Integrating Navigation, Imaging and Robotics in Modern Spine Surgery
By Admin | March 31, 2026
Each year, over a million spine surgeries are performed in the United States. In an era defined by rapid technological innovation, one might expect robotic technology to be more commonplace in these operating rooms. Yet more than two decades after the first FDA approval of a robotic platform for spine surgery in 2004, its presence remains the exception rather than the rule.
The data tell a story of cautious integration. A 2024 survey of the AO Spine’s international membership found that only 7% of respondents apply robotics on a routine basis for spinal instrumentation. Meanwhile, here in the U.S., an analysis of the Nationwide Inpatient Sample from 2016 to 2019 reported an overall robotic-assisted lumbar fusion rate of just 1.2%, albeit with a fourfold increase over that interval.
Against this backdrop of incremental growth, select institutions have embraced robotic platforms more broadly. At the Center for Spine Health at Cleveland Clinic in Florida, the use of robotic spine technology is extended beyond routine instrumentation to some of the most complex deformity cases referred from throughout the region.
Two-stage scoliosis case
In one recent case, a 69-year-old man was referred with untreated scoliosis, advanced degenerative changes and multiple failed prior surgeries. His spine had fused in a collapsed scoliotic position with major coronal and sagittal plane deformities.
“The spine was stiff, scarred and required complex corrective surgery using a 360 degree approach,” states Hoon Choi, MD, PhD, Director of Spine Surgery at Cleveland Clinic in Florida. “It entailed three-column mobilization at five levels in order to achieve satisfactory three-dimensional correction in addition to decompression of nerves.”
The procedure was performed in two stages over two days. The first stage involved a lateral approach for osteotomy and realignment. The second stage required extensive posterior instrumentation and correction. Dr. Choi used the ExcelsiusGPS™ robotic navigation system and Excelsius3D™ imaging platform for preoperative planning, intraoperative imaging, and computer-guided screw placement.
“The robotic navigation system enabled precise, minimally invasive osteotomies and screw insertions, with significant muscle preservation,” he describes. “The system’s flexibility also allowed us to use the navigation function independently when the robotic arm was not needed.”
The patient was discharged to acute rehabilitation, demonstrated significant improvement in preoperative symptoms and returned home after two weeks. “This case was made less invasive and more precise by leveraging robotic navigation and custom instruments and will be discussed at two upcoming annual spine conferences,” adds Dr. Choi.
A growing robotic program in Florida
Based at Cleveland Clinic Weston Hospital, the Center for Spine Health is the highest volume robotic spine surgery program in southeast Florida, and one of just a handful in the state. “Our team of spine surgeons use the full spectrum of...(More)
For more info please read, Integrating Navigation, Imaging and Robotics in Modern Spine Surgery, by Cleveland Clinic
