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Does Robot Spine Surgery Correct Congenital Scoliosis?

Does Robot Spine Surgery Correct Congenital Scoliosis?

Scoliosis, simply defined as a lateral curvature of the spine, has been recognized clinically for centuries. Adolescent idiopathic scoliosis is a lifetime, probably systemic condition of unknown cause, resulting in a spinal curve or curves of ten degrees or more in about 2.5% of most populations (1). The initiative from Abu Dhabi – Health Authority (HAAD) in this regard is commendable as the screening, diagnosis, and treatment of Scoliosis in school children could bring about an effective result in the treatment of the condition. Scoliosis occurs as a congenital condition (chromosomal abnormalities); idiopathic or may be caused due to the neuromuscular or connective tissue disorder (2).

It has been observed that there is an increase in the percentage of accuracy and minimal invasiveness with robotic surgical assistance. Even though various reasons that had prevented full success with spine surgery miniature robot-assisted technology, there are new ways introduced to avoid technical and surgeon related issues. Based on the results of several studies, significant software and hardware improvements have already been implemented. The system may be used for wide range of applications including but not limited to pedicle screws, transfacet and translaminar screws, biopsy needles and vertebroplasty or kyphoplasty tools. (3).

According to Dr. Christopher Good; “Robot-assisted surgery represents a major technological breakthrough for patients. My experience with Robotic surgery began six years ago and it is very exciting to see the progress that has been made. Robot-assisted surgery helps make surgery safer and I am proud to be able to offer this revolutionary technology to my patients.” (4).

In a retrospective study conducted involving more than 800 cases to verify the clinical acceptance and accuracy of robotically-guided spinal implants and compare to those of unguided free-hand procedures; it showed that robot-assisted surgical procedure was found to be clinically acceptable in 98% of the cases when evaluated by fluoroscopic images. The robotic technology offers enhanced performance in spinal surgery when compared to freehand surgeries, by increasing placement accuracy and reducing neurologic risks (5).

Awareness of Adolescent Idiopathic Scoliosis in the United Arab Emirates needs to be taken into serious consideration as there is a lack of awareness of scoliosis in general (6).

Efforts are currently being made to remedy this in terms of awareness and scope of effective treatment procedures. The culture and environment have made the Emirati people a closed group and there are some factors within this group that suggest that the incidence of AIS might be higher than in other parts of the world. Another study published by the same group has suggested that ligamentous laxity is prevalent among many young Emirati women which seem to be correlated to incidence of AIS (7).

Our Upcoming Event – 7 CME Hours

To get a better point of view with an analysis of clinical utilization of this system, attend the upcoming event; “Recent Advances in Neuroscience and Orthopedic Conference” hosted by Medetarian Conferences Organizing (MCO), Abu Dhabi and Apollo Hospitals Group, India; which is approved my HAAD for 7 CME hours.

References

  1. Asher, Marc A., and Douglas C. Burton. “Adolescent idiopathic scoliosis: natural history and long-term treatment effects.” Scoliosis 1.1 (2006): 2.
  2. https://schoolsforhealth.haad.ae/template/haad/pdf/
  3. Barzilay, Y., et al. “Miniature robotic guidance for spine surgery—introduction of a novel system and analysis of challenges encountered during the clinical development phase at two spine centres.” The International Journal of Medical Robotics and Computer Assisted Surgery 2.2 (2006): 146-153
  4. https://www.spinemd.com/treatments/robotic-surgery#scoli
  5. Devito, Dennis P., et al. “Clinical acceptance and accuracy assessment of spinal implants guided with SpineAssist surgical robot: retrospective study.” Spine 35.24 (2010): 2109-2115.
  6. Bagnall, K., et al. “Bodymass index and scoliosis among the population of the United Arab Emirates.” Scoliosis 7.1 (2012): P9.
  7. Bagnall, K., et al. “Incidence of ligamentous laxity and scoliosis among the population of the United Arab Emirates.” Scoliosis 7.S1 (2012): O70.