Lois Pope LIFE Centre, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida.
Department of Neurosurgery, Westmead Hospital, Westmead, Australia.
Oper Neurosurg (Hagerstown). 2021 Apr 15;20(5):E361. doi: 10.1093/ons/opaa441.
Endoscopy and robotics represent two emerging technologies within the field of spine surgery, the former an ultra-MIS approach minimizing the perioperative footprint and the latter leveraging accuracy and precision. Herein, we present the novel incorporation of robotic assistance into endoscopic laminotomy, applied to a 27-yr-old female with a large caudally migrated L4-5 disc herniation. Patient consent was obtained. Robotic guidance was deployed in (1) planning of a focussed laminotomy map, pivoting on a single skin entry point; (2) percutaneous targeting of the interlaminar window; and (3) execution of precision drilling, controlled for depth. Through this case, we illustrated the potential synergy between these 2 technologies in achieving precise bony removal tailored to the patient's unique pathoanatomy while simultaneously introducing safety mechanisms against human error and improving surgical ergonomics.1,2 The physicians consented to the publication of their images.
内窥镜检查和机器人技术代表了脊柱外科领域的两项新兴技术,前者是一种微创超微创手术方法,最大限度地减少了围手术期的创伤,后者则利用了准确性和精度。在此,我们将机器人辅助技术新颖地应用于内窥镜椎板切开术,该技术应用于一位 27 岁的女性,她患有巨大的腰骶移行 L4-5 椎间盘突出症。获得了患者的同意。机器人引导系统用于:(1)规划聚焦式椎板切开图,以单个皮肤入点为枢轴;(2)经皮定位椎板间窗;(3)执行精确钻孔,控制深度。通过这个病例,我们展示了这两种技术之间的潜在协同作用,即在实现针对患者独特病理解剖结构的精确骨切除的同时,引入了防止人为错误的安全机制,并改善了手术的人体工程学。1,2 医生同意发表他们的图像。