Dr. Timothy O’Connor, Director of Minimally Invasive Surgery and Robotic Spine Surgery with Marcus Neuroscience Institute at Boca Raton Regional Hospital, a part of Baptist Health, shares a case study and discusses minimally invasive robotic spine surgery.
Hi, my name is DR TIM O'Connor and I'm the director of middle invasive and robotic spine surgery here at the Marcus neuroscience Institute. I'm a fellowship trained neurosurgeon specializing in minimally invasive spine surgery and I'm also faculty within the department of surgery at florida atlantic University. I see patients at boca Raton Regional Hospital in Bethesda Hospital, East and West, all part of baptist south. I actually grew up around south florida and after training at the university of florida and then buffalo new york were also did my fellowship. I couldn't wait to come back home to help people around the town I grew up in. So robotic technology has evolved over several generations to advance minimally invasive techniques and integrate computer guidance in the operating room. Although traditional techniques for spine surgery is still widespread, newer technology has increased the reliability of accurately planning surgery with smaller incisions and subsequent decreased length of hospital stays, robotic surgical systems assist with aligning the ideal working trajectory for each patient and they improve the ergonomics throughout the surgery Using the advanced tools within the robotic platform, there's less blood loss than traditional surgery because I can use the advanced planning system for targeted guidance on exactly where I need to go with a smaller incision. And so this also results in less pain for the patient and a faster recovery after surgery. So there are several robotic platforms that have been developed in the Missouri robots and advanced surgical platform that combines advanced planning software, computer guidance as well as a robotic effect her arm to assist me during surgery using the surgical software integrated into the system, I can align the ideal trajectory for each patient's unique anatomy using their own imaging, I can essentially plan the entire surgery before the patient even steps into the operating room and see their anatomy with three D. Virtual imaging robotic assisted techniques can also help significantly decreased radiation used to both the patient and the treatment team. The patient's preoperative imaging can be merged with robotic planning software. Without any additional cT scans. The computer navigation systems that are now integrated into the robot allow improved visualization of the patient's anatomy with real time guidance without the associated radiation. In addition, the significant increase in accuracy while using robotic technology helps reduce concurrent fluoroscope. He used to reposition a screw that may not be places accurately without this technology Studies have reported nearly a 74% reduction in radiation exposure when robotic guidance platforms are used compared to typical flores, coptic guiding techniques. Several of the studies that published have answered the question of how this technology benefits patients using a minimally invasive technique with a robotic system significantly improves the recovery and decreases the length of hospital stays on average, patients stay around 1.5 days before going home after surgery and the hospital stays can be over double this with more traditional techniques. After conservative treatment options have really been exhausted and the patient is continuing to have symptoms. Any patient requiring spine surgery can benefit from a more minimally invasive approach using this technology. So I published multiple papers on robotic technologies and I presented at the Congress of neurological surgeons, among many others. And here's a case study using robotic technology that you may find interesting. It's the story of a 60 year old woman with a history of prior left sided fusion from L. 3 to L5, her symptoms resolved post operatively and she was doing very well. The following year the patient returned to clinic with progressive symptoms from the level below with bilateral S. one ridiculous empathy and progressive mechanical back pain. She completed six months of physical therapy without relief and we then discuss surgical options. The preoperative lumber. M. R. I demonstrated an L. Five S. One disc bulge with this collapse and motive changes at L. Five and S. One with loss of segmental, low doses secondary to adjacent segment disease. After discussing the various surgical options, we proceeded with anti lumber in her body placement with the restoration of segmental or doses and indirect abdominal decompression. This picture shows her imaging after the anterior lumber in her body fusion for the second stage of the operation. I then use the robotic platform to perform a minimally invasive surgery. These images show her X rays. After using the robotic platform to accurately place these screws in a minimally invasive fashion. Postoperative CT demonstrated excellent placement of all instrumentation. The patient did extremely well after surgery. She was able to go home after several days and was delighted to get back to her normal everyday activities. If this is something you think your patients can benefit from, Please reach out anytime and I'll be happy to help, mm hmm.