ExcelsiusGPS Robotic Navigation Spine Surgery

ExcelsiusGPSRobotic SurgerySpine Surgery

GPS-like Robot Proves a “Groundbreaking” option for Spinal Fusion Surgery at Atlantic Spine Center.

Dr. Praveen Kadimcherla with Atlantic Spine Center describes the quick and precise technique of this robotically navigated spine surgery.

What is minimally invasive surgery?

Atlantic Spine Center has become the first ambulatory surgery practice of its kind along the mid-Atlantic seaboard to perform a successful spinal fusion operation using a next-generation, GPS-like robotic navigation system called the ExcelsiusGPS®, which the Medical Director Praveen Kadimcherla, calls “groundbreaking.”

“The technology is among the most advanced systems available. The robot proved quicker and more precise than any experienced surgeon performing a standard spinal fusion. The patient was able to be discharged home the same day with almost no pain following surgery, assisted with continuous pain infusion for up to 3 days,” said Dr. Kadimcherla, a renowned spinal surgeon noted for his expertise in endoscopic and minimally invasive spine surgery.

He and his colleague, Kaixuan Liu, MD, performed the robotic operation at their center’s Advanced Spine and Outpatient Surgery facility.

What are the benefits of robotically navigated surgery?

Spine fusion is intended to stabilize and strengthen a spine compromised by conditions like a herniated disc, spinal tumor, or compressed nerve, which can cause debilitating chronic pain. The operation involves permanently connecting (fusing) two vertebrae in the spine after removing the diseased or damaged material from in between them.

Dr. Kadimcherla and his colleague Dr. Kaixuan Liu MD, PhD used the ExcelsiusGPS®, which Globus Medical developed, to relieve pain in a 57-year-old patient suffering from a collapsed disc in his lower back and a bone spur impinging on a sciatic nerve. Medical images of the diseased area were imported into the ExcelsiusGPS® software, which then provided the surgeons with an anatomical plan displayed on a screen and a GPS-like mapping system to guide a robotic arm with pinpoint accuracy.

Through small incisions, the two surgeons first inserted an endoscope, a long, narrow tube equipped with a 3-D camera, to remove the herniated disc material and, in its place, load a tiny, expandable titanium cage with bone material to fill the void. The endoscope’s camera is comparable to a magnifier placed inside the spinal area. It enables surgeons to see the smallest anatomical details. Using the robot arm, Drs. Kadimcherla and Liu then positioned four screws in the spine to stabilize it.

“Insertion of the screws typically takes as long as an hour, but with the robot, we completed the procedure in under 10 minutes,” Dr. Kadimcherla said. Globus Medical data indicate that the ExcelsiusGPS® system decreases overall procedure time by more than 50 percent.

“Our patient was able to go home immediately after surgery without the intense pain that normally follows this kind of spinal fusion and avoid a costly, extended hospital stay,” Dr. Kadimcherla added.

Dr. Kadimcherla agreed, stating, “This latest technology enables procedures to be performed more quickly through smaller incisions and with less muscle and soft tissue damage. For the patient, such efficiency means a lower risk of postoperative infection, minimal blood loss, less dependency on pain medications, improved cosmetic results due to the limited size of the surgical cuts, and a quicker return to everyday activities. The system also reduces radiation exposure for both patient and surgeon.”

Recent studies of the ExcelsiusGPS® support such comments. In a 2018 issue of the Chinese Neurosurgical Journal, scientists reported that the ExcelsiusGPS® appears to have “several technological advances over prior spine robots and allows for precise execution of an intended pre-planned trajectory and accurate screw placement” in the spine.

In an article published in February 2021 in Frontiers in Surgery, authors argue that early clinical results show robotic systems offering “equivalent accuracy and decreased radiation exposure compared with other methods of spinal screw placement.” They add that a high degree of accuracy in the insertion of screws in the spine is critical because “screw malposition may lead to serious complications, such as neurologic or vascular injury.”

Although robotics, in general, is not new technology, the ExcelsiusGPS® represents a significant step forward. Dr. Kadimcherla said, “It keeps Atlantic Spine Center on the cutting edge of advancements and novel applications in spinal surgery.”

Atlantic Spine Center is a nationally recognized leader in endoscopic spine surgery with several locations in NJ and NYC. Contact our team for more information on how your spine health may benefit from the newest innovations in spinal care.