ROBOTIC-ASSISTED ENDOSCOPIC SURGERY IN LUMBAR SPINE: A TECHNICAL OVERVIEW AND CASE DEMONSTRATION.

Endoscopic spine surgery is expected to advance as endoscopic instruments become fully developed and navigable by robotic-assisted systems. This combination promises to revolutionize spine surgery, making procedures less invasive and more precise. Adopting these technologies can improve patient outcomes. A 70-year-old man was referred to our clinic presenting with right leg pain, clamping, and numbness along the right lateral aspect of the lower leg. Upon physical examination, manual muscle power testing confirmed a grade 5 strength, decreased pinprick, and light touch sensation along the L4 dermatome area of the right leg. The initial diagnosis was right L4/5 neural foramen stenosis. The procedure utilized the Excelsius GPS robotic guidance system for a robotic-assisted right L45 lateral recess and foraminal decompression via a left contralateral approach. His symptoms, particularly the right leg pain and cramping, showed significant improvement. The ongoing development and integration of robotic systems in spine surgery present substantial benefits, including increased accuracy of surgical incisions and instrument placement, reduced operative time, and decreased radiation exposure. The new electromagnetic tracking navigation system used with robotic systems may offer a better solution than the optical navigation system for reducing pin site pain and radiation exposure. However, challenges such as the suitability of robotic instruments for endoscopic spine surgery and the associated learning curve must be addressed. ABSTRACT FROM AUTHOR