What is Mazor X surgical robot?

The Mazor X Stealth Edition, the latest model of the Mazor, is a robotic surgery system consisting of a workstation and a robotic arm.

Unlike its predecessors, includes an integrated optical camera that allows the robot to acquire images in real time and perform a volumetric evaluation of the surgical field to auto-detect its location and avoid collisions with other system components.

What surgeries is it used for?

SURGERY TO CORRECT SCOLIOSIS

ARTHRODESIS OF THE DORSAL SPINE (DEGENERATIVE, TRAUMATIC OR TUMOR PATHOLOGY)

ARTHRODESIS OF THE LUMBAR SPINE (DEGENERATIVE, TRAUMATIC OR TUMOR PATHOLOGY)

VERTEBRAL INTERBODY FUSION

VERTEBRAL BIOPSY (TUMOR PATHOLOGY)

KYPHOPLASTY (VERTEBAL FRACTURES)

What are the benefits for the patient?

Robotic surgery systems have shown obvious advantages in comparison with conventional surgery of the spine:

  • Improved precision in the placement of implants. Recent studies have confirmed that the system has a 98.7% precision rate of correct placement of screws (without deviation).
  • Minimizes exposure to ionizing radiation, both for the patient and for all the operating room personnel. The average time required to insert a screw is 3.6 minutes, which reduces both the duration of the surgery and the risk of infection, as well as reduced exposure to radiation.
  • Facilitates minimally invasive surgeries, which means a smaller surgical incision, and reduced loss of blood.
  • Reduced postoperative pain thanks to the use of the robotic arm that less muscle retraction needed to operate in deep tissue.
  • Contributes to a lower risk of infection thanks to a shorter time in surgery.
  • Reduced risk of infection in the adjacent segment according to recent studies.

How does it work?

The Mazor X robotic surgery system works as follows:

  • The surgeon plans the surgical path of the implants using the patient’s images (CT scan taken before or during surgery) at the Mazor X Stealth Edition work station.
  • The patient is placed on the operating table.
  • The robot is anchored to the table and to the patient.
  • The robotic arm records images of the patient. Mazor X features an innovative cross-modality image recording process, each vertebral body is independently registered. The robotic guidance system analyzes and pairs images from different modalities, such as matching a preoperative CT scan with intraoperative fluoroscopy or 3D surgical images, including images captured at different times and in different anatomical planes.
  • The software guides the robotic arm according the the plan established by the surgeon for the surgical field.
  • Placement of implants by the surgeon aided by the real-time neuronavigation system and guided by the robotic arm.

Sources

  • Robotic-Assisted Spine Surgery: History, Efficacy, Cost, And Future Trends. D'Souza M, Gendreau J, Feng A, Kim LH, Ho AL, Veeravagu A. Robot Surg. 2019 Nov 7;6:9-23. doi: 10.2147/RSRR.S190720. eCollection 2019. Review.
  • Da Vinci Surgical System vs. Renaissance Robotic Surgical System – Is Mazor Robotics the Next Intuitive Surgical?; 2018. Garrity M. Available from: https://www.beckersspine.com/orthopedic-a- spine-device-a-implant-news/item/39853-da-vinci-surgical-system- vs-renaissance-robotic-surgical-system-is-mazor-robotics-the-next- intuitive-surgical.html. Accessed October 25, 2019.
  • Mazor Robotics, Ltd. Mazor X Stealth Edition Site Pre- Installation Guide; 2018. Accessed October 25, 2019.
  • First Prospective Study of Robotic-Guided Spine Surgery Reveals Five-Fold Reduction in Surgical Complications with Mazor CoreTM Technology; 2017. Available from: https:// www.businesswire.com/news/home/20171025005354/en.
  • Biomechanical advantages of robot-assisted pedicle screw fixation in posterior lumbar inter- body fusion compared with freehand technique in a prospective randomized controlled trial—perspective for patient-specific finite element analysis. Kim HJ, Kang KT, Park SC, et al. Spine J. 2017. doi:10.1016/j.spinee.
  • Introduction. Robotics in neurosurgery. Wang MY, Goto T, Tessitore E, Veeravagu A. Neurosurg Focus. 2017;42(5):E1. doi:10.3171/2017.2.FOCUS17832016.11.010
  • A review of surgical robots for spinal interventions. Bertelsen A, Melo J, Sánchez E, Borro D. Int J Med Robot Comput Assist Surg. 2013;9:407–422. doi:10.1002/rcs.1469
  • Impact of robot-assisted spine surgery on health care quality and neurosurgical economics: a systemic review. Fiani B, Quadri SA, Farooqui M, et al. Neurosurg Rev. 2018. doi:10.1007/s10143- 018-0971-z
  • Current applications of robotics in spine surgery: a systematic review of the literature. Joseph JR, Smith BW, Liu X, Park P. Neurosurg Focus. 2017;42:E2. doi:10.3171/2017.2.FOCUS16544
  • Next-generation robotic spine surgery: first report on feasibility, safety, and learning curve. Khan A, Meyers JE, Siasios I, Pollina J. Oper Neurosurg. 2018. doi:10.1093/ons/opy280

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