Robot-Assisted Surgery in Severe Spinal Deformities

Severe spinal deformities present extraordinary challenges for surgical correction due to distorted anatomy and high risks of neurological complications. Traditional freehand pedicle screw placement in these cases is often limited by obscured landmarks. This chapter provides a comprehensive review of robot-assisted (RA) technology in the management of severe spinal deformities. By integrating three-dimensional preoperative planning and real-time intraoperative navigation, RA technology significantly enhances surgical precision and safety. We detail the technical principles, clinical indications, and surgical workflows associated with modern robotic systems. Furthermore, a clinical case of a 9-year-old patient with severe congenital scoliosis (Cobb angle 83°) is presented, demonstrating successful RA growing rod implantation with a 65% correction rate and perfect screw accuracy. Institutional data from Beijing Chaoyang Hospital further validates these findings, revealing that RA achieves superior pedicle screw accuracy (90.39%) compared to conventional fluoroscopy-assisted techniques (76.59%) in severe complex deformities, alongside a significant reduction in neurological complications (5.88% vs. 29.41%). Despite a steep learning curve and higher costs, RA technology proves to be a reliable and transformative tool for complex deformity correction. Future advancements, including artificial intelligence and augmented reality, will continue to optimize its clinical application.