====== Mazor Robotics ======

http://www.mazorrobotics.com

https://www.medtronic.com/us-en/healthcare-professionals/products/spinal-orthopaedic/spine-robotics/mazor-x-stealth-edition.html

Mazor Robotics (Hebrew: מזור רובוטיקה‎, Mazor Robotika) was an Israeli medical device [[company]] and manufacturer of a robotic guidance system for spine surgery that was acquired by Medtronic in December [[2018]].

Surgeons that utilize Mazor Robotics Renaissance generally specialize in orthopedic surgery or neurosurgery.


===== Case series =====

Adult patients (≥18-years-old) who underwent robot-assisted spine surgery from 2016-2019 were assessed. A propensity score matching (PSM) algorithm was used to match Mazor X to Renaissance cases. Preoperative CT scan for planning and an intraoperative O-arm for screw evaluation were preformed. Outcomes included screw accuracy, robot time/screw, robot abandonment, and radiation. Screw accuracy was measured using Vitrea Core software by 2 orthopedic surgeons. Screw breach was measured according to the Gertzbein/Robbins classification.

Results: After PSA, a total of 65 patients (Renaissance: 22 vs. X: 43) were included. Patient/operative factors were similar between robot systems (P > .05). The pedicle screw accuracy was similar between robots (Renaissance: 1.1%% vs. X: 1.3%, P = .786); however, the S2AI screw breach rate was significantly lower for the X (Renaissance: 9.5% vs. X: 1.2%, P = .025). Robot time per screw was not statistically different (Renaissance: 4.6 minutes vs. X: 3.9 minutes, P = .246). The X was more reliable with an abandonment rate of 2.3% vs. Renaissance:22.7%, P = .007. Radiation exposure were not different between robot systems. Non-robot related complications including dural tear, loss of motor/sensory function, and blood transfusion were similar between robot systems.

Conclusion: This is the first comparative analyses of screw accuracy, robot time/screw, robot abandonment, and radiation exposure between the Mazor X and Renaissance systems. There are substantial improvements in the X robot, particularly in the perioperative planning processes, which likely contribute to the X's superiority in S2AI screw accuracy by nearly 8-fold and robot reliability by nearly 10-fold
((Lee NJ, Zuckerman SL, Buchanan IA, Boddapati V, Mathew J, Marciano G, Robertson D, Lakomkin N, Park PJ, Leung E, Lombardi JM, Lehman RA. Is There a Difference in Screw Accuracy, Robot Time Per Screw, Robot Abandonment, and Radiation Exposure Between the Mazor X and the Renaissance? A Propensity-Matched Analysis of 1179 Robot-Assisted Screws. Global Spine J. 2021 Jul 8:21925682211029867. doi: 10.1177/21925682211029867. Epub ahead of print. PMID: 34235996.)).
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To study the differences between robot-guided (Mazor X, Mazor Robotics Ltd., Caesarea, Israel) and 3-dimensional (3D) computed tomography (CT) navigation (O-arm Surgical Imaging System, Medtronic, Minneapolis, Minnesota, USA) for the insertion of pedicle screws.

METHODS:
We reviewed the charts of 50 patients who underwent robot-guided pedicle screw insertion (between May 2017-October 2017), and 49 patients who underwent 3D-CT navigation pedicle screw insertion (between September 2015-August 2016). Variables included were age, sex, body mass index, blood loss, length of stay, lumbar level(s), operation time, fluoroscopy time, radiation dose, accuracy, and time-per-screw placement.

RESULTS:
Mean ages were 59.3 years in the robotic group and 58.2 years in the 3D-CT navigation group. Mean was 30.7 kg/m2 in the robotic group and 32.1 kg/m2 in the 3D-CT navigation group. Mean time-per-screw placement was 3.7 minutes for the robotic group and 6.8 minutes for the 3D-CT navigation group, P < 0.001. In the robotic group, 189 of 190 screws were placed with Ravi grade I accuracy, and 1 was grade II. In the 3D-CT navigation group, 157 of 165 screws were Ravi grade I, and 8 were grade II (P = 0.11). Fluoroscopy time (P < 0.001), time-per-screw placement (P < 0.001), and length of stay (P < 0.001) were significantly lower in the robotic group.

CONCLUSIONS:
Both technologies are safe and accurate. Robotic technology exposed patients to less fluoroscopy time, decreased time-per-screw placement and shorter hospital stay than 3D-CT navigation. Further studies are warranted to verify our results
((Khan A, Meyers JE, Yavorek S, O'Connor TE, Siasios I, Mullin JP, Pollina J.
Comparing Next-Generation Robotic Technology with 3-Dimensional Computed
Tomography Navigation Technology for the Insertion of Posterior Pedicle Screws.
World Neurosurg. 2018 Nov 27. pii: S1878-8750(18)32749-9. doi:
10.1016/j.wneu.2018.11.190. [Epub ahead of print] PubMed PMID: 30500593.
)).