Abstract
Background Minimally invasive techniques in spine surgery have gained significant popularity
due to decreased tissue dissection and destruction, postoperative pain, and hospital
stay. The laparoscopic anterior lumbar interbody fusion (ALIF), an innovation in minimally
invasive spine surgery, is rarely done because it has marginal benefit over the mini-open
ALIF technique in rates of retrograde ejaculation and vascular complications. We propose
these outcomes can be improved with enhanced robotic-assisted dissection and exposure
for ALIF.
Patients Two patients with single-level degenerative spine disease at L5-S1, associated with
mechanical back pain, underwent anterior spinal exposure using the da Vinci S Surgical
Robot during ALIF.
Results In this report, we provide the first description of the use of a surgical robot in
the dissection and exposure for ALIF in patients with degenerative spine disease.
We demonstrate successful use of the da Vinci Surgical Robot in separating the presacral
nervous plexus from retroperitoneal structures without postoperative vascular or urological
complications over a 1-year follow-up period.
Conclusion Use of the robotic assistance in the performance of ALIF is possible without significant
operative complications. This technique may provide added benefit over conventional
laparoscopic approaches to the spine.
Keywords
minimally invasive spine - spinal fusion - endoscopy
