Robotic Assistance for Safer Spinal Surgery
If conservative treatments such as rest and medication are ineffective in the treatment of spinal disorders, surgery might be performed to correct the spine to a better conformation and fix it in the correct position. When the spine becomes severely bent or misaligned, it becomes difficult to stand or walk due to nerve damage if left untreated, so corrective spinal fusion surgery is required. In particular, few spine surgeons in Japan specialize in children’s spinal deformities, and patients come to our clinic not only from Tokushima Prefecture, but also from Shikoku, Kyushu, and other parts of Japan.
In corrective spinal fusion, screws are inserted into each of the curved spine and fixed to rods to correct and fix the spine in its normal position and angle. In April 2022, the Department of Orthopedics introduced the Cirq robotic arm for spine surgeries at our hospital, and has applied it to spine surgeries (Fig. 1). The Cirq robotic arm assists in drilling a bony hole for screw placement (Fig. 2).
This is a difficult surgery because the spine is surrounded by the spinal cord and aorta, and the bones that require surgery are sometimes deformed. However, the use of a surgical robotic arm, which allows the surgeon to view actual intraoperative images using CT and navigational guidance, makes it possible to drill a bone hole in the targeted position without shaking the hand, making the surgery safer and more reliable. This makes it possible to perform the surgery more safely and reliably (Fig. 3).
Surgical Assistance Robots for Accurate Joint Replacement (Mako/CORI)
Many people suffer from hip and knee joint pain, with the most common cause being osteoarthritis. Osteoarthritis is a condition where the cartilage wears down due to aging and overuse, leading to pain. When pain persists despite medication and rehabilitation, joint replacement surgery becomes necessary. Surgical assistance robots support the accurate joint replacement.
The accurate hip joint replacement is crucial in preventing dislocation after surgery. The Mako robotic-arm assisted surgical system, the first of its kind approved in Japan, allows for three-dimensional planning of the position, size, and depth of bone cuts for the artificial joint based on preoperative CT scan data. The Mako robotic arm moves and stops with high precision, avoiding the shakiness of human hands, enabling safe and accurate (Fig. 4).
The knee replacement surgery is very common in Japan, but issues such as discomfort and residual pain in knee movement remain. Research has shown that accurate replacement is linked to postoperative satisfaction. CORI uses navigation system technology with infrared cameras to scan the position information of bones and ligaments during surgery. This system not only determines the position and angle of the artificial joint but also quantifies the balance of the supporting ligaments, allowing for accurate replacement tailored to each patient. Additionally, the drill used for bone cutting stops rotating or retracts the drill bit when it reaches unintended areas, ensuring a safe surgery (Fig. 5).
