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When Precision Matters: New Technology at Marcus Neuroscience Institute Supports Robotic-Assisted Spine Surgery

Every millimeter matters when you’re undergoing delicate spine surgery. That’s why a new groundbreaking robotic platform to assist neurosurgeons adds an extra measure of surety at Marcus Neuroscience Institute.

Using state-of-the art technology that promises to become tomorrow’s standard of care, neurosurgeons Frank Vrionis, M.D. and Timothy Miller, M.D., recently performed robotic-assisted surgery on a patient who required spinal fusion.

“This is the new evolution of spine surgery,” says Dr. Vrionis, director of Marcus Neuroscience Institute, located at Baptist Health’s Boca Raton Regional Hospital. “Robotics allow us to perform minimally-invasive surgeries with increased safety and precision, leading to less blood loss, less post-operative pain and faster recovery.”

(Watch now: Hear from neurosurgeons Frank Vrionis, M.D. and Timothy Miller, M.D., about a groundbreaking robotic platform that adds an extra measure of surety for patients at Marcus Neuroscience Institute. Video by George Carvalho.)

The first patient, a man in his 70s, successfully underwent spinal fusion to stabilize the lumbar area of his back using the Mazor X™ Robotic Guidance Platform. Marcus Neuroscience Institute is the only facility in Palm Beach and Broward counties to offer this advanced technology and one of only two facilities between Central Florida and the Florida Keys, according to the manufacturer.

The robotics platform assists surgeons by combining 3D pre-operative planning, robotic guidance and navigation assistance during surgery for precise placement of spinal implants and screws. “We have to make sure that whatever we do is extremely accurate and precise because the margin of error in the spine — and the brain, of course — is minimal,” Dr. Vrionis explains. “One or two millimeters can make a big difference.”

How It Works

The Mazor X™ Robotic Guidance Platform provides surgeons comprehensive information and visualization before ever making an incision. Using 3D imaging and computer analytics, the surgeon can plan an optimal surgery in a CT-based 3D simulation of the patient’s spine. This means the angle, width and length of every screw are very specifically mapped for each patient and guided in real time during the implantation process.

During surgery, the robot “arm” with multiple joints gives the surgeon the exact, individualized trajectory to place screws, cages or other implants within the bones. Advanced intra-operative imaging and 3D cameras synchronize the position of the robotic surgical arm to conform to the pre-op surgical blueprint.

Like other robotic-assisted technologies, this system enhances the surgeon’s human skills to deliver superior precision — all while the surgeon retains full control of the procedure. The robotic arm serves as a guide as the surgeon inserts tools and implants, ensuring the correct location, trajectory and depth.

“This is a really an all-inclusive planning tool and intraoperative tool for spine surgery,” Dr. Miller says. “It allows us to plan these things very precisely pre-operatively, and then execute with extreme precision in the operating room.”

An Important Step Forward

As spinal surgery has evolved, more focus has been placed on minimally invasive techniques as an alternative to traditional open surgery. “Some of the benefits the patient would be things such as reduced blood loss, reduced intraoperative time, reduced postoperative pain, which allows patients to mobilize easier, and just an enhanced recovery,” Dr. Miller says. However, smaller incisions can pose a challenge to neurosurgeons because they offer only limited view of the patient’s anatomy during procedures.

By combining 3D pre-operative planning, robotic guidance and surgical navigation, the new technology can assist surgeons in using smaller incision to treat many spine conditions.

Among them is spinal fusion surgery, a procedure that fuses together damaged vertebrae using a bone graft to create a single, solid bone. Screws and rods are often used to hold the bones together, stabilizing the spine and reducing back pain. Other conditions that could benefit from robotic-guided spine surgery include degenerative disc disease, spinal deformity, herniated discs, spinal stenosis, revisions of previous surgeries, radiculopathy, complex scoliosis, tumor surgery and others.

“With our new sophisticated robotic system, we will be able to perform more minimally invasive procedures safely and effectively,” Dr. Vrionis says. “This is particularly beneficial to our aging population, because it reduces the risk of infection and shortens hospital stays.”

Part Of A Bigger Picture

The new robotic technology was acquired as part of continuing efforts to expand Boca Raton Regional Hospital and provide the most advanced, life-saving care to area residents.
“We are becoming a comprehensive spine center — one of the very few out of 100 in the United States and the only one in Palm Beach County — so we are very well equipped with the newest technology,” Dr. Vrionis says.

The new robotic platform is only one example of the advanced technology available at Marcus Neuroscience Institute, however. “We offer the full spectrum of comprehensive spine care from the least invasive to the most invasive,” Dr. Vrionis says.

To learn more about the spine program at Boca Raton Regional Hospital’s Marcus Neuroscience Institute, call 561-955-4600 or visit

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