incorporating the robot

Robotic Surgery Implementation

  • Team: Three full-time surgeons, two casual surgeons
  • Case Experience:
    • Personal: ~100 cases
    • Collective: ~300 cases
  • Key Benefits:
    • Predictability and precision in surgical planning
    • Enhanced accuracy in screw placement

Planning and Workflow

  • Pre-Operative Planning:
    • Typically involves CT on the day of surgery
    • Quick planning facilitated by AI enhancements
  • Registration Workflow:
    • Pre-op CT for elective cases
    • O-arm or C-arm for immediate registration
  • Challenges:
    • Misplaced screws and registration issues
    • Importance of accurate mounting and alignment

Advantages of Robotic Surgery

  • Precision and Safety:
    • Advanced pre-planning for screw trajectories
    • Reduced lateral breaches
  • Efficiency:
    • Streamlined workflow without significant time addition
    • Enhanced correction planning with panoramic view

Case Studies and Applications

  • Fractures:
    • Percutaneous instrumentations
    • Anatomical screw planning aids in fracture reduction
  • MIS TLIFs:
    • Use of Space-D retractor system
    • Integration with microscope for decompression
  • Pathological and Complex Cases:
    • Pathological fractures with lateral corpectomy
    • Ability to plan around existing hardware

Technical Considerations

  • Skiving Issue Mitigation:
    • Importance of proper sleeve placement
    • Use of Acorn drill for better landing points
  • Recommendations for Use:
    • Careful review of plans by surgeons
    • Use of power tools for reducing torque

Training and Future Implications

  • Robotics in Education:
    • Balancing traditional freehand techniques with robotic training
    • Potential for more simulation-based training
  • Future Applications:
    • Exploration of robotics for cervical spine
    • Integration with other robotic technologies like Da Vinci

Conclusion

  • Continued Development:
    • Potential for increased capabilities in robotics
    • Future innovations likely to expand applications
  • Acknowledgment:
    • Importance of collaboration and shared learning in the field

Closing Remarks

  • Holidays: No upcoming session due to holiday
  • Contact and Updates: Follow on LinkedIn and Twitter for future sessions.

These notes provide a comprehensive overview of Dr. Carlos Gouard's presentation on the use of robotics in spine surgery, detailing the implementation, benefits, technical challenges, and future directions of robotic applications in this field.

Full transcript