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Navigation, Robotics and 3D Printing in Spine Surgery
Current and Emerging Techniques
SumeetGarg ChristopherJ.Kleck
123
Navigation, Robotics and 3D Printing in Spine Surgery
Sumeet Garg • Christopher J. Kleck
Editors
Navigation, Robotics and 3D Printing in Spine Surgery
Current andEmerging Techniques
Editors
Sumeet Garg Division of Orthopedics University of Colorado Aurora, CO, USA
Christopher J. Kleck Spine Center University of Colorado Health Aurora, CO, USA
ISBN 978-3-031-68677-1 ISBN 978-3-031-68678-8 (eBook)
https://doi.org/10.1007/978-3-031-68678-8
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2024 This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microlms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specic statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
If disposing of this product, please recycle the paper.

Preface

We are pleased to present the rst edition of Navigation, Robotics and 3D Printing in Spine Surgery. This edition was developed after the editors’ presented workshops
on enabling technologies in spine surgery at several international society meetings and courses beginning in 2020. The pace of adoption of enabling technologies by spine surgeons has accelerated since 2020in tandem with an increased variety of offerings of enabling technologies. Ten years ago, most spine navigation was done with radiography-based imaging utilizing preoperative or intraoperative CT or 3D uoroscopy. Now there are options involving use of optical technology, increased use of robotic assistance, and high-resolution 3D printing.
This textbook is designed for the practicing spine surgeon as well as orthopedic and neurosurgical residents and fellows as an overview of contemporary enabling technologies for spine surgery. It is divided into three primary sections for each of the main modern enabling technologies for spine surgery: Image Based Navigation, Robotic Navigation, and 3D-Printed Patient-Specic Guides. Each section will review the underlying principles of the technology followed by practical guidance on application of the technology in surgery and ending with a summary of published clinical results using the technology. The book will end with a discussion of the future of navigation in spine surgery.
We encourage you to reach out to us with your comments and suggestions for future editions of this book. The authors of this book span the breadth of the United States and treat the most challenging spine deformities in children and adults. We are proud to share their expertise with our readers. We thank the authors for prepar­ing thoughtful chapters to share their expertise and improve spine care for our audi­ence. Thanks also to the team at Springer Nature and our production editor Nishanthini Vetrivel for herding a busy group of spine surgeons along over the past 2 years. We hope this textbook serves to aid your journey in improving safety and quality of spine surgery.
Aurora, CO, USA SumeetGarg Aurora, CO, USA ChristopherJ.Kleck
v

Contents

1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Sumeet Garg
Part I Image Based Navigation
2 Image-Based Spinal Navigation: Current Technology and Future
Applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
K. Aaron Shaw, Michael O’Sullivan, and Jaysson T. Brooks
3 Image-Based Navigation: Room and Patient Positioning,
Reference Frame Types and Application . . . . . . . . . . . . . . . . . . . . . . . 17
Felicity Fisk and Nolan Wessell
4 Image-Based Navigation: Instrumentation . . . . . . . . . . . . . . . . . . . . . 29
Ali S. Farooqi, Sachin Gupta, Stuart L. Mitchell, and Jason B. Anari
5 Imaging-Based Navigation: Applications Beyond Instrumentation . . 47
Keemia Soraya Heidari and Christopher J. Kleck
6 Imaging-Based Navigation: Summary of Clinical Results . . . . . . . . . 73
John Whitaker and David Ou-Yang
Part II Robotic Navigation
7 History of Robotics in Spine Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Alex C. DiBartola and Dennis P. Devito
8 Robotic Navigation: Mounting Systems . . . . . . . . . . . . . . . . . . . . . . . . 103
Craig M. Birch and Daniel Hedequist
9 Robotic Navigation: Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Mariano Garay and Mark A. Erickson
vii
viii
Contents
10 Robotic Navigation: Instrumentation . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Theresa J. C. Pazionis, James Suk, and Jeffrey L. Gum
11 Robotic Navigation: Applications Beyond Instrumentation . . . . . . . . 145
Matthew E. Simhon, Gerard F. Marciano, Nathan J. Lee, Michael W. Fields, and Ronald A. Lehman
12 Robotic Navigation: Summary of Clinical Results . . . . . . . . . . . . . . . 159
Gerard F. Marciano, Matthew E. Simhon, Nathan J. Lee, and Ronald A. Lehman
Part III 3D Printed Patient Specic Guides
13 3D-Printed Patient-Specific Guides: Basics and Current Systems. . . 179
Seongho Jeong, Meera M. Dhodapkar, Ally Yang, Ali Elaydi, Taikhoom Dahodwala, and Dominick Tuason
14 3D-Printed Patient-Specific Guides: Planning and
Instrumentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Christina K. Hardesty
15 3D-Printed Patient-Specific Guides: Summary of Clinical
Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Devon LeFever, Aiyush Bansal, and Rajiv Sethi
Part IV Additional Navigation Considerations
16 Economic Considerations for Navigation in Spine Surgery . . . . . . . . 217
Jessica H. Heyer, Jason B. Anari, and John (Jack) M. Flynn
17 Robotic Navigation: Legal Considerations . . . . . . . . . . . . . . . . . . . . . . 227
Theresa J. C. Pazionis and Jeffrey L. Gum
18 Future Directions for Navigation in Spine Surgery . . . . . . . . . . . . . . . 233
Nicholas A. Felan and Evalina Burger
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245

