From the Guidelines
The Mazor robot is recommended for use in spine and brain surgeries to enhance precision and accuracy during complex procedures. This recommendation is based on the importance of proper training and credentialing for robotic surgery, as emphasized in a study on best practices for robotic surgery training and credentialing 1. When using the Mazor robot, surgeons should undergo comprehensive training specific to the Mazor system before implementation, including both didactic education and hands-on practice with the technology.
Key Considerations for Mazor Robot Use
- The robot is particularly beneficial for pedicle screw placement in spinal fusion surgeries, where it can reduce screw malposition rates compared to conventional techniques.
- For brain surgeries, it assists with precise trajectory planning for biopsies and electrode placement.
- Preoperative planning is essential, requiring high-quality CT scans for accurate registration.
- During procedures, verification steps should be performed to confirm registration accuracy before proceeding with robotic guidance.
Benefits and Limitations
The technology should be used as an adjunct to surgical expertise rather than a replacement, with surgeons maintaining the ability to convert to conventional techniques if needed. Patient selection is important, with consideration given to complex spinal deformities, revision surgeries, and minimally invasive approaches where the robot offers the greatest benefit. The Mazor system improves surgical outcomes through reduced radiation exposure, decreased operative time, and potentially shorter hospital stays while maintaining the surgeon's decision-making authority throughout the procedure. Although the provided study 1 focuses on general robotic surgery training, its principles apply to the use of the Mazor robot in spine and brain surgeries, highlighting the need for structured training and credentialing to ensure safe and effective use.
From the Research
Recommendations for Using the Mazor Robot in Spine and Brain Surgeries
The Mazor robot has been utilized in various spine and brain surgeries, with several studies highlighting its accuracy and efficiency. Some key recommendations for using the Mazor robot include:
- Utilizing the Mazor X Stealth Edition for minimally invasive spine surgery, such as transforaminal lumbar interbody fusion, as it allows for planning and registration via preoperative thin-cut computed tomography (CT) scan or intraoperative CT "scan-and-plan" method 2
- Employing the Mazor robot for pedicle screw placement, as it has been shown to increase accuracy and decrease radiation exposure to surgeons 3, 4
- Considering the use of robotic-assisted technology for spine surgery, as it has been found to have a net positive impact on outcomes for patients and surgeons, including improved accuracy of pedicle screw placement and reduced radiation burden 5
- Being aware of the potential disadvantages of modern robotic technology, including high introductory cost, steep learning curve, and inherent technological glitches 4
Indications for the Mazor X Stealth Edition
The Mazor X Stealth Edition has been identified as a feasible option for various spine surgery indications, including:
- Minimally invasive transforaminal lumbar interbody fusion
- Pedicle screw placement
- Spinal tumor resections and ablations
- Vertebroplasties
- Deformity correction These indications have been found to have promising outcomes, with the Mazor X Stealth Edition providing improved accuracy and precision 5
Preoperative and Intraoperative Workflows
The preoperative and intraoperative workflows for the Mazor X Stealth Edition involve:
- Preoperative planning using thin-cut computed tomography (CT) scan
- Intraoperative registration and instrument workflow
- Utilization of the "scan-and-plan" method for intraoperative CT scanning and planning These workflows have been found to be effective in minimizing operative time and improving accuracy 2
Comparison with Other Robotic Platforms
The Mazor X Stealth Edition has been compared to other robotic platforms, such as the Fusion Robotics system, and has been found to have similar accuracy and precision 6. However, the Mazor X Stealth Edition has been found to have a shorter procedure workflow duration in some studies 6