Spine Center adopts robotic technology | MUSC

 Spine Center adopts robotic technology | MUSC

Lying in his hospital bed in an operating room while staff were busy, preparing for surgery, the patient quietly taunted the doctor: “Have you got all your toys?”

He did, he assured her. His operation was the first in the MUSC Health-Charleston Division using the Mazor X Stealth robotic system and Medtronic O-arm mobile X-ray machine. But those “toys” are more than shiny new toys for surgeons. Neurosurgeon Bruce Frankel, MD, believes they will allow doctors in his division to continue to innovate and improve surgeries for patients, moving MUSC Health to the highest point in spinal offerings. surgery.

The patient was clearly ill, trembling as the anesthesia team lowered the head of the bed as slowly as possible. The operation, a microdiscectomy, is to resolve the pain. This is a common method of dealing with a herniated disc within the spinal column that presses on the nerves, causing sciatica.

This isn’t usually done on the Mazor X, though. Even if the robotic system was not designed to have a discectomy in mind, Frankel wanted to see if the imaging and navigation capabilities of the system would allow for more precision when this operation was performed.

“It’s the way you challenge yourself to adopt a new technology to improve an aging operation,” he said.

a surgeon holds two tall, leather cylindrical steel instruments before inserting them into a port
Dr. Bruce Frankel prepares to start surgery. The robot is positioned to ensure that the instruments are inserted at the correct angle.

While robotic surgery has become common among other specialists, it is still very new in the field of spinal surgery. Over the past few years, several studies comparing robotic surgeries to traditional methods have shown that common spinal surgeries performed with robotic assistance can result in more accurate screw placement, less loss. of blood and shorter hospital stays for those surgeries that require hospitalization. But techniques and protocols continue to evolve as surgeons explore the possibilities of the various robotic systems the company has introduced in recent years.

Physicians of Neurosurgery and Orthopedic Surgery practice at MUSC Health reviewed five of such systems and reported their findings to hospital management. Even if MUSC had a cost-based healthcare partnership with Medtronic, which owns Mazor, the partnership didn’t push the decision to continue the Mazor system-the quality did. However, now that the health system has acquired two of the Mazor X Stealth robots, there are opportunities to continue innovation within the framework of the partnership, said Caroline Brown, chief officer of external affairs.

Part of that innovation will take place at MUSC Shawn Jenkins Children’s Hospital, which will be the first pediatric hospital in South Carolina to have the Mazor X Stealth robot.

“We are excited to announce the implementation of this advanced technology for the most complex pediatric spinal deformity patients,” said Robert Murphy, MD, chief of pediatric orthopedics. “We can provide the safest and most up-to-date orthopedic surgical care for children and adolescents with spine deformities and related spine conditions.”

After his first operation on the Mazor X – which went well, with the patient returning home the same day – Frankel said he hoped he would continue to use it for discectomies, with some adjustments.

“It gives you this precision that you didn’t get before,” he said.

The system works by taking images of the spine and then mapping the patient images to the table. This allows the surgeon to program the robotic arm to enter a port at a precise angle and location. In the past, Frankel said, doing this required multiple X-rays as he went through each step of the operation.

the screen shows x-rays of the spine and the correct path for the instruments
Brad Morrison, senior Mazor robotic trainer, left, and Salley Carson, Mazor’s spinal robot consultant assigned to MUSC Health, assisted with robot setup during the operation.

“It’s regular fluoroscopy,” he says, referring to real-time X-ray movement. “It can take a few minutes of it in complicated cases. While with it, it’s a spin on the O-arm. It reduces fluoroscopy time, which is better for the patient’s health and the health of everyone present. in the room that is also lit. ”

Frankel went on to perform a transforaminal lumbar interbody fusion – a fusion of two vertebrae – using Mazor X. In the coming months, he will use the system for most of his surgeries. He hopes that, as he already knows the strengths and limitations of the system, he can decide to use it in about three-quarters of his cases.

“This system, with its imaging, navigation and robotic assistive capabilities, will allow us to further refine the surgeries we offer at the Spine Center and improve the experiences of hospital patients and their recovery at home. , “he said.

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