Impact of robot-assisted spine surgery on health care quality and neurosurgical economics: A systemic review

  • Brian Fiani
  • Syed A. QuadriEmail author
  • Mudassir Farooqui
  • Alessandra Cathel
  • Blake Berman
  • Jerry Noel
  • Javed Siddiqi


Whenever any new technology is introduced into the healthcare system, it should satisfy all three pillars of the iron triangle of health care, which are quality, cost-effectiveness, and accessibility. There has been quite advancement in the field of spine surgery in the last two decades with introduction of new technological modalities such as CAN and surgical robotic devices. MAZOR SpineAssist/Renaissance was the first robotic system to be approved for the use in spine surgeries in the USA in 2004. In this review, the authors sought to determine if the current literature supports this technology to be cost-effective, accessible, and improve the quality of care for individuals and populations by increasing the likelihood of desired health outcomes. Robotic-assisted surgery seems to provide perfection in surgical ergonomics and surgical dexterity, consequently improving patient outcomes. A lot of data is present on the accuracy, effectiveness, and safety of the robotic-guided technology which reflects remarkable improvements in quality of care, making its utility convincingly undisputable. The technology has been claimed to be cost-effective but there seems to be lack of data in the literature on this topic to validate this claim. Apart from just the outcome parameters, there is an immense need of studies on real-time cost-efficacy, patient perspective, surgeon and resident learning curve, and their experience with this new technology. Furthermore, new studies looking into increased utilities of this technology, such as brain and spine tumor resection, deep brain stimulation procedures, and osteotomies in deformity surgery, might authenticate the cost of the equipment.


Robotic spine surgery Minimally invasive spine surgery Mazor robotics Neurosurgical economics 


Funding source

The authors have not received any funding for this work from any organization.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures were done in accordance with the ethical standards. The radiological images used in this review were reviewed and approved by the local institutional review board (IRB) and have all been de-identified to maintain patient confidentiality.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.NeurosurgeryDesert Regional Medical CenterPalm SpringsUSA
  2. 2.University of Oklahoma Health Sciences CenterOklahoma CityUSA

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