Congenital spinal deformities result from abnormal vertebral development, with hemivertebrae (half-formed vertebrae) being a common cause of progressive scoliosis or kyphosis. These malformed vertebrae act as wedges, forcing the spine to curve as growth occurs. Hemivertebra excision involves the complete removal of the malformed vertebra followed by instrumented fusion of the adjacent segments, effectively removing the driver of the deformity and preventing further progression.
With robotic assisting hemivertebra excision, the first stage is meticulous preoperative planning directed toward the abnormal segment and normal surrounding anatomy. Patient positioning and registration follow, and the robot subsequently generates a 3D model of the patient's anatomy. The surgeon determines the exact margins for the hemivertebra to be resected and considers the best screw pathways in the neighbouring vertebrae, which are extremely challenging in the small anatomy of a pediatric patient.
The robotic arm tracks every step of the procedure, ensuring full hemivertebra resection without damage to adjacent neural structures. After resection, robot-assisted insertion of pedicle screws above and below the said vertebrae is done with compression applied to close the gap and correct the deformity. Compared with standard methods, this precise mode of correction may allow better correction with fewer fused levels.
