Novel Robot-assisted Technique in Lumbar Disk Replacement

Introduction: Lumbar disk replacement (LDR) has gained popularity in recent years as a treatment option for low back pain caused by degenerative disk disease (DDD) and as a motion-preserving alternative to lumbar fusion surgery. Modern keeled implant (Prodisc-L) confers higher stability to prevent early migration and improve bony ongrowth. The placement and trajectory of keel cuts are hence vital for the implant’s effectiveness and longevity. Materials and Methods: The authors describe their technique of integrating ExcelsiusGPS robot-arm navigation to improve the accuracy of LDR placement. Results: With this approach, we are able to reliably reproduce the centralised alignment of the LDR keel cut and implant insertion on the coronal and sagittal plane. Discussion: This is the first reported case of robot-arm assistance used in anterior-based lumbar disk replacement. This technique lays the groundwork for future workflow and designs of navigation software and tools specific to LDR. Level of Evidence: IV