Posterolateral fusion represents a traditional approach to stabilising the spine after decompression for lumbar stenosis, particularly in cases with pre-existing instability or when extensive facet removal is necessary for adequate decompression. This technique involves decompression of neural elements followed by placement of pedicle screws connected by rods, with bone graft placed in the lateral gutters between the transverse processes. The procedure provides stability while avoiding the additional steps required for interbody fusion.
The robotic approach to posterolateral fusion begins with comprehensive preoperative planning to identify areas requiring decompression and optimal screw trajectories. After registration, the robotic system creates a detailed map of the patient's lumbar anatomy. The surgeon performs neural decompression under robotic guidance, ensuring complete relief of stenosis while preserving stability when possible. The robotic arm then guides the placement of pedicle screws with exceptional accuracy, potentially reducing the risk of breaches that could damage neural or vascular structures. After screw placement and rod fixation, bone graft material is placed in the posterolateral gutters to promote fusion. The precision of robotically guided instrumentation potentially reduces hardware-related complications while providing optimal conditions for successful arthrodesis, addressing both the neurological symptoms and mechanical instability that characterise lumbar stenosis.
