Robotic Anterior Lumbar Interbody Fusion

Robotic anterior lumbar interbody fusion (ALIF) is an innovative technique combining the advantages of laparoscopic technology and robotic surgical systems. Anterior approaches to lumbar spinal fusion are indicated for patients with lumbar instability and radiographic evidence of decreased lumbar lordosis or loss of interbody disk height. Historically, a large abdominal incision is made to allow an access surgeon to approach the anterior lumbar spine, then a neurosurgeon or an orthopaedic surgeon removes a disk and places an interbody cage. The use of a combined laparoscopic and robotic surgical system allows the surgeon to maintain manual dexterity and a wide view of the surgical field despite smaller incisions. One limitation of this technique is its reliance on multiple surgical teams, and poorly described federal and local regulations for its use. This chapter will review the technical aspects of robotic-assisted ALIF and discuss the advantages and limitations of this technique.