Technological Advancement & Robotics in the Treatment of Spine Conditions

The Spine conditions and disorders:

Back pain is an increasingly common presentation to the orthopaedic surgeon’s clinic. A combination of different injury types, sedentary lifestyle, poor ergonomics and poor core muscle strength like contribute to this evolving endemic at varying proportions.

In its common presentation, back pain is most commonly secondary to ‘wear and tear’ or degeneration of different elements of the spine. These may often be the intervertebral disc, the bones or ‘vertebrae’ themselves or the nerves that are being pinched by spurs or extra bone formation due to degeneration.

Pain, numbness and weakness are likely the commonest symptoms from long-standing spinal conditions. In its more serious forms, the spinal column can fracture from a bad fall or road traffic accident resulting in compression of the spinal cord, deformity of the back and long standing back pain.

There are some others spine conditions that result in deformity of the vertebral column since birth. For instance, some kids develop a rounded back or humpback. This accounts for poor sitting and standing positions and as a result, chronic back pain. Viewed from the back, when the back curves perpendicularly in an “S” or else “C” form, the spine disease is calleda scoliosis and can result in differing levels of the shoulder and pelvis.

Classification of Spine Disorders

There are a variety of spinal conditions that may affect the spinal column ( bones ) , the spinal cord or the nerves exiting from the spinal cord. Secondary pain may also affect the backside, shoulders, neck and lower back of the human body. Amongst the commonest spinal conditions are :

• Intervertebral disc disorder ( inflammation like disciitis )
• Ruptured or slipped disc
• Lumbar spinal cord stenosis disease
• Muscular neck ache( muscle imbalance or tightness )
• Weakness of bones and vertebral fractures( osteoporotic fractures )
• Curved spine( scoliosis )
• Spinal cord cancer
• Backbone fractures
• Degeneration of the spinal column joints ( facet joints )

Associated risk factors for lower back pain  :

Various physical, lifestyle and environmental factors can contribute to the cause or worsening of lower back pain. Some of these examples include :

• Excess body weight and poor core strength
• Inaccurate lifting techniques
• Occupational hazards like heavy and repetitive lifting jobs without proper equipment
• Poor ergonomics like desk heights, long periods of sitting etc
• Excessive exercise or risky recreational activities
• Poor angle and body posture, especially with pre-existing deformity

Red flag signs of worsening Spine Conditions:

Many signs & symptoms pre-warn us of a worsening spinal condition, such as :

• Intense, recurrent ‘shooting pains’ or numbness down the arms or legs
• Bladder disorder, in particular urinary retention
• Worsening lower back pain with difficulty finding a position of comfort
• Muscle weakness or paralysis with visible wasting

Technological Advancement & Robotics in the Treatment of Spine Conditions:

Enhancing the quality of living is one of the main advantages of combining innovations into medicine. Medical technologies like minimally-invasive operations, better monitoring systems, and more convenient scanning devices enable patients to consume less time in healing and more time enjoying a healthy life.

Robots in medicine augment healthcare by assisting medical staff with everyday tasks that take their time apart from more pressing duties and making medical systems more reliable and less harmful. They can also deliver precision surgery in small, inaccessible body partswith relative ease and less risk.

Robotic ‘augmentation’ systems in orthopaedicsurgical procedures:

The robotic supervision system consists of a cylinder-shaped device with clip-on units that can change in six-degrees-of-choice. This computer unit hosts an interface software that helps surgical planning, intraoperative picture recovery and recording, mechanical and kinematic predictions as well as automatic robot motion control.

A standard CT scan with 1 mm slices is delivered and uploaded to the robotic system preparation software ahead of surgery. Preoperatively, the surgeon shortlists different implants by choosing the length, diameter, orientation, and insertion angle on a virtual 3-D model of the spine. If required, the surgeon can also pre-determine the pin trajectories for the size augmentation element of the system. At the start of the surgery, the surgeon uploads the preoperative treatment plan onto the workstation attached to the operating room C-Arm’s robotic guidance device.

Intraoperatively, once the surgical site is already opened and the spinal levels established, the robotic system clip is connected to the spinous process. The source frame is installed onto the clamp. An oblique and an AP x-ray is then taken for registration. Once the robotic system bridge is fixed onto the clamp, the robot is installed onto the bridge. The robot is then transmitted to each of the stations to promote each pedicle fastener’s trajectory and the cement augmentation needles based on the preoperative procedure. Pedicle screws ( fixation screws for the spine ) are then inserted, and the location of the screws was verified with x-rays.

Advantages of robotic in spine conditions:

Surgical precision and implantation efficiency is developed with the use of mechanical robot-assisted spine surgery. These advantages usually mean more miniature surgeries and faster healing for cases, plus potential assistance in revision or cancer surgery.

• Likely decreased radiation exposure
• Reduced degree of technical difficulty with re-operations and postoperative analgesic requirements
• The decreased length of stay in the hospital

Surgical robotic technology is also beneficial for non-pedicle-screw operative methods, such as biopsies and vertebral augmentation. The distinct advantage of being able to pre-operatively prepare and accurately execute the surgical plan confers robotic spinal surgery an important role in the surgeon’s toolbox.

Orthofoot MD is anorthopaediccenter that provides holistic care for musculoskeletal conditions. For further information please contact Dr. GowreesonThevendran or visit the website www.orthofootMD.com