Complex cervical pathology sometimes requires a comprehensive approach addressing both anterior and posterior compression while providing circumferential stability. This combined procedure is indicated for severe multilevel stenosis, cases with both anterior and posterior compression, significant instability, or correction of kyphotic deformity. The approach provides maximal decompression and optimal stability for the most challenging cervical pathologies.
The robotic approach to combined procedures typically begins with the anterior stage, where the robotic system guides discectomy or corpectomy and the placement of interbody grafts or cages to restore height and alignment. After completion of the anterior procedure, the patient is carefully repositioned for the posterior approach. Using updated intraoperative imaging, the robotic system creates a new 3D map incorporating the changes from the anterior surgery.
The posterior decompression is performed under robotic guidance to ensure complete neural decompression. The robotic arm then guides the placement of lateral mass or pedicle screws with exceptional precision, which is particularly valuable after anterior structural changes. This coordinated circumferential approach maximizes decompression while providing optimal stability, potentially improving outcomes in the most challenging cervical pathologies that a single approach would inadequately address.
