Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA.
Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, 94305, USA.
Front Med. 2019 Dec;13(6):723-729. doi: 10.1007/s11684-019-0716-6. Epub 2019 Oct 31.
Robotic systems in surgery have developed rapidly. Installations of the da Vinci Surgical System® (Intuitive Surgical, Sunnyvale, CA, USA), widely used in urological and gynecological procedures, have nearly doubled in the United States from 2010 to 2017. Robotics systems in spine surgery have been adopted more slowly; however, users are enthusiastic about their applications in this subspecialty. Spinal surgery often requires fine manipulation of vital structures that must be accessed via limited surgical corridors and can require repetitive tasks over lengthy periods of time - issues for which robotic assistance is well-positioned to complement human ability. To date, the United States Food and Drug Administration (FDA) has approved 7 robotic systems across 4 companies for use in spinal surgery. The available clinical data evaluating their efficacy have generally demonstrated these systems to be accurate and safe. A critical next step in the broader adoption of surgical robotics in spine surgery is the design and implementation of rigorous comparative studies to interrogate the utility of robotic assistance. Here we discuss current applications of robotics in spine surgery, review robotic systems FDA-approved for use in spine surgery, summarize randomized controlled trials involving robotics in spine surgery, and comment on prospects of robotic-assisted spine surgery.
手术机器人系统发展迅速。美国泌尿外科和妇科手术中广泛应用的达芬奇手术系统（直觉外科公司，加利福尼亚州森尼韦尔），其安装数量从 2010 年到 2017 年几乎翻了一番。脊柱手术机器人系统的采用速度较慢；然而，用户对其在该亚专业领域的应用非常感兴趣。脊柱手术通常需要精细操作重要结构，这些结构必须通过有限的手术通道进入，并且可能需要长时间重复任务 - 这些问题正是机器人辅助非常适合补充人类能力的地方。迄今为止，美国食品和药物管理局（FDA）已批准 4 家公司的 7 种机器人系统用于脊柱手术。评估其疗效的现有临床数据普遍表明这些系统准确且安全。在脊柱手术中更广泛地采用手术机器人的关键下一步是设计和实施严格的对照研究，以探究机器人辅助的实用性。在这里，我们讨论了机器人在脊柱手术中的当前应用，回顾了 FDA 批准用于脊柱手术的机器人系统，总结了涉及脊柱手术机器人的随机对照试验，并对机器人辅助脊柱手术的前景进行了评论。
