Computer Assisted Spine Surgery
Computer Navigation in Spine Surgery
Computer assisted spine surgery involves use of computer navigation for spine instrumentation. Multiple x-ray/ CT images of patients spine are fed into the computer. These images are obtained either by a pre-operative CT scan or intra-operative O-arm/ C-arm based fluoroscopic images. Computer will analyse these images and will make a 3D image of spine. With the help of infra-red markers, computer will navigate implant insertion instruments in the correct direction as will be seen on computer screen.
A robotic spine surgery will have all these steps. In addition, a robotic arm will align itself in line with planned trajectory for screw insertion to remove any error caused by hand movements while inserting the screws.
Advantages of Computer Navigation Assisted/ Robotic Spine Surgery:
- Accuracy of screw insertion is increased compared to free hand screw insertion.
- Minimally Invasive Spine Surgery: These techniques will help in MIS spine surgery as screw entry landmarks are not exposed.
- Severe Spine Deformity: These techniques are especially useful for inserting screws in deformed bones in cases with severe scoliosis/ kyphosis.
- Cervical screw insertion: Margin of error is very narrow in cervical spine. Computer navigation is especially useful to avoid inadvertent damage to surrounding vital structures while instrumenting small bones of cervical spine.
- Revision Spine Surgery: Bony landmarks for screw insertion are not available in revision spine surgeries.
Disadvantages/ Limitation of Computer Assisted Spine Surgery:
- Even though the accuracy of screw insertion is increased, still there is some error due to inherent technical factors.
- Cost of surgery goes up due to the use of specialized instruments and disposable items required for these procedures.
- There is significant cost of these specialized machines, hence they are available in selected hospitals only.
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It is important to understand that even though computer navigation provides better accuracy for spine instrumentation, it is not required for routine spine surgeries. Availability and increased cost are also important factors.