Contributors

Jason B. Anari Department of Orthopaedic Surgery, Children’s Hospital of
Philadelphia, Philadelphia, PA, USA
AiyushBansal Department of Neurosurgery, Center for Neuroscience and Spine,
Virginia Mason Medical Center, Seattle, WA, USA
CraigM.Birch Department of Orthopaedic Surgery, Boston Children’s Hospital,
Boston, MA, USA
JayssonT.Brooks Scottish Rite for Children/UT-Southwestern, Dallas, TX, USA
EvalinaBurger Department of Orthopedics, School of Medicine, University of
Colorado Anschutz Medical Campus, Aurora, CO, USA
Taikhoom Dahodwala Yale University School of Medicine Department of
Orthopaedics and Rehabilitation, New Haven, CT, USA
Dennis P. Devito Department of Orthopaedic Surgery, Children’s Healthcare of
Atlanta, Atlanta, GA, USA
Meera M. Dhodapkar Yale University School of Medicine Department of
Orthopaedics and Rehabilitation, New Haven, CT, USA
Alex C. DiBartola Department of Orthopaedic Surgery, Nationwide Children’s
Hospital, Columbus, OH, USA
AliElaydi Yale University School of Medicine Department of Orthopaedics and
Rehabilitation, New Haven, CT, USA
Mark A. Erickson Department of Orthopedic Surgery, University of Colorado
School of Medicine, Aurora, CO, USA
AliS.Farooqi Department of Orthopaedic Surgery, University of Pennsylvania,
Philadelphia, PA, USA
NicholasA.Felan University of Colorado School of Medicine, Aurora, CO, USA
ix
x
Contributors
Michael W. Fields Columbia University Medical Center, Department of
Orthopedics, New York, NY, USA
Felicity Fisk Department of Orthopaedic Surgery, West Virginia University,
Morgantown, WV, USA
John(Jack)M.Flynn Department of Orthopaedic Surgery, Children’s Hospital of
Philadelphia, Philadelphia, PA, USA
Mariano Garay Orthopedic Surgery, Penn State Children’s Hospital,
Hershey, PA, USA
Sumeet Garg Department of Orthopedics, Children’s Hospital Colorado,
University of Colorado, Aurora, CO, USA
JeffreyL.Gum Norton Leatherman Spine Center, Louisville, KY, USA
Sachin Gupta Department of Orthopaedic Surgery, University of Pennsylvania,
Philadelphia, PA, USA
Christina K. Hardesty Orthopaedic Surgery, Rainbow Babies and Children’s
Hospitals, Case Western Reserve University, Cleveland, OH, USA
Daniel Hedequist Department of Orthopaedic Surgery, Boston Children’s
Hospital, Boston, MA, USA
Keemia Soraya Heidari University of Colorado School of Medicine,
Aurora, CO, USA
JessicaH.Heyer Pediatric Orthopaedic Surgery Department, Hospital for Special
Surgery, New York, NY, USA
SeonghoJeong Yale University School of Medicine Department of Orthopaedics
and Rehabilitation, New Haven, CT, USA
ChristopherJ.Kleck University of Colorado School of Medicine, Aurora, CO, USA
NathanJ.Lee Columbia University Medical Center, Department of Orthopedics,
New York, NY, USA
DevonLeFever Department of Neurosurgery, Center for Neuroscience and Spine,
Virginia Mason Medical Center, Seattle, WA, USA
Ronald A. Lehman The Daniel and Jane Och Spine Hospital at New York-
Presbyterian/Allen, New York, NY, USA
Gerard F. Marciano Columbia University Medical Center, Department of
Orthopedics, New York, NY, USA
Stuart L. Mitchell Department of Orthopaedic Surgery, University of North
Carolina School of Medicine, Chapel Hill, NC, USA
Contributors
xi
Michael O’Sullivan Children’s University Hospital, Children’s Health Ireland,
Dublin, Ireland
DavidOu-Yang Division of Spine Surgery, Department of Orthopedic Surgery,
School of Medicine, University of Colorado, Boulder, CO, USA
Theresa J. C. Pazionis Temple University Hospital, Lewis Katz School of
Medicine, Fox Chase Cancer Center, Philadelphia, PA, USA
Rajiv Sethi Department of Neurosurgery, Center for Neuroscience and Spine,
Virginia Mason Medical Center, Seattle, WA, USA
School of Medicine,University of Washington, Seattle, WA, USA
K. Aaron Shaw Children’s Mercy Kansas City/University of Missouri Kansas
City, Kansas City, MO, USA
Matthew E. Simhon Columbia University Medical Center, Department of
Orthopedics, New York, NY, USA
James Suk Temple University Hospital, Lewis Katz School of Medicine, Fox
Chase Cancer Center, Philadelphia, PA, USA
DominickTuason Yale University School of Medicine Department of Orthopaedics
and Rehabilitation, New Haven, CT, USA
Nolan Wessell Department of Orthopaedic Surgery, University of Colorado,
Aurora, CO, USA
John Whitaker Division of Spine Surgery, Department of Orthopedic Surgery,
School of Medicine, University of Colorado, Boulder, CO, USA
AllyYang Yale University School of Medicine Department of Orthopaedics and
Rehabilitation, New Haven, CT, USA