Robotics, AR 'just beginning to scratch the surface' in spine surgery, Dr. Kornelis Poelstra says


Kornelis Poelstra, MD, PhD, has completed 1,111 robotic-assisted spine surgeries and says enabling technologies such as robotics and augmented reality are "just beginning to scratch the surface" in spine surgery.

In May, Dr. Poelstra, director of The Robotic Spine Institute of Las Vegas, performed the first spine surgery that combined AR with a surgical robot. The posterior lumbar fusion, completed in under two hours, integrated Medtronic's Mazor X robot and Augmedics' Xvision AR system, according to a March 7 news release.

Robotics has demonstrated an ability to improve accuracy and efficiency and shorten recovery times for spine surgery patients.

One of the biggest educational hurdles about spine robots is they take "too long to set up intraoperatively," but training and practice can help surgeons use the technology without wheeling in intraoperative 3D imaging technology, which can prolong procedure times, according to Dr. Poelstra.

"Utilizing simple 2D fluoroscopy views for 3D augmented robotics is right around the corner and will be our next step in revolutionizing automation in the OR," he said.

Dr. Poelstra said robots can be used for decompressions and disc preparation, not just for the placement of pedicle screws.

"Backed by data at the institute, we have proven that the robot has decreased the size of my incisions and also saved me time in the operating room by more directly and precisely targeting important anatomy," he said.

Robots currently are used in unison with traditional forms of imaging to provide lateral and axial views to help surgeons place pedicle screws.

The surgeon predicts robotics paired with AR tech will provide a 3D view of a patient's anatomy that does not yet exist, greatly improving precision and efficiency in spine surgery and reducing recovery times.

Dr. Poelstra also predicts AR tech will allow surgeons to see bone, ligaments and nerves, helping them to further identify impingements and other pathology that needs to be addressed.

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