Spine Division | Robotic Surgical Guidance

Surgical innovation is a key element to fostering improved outcomes in spinal surgery. Innovative technology, however, is only as good as the team using it. The Spine Division at Boston Children’s Hospital has been a center of excellence since well before the advent of robotic surgery. Our surgical team has deep experience in all methods of spinal surgery for a variety of spine conditions. By coupling our experience with cutting-edge innovation, we continue to deliver the safest possible outcomes for patients.

Boston Children’s is one of the first children’s hospitals in the world to use the newest generation of robotic technology for patients with spine deformities, the Mazor X Stealth Robotic Guidance system.

Dr. Daniel Hedequist, chief of the Spine Division, performs spinal fusion surgery using a robotic guidance system. The robotic arm helps determine the exact location and angle of the screws used to correct spinal deformities as the surgeon attaches them to the spine.


Learn more about spinal fusion surgery

How can robotic guidance improve the quality and safety of spine surgery?

Spinal surgery aims to correct spinal deformities through the attachment of instrumentation (metal rods, hooks, and screws) to the vertebrae of the spine. Because of its close proximity to the spinal cord, this instrumentation must be attached with absolute precision. Robotic surgery combines software, imaging, and mechanical guidance to assist the surgical team in the exact placement of surgical hardware, leaving the spinal cord and the many nerves surrounding the spine undisturbed.

Before surgery, the system’s preoperative planning software helps the surgical team determine the size and type of spinal instrumentation best suited to a child’s individual anatomy. The software also provides anatomical images to help surgeons fully understand their patient’s anatomy before they enter the operating room. This detailed knowledge is particularly helpful when a child is very small or has a severe a deformity that may affect the angle of the vertebrae in unpredictable ways.

During surgery, as the surgeon attaches hardware to the spine, an automated robotic arm guides the trajectory of screw placement, minimizing any misplacement of screws and preventing surgical harm. Throughout the procedure, the system provides real-time imaging of the spine so the surgeon can verify the exact placement of each implant, providing another layer of safety. 

Robotic surgery holds the promise of improving surgical accuracy of placing spinal instrumentation in children. This accuracy could lead to an eventual decrease in surgical complications and ultimately improve the safety of pediatric spinal deformity surgeries.