Virtua Health has become the first health system in the Philadelphia and South Jersey region to use a new “safe-zone” navigation technology for robotic-assisted spine surgery. The Marlton, New Jersey-based organization now offers spinal fusion procedures using Stryker’s Spine Guidance software, which allows surgeons to set boundaries that prevent surgical tools from entering certain areas, reducing the risk of injury to surrounding tissues.
“It’s the only software on the market that allows us to set up safe zones, which enables us to relieve pressure on compressed nerves more safely and efficiently,” said Dr. James Sanfilippo, vice president of clinical operations for musculoskeletal services at Virtua Health.
Robotic-assisted spine surgery is still not widely available in the United States. Virtua Health has been involved in robotic surgery for over 20 years, performing various procedures such as hip and knee replacements. Dr. Sanfilippo explained, “Our decades of experience performing other types of robotic-assisted orthopedic surgery have positioned us to readily embrace new forms of the technology as they’re introduced.” He added that Virtua works closely with manufacturers like Stryker to offer advanced options for patients.
The system combines Stryker’s Mako Spine robotic platform with its navigation software, offering greater precision than traditional techniques. This can help protect healthy tissue and reduce recovery time following spinal fusion—a common procedure used to treat chronic back or leg pain due to trauma, aging-related degeneration, herniated discs, or misaligned vertebrae.
About 1.6 million spinal fusions are performed annually in the U.S., according to Stryker data. While most pedicle screws in these surgeries are placed using some type of navigation system, only a small portion—between 10% and 15%—currently involve robotics.
“It is likely that robotics can be used in at least 70% of spine fusion surgeries and, in my opinion, that number is actually higher,” Dr. Sanfilippo said.
The technology enables surgeons to directly control a robotic arm and wrist with a greater range of motion than human hands alone. “We’re extremely proud to offer this leading-edge technology, so we can help our patients recover better and more quickly from a range of debilitating spine conditions,” Dr. Sanfilippo said.
He noted that he and his colleagues have already completed over 300 procedures using Spine Guidance software at Virtua hospitals.
“The instruments are integrated into the navigation software, so the robotic system helps us position and control the instruments very precisely,” he explained. “It allows us to remove bones and ligaments off of nerves in the spine in a more precise fashion. It also allows us greater precision as we place the screws into the bones. It’s a safer and more efficient way of doing these surgeries.”
“Our patients have had great success with robotic-assisted spine surgery,” added Dr. Sanfilippo. “It has reduced postoperative pain and complications by making the surgeries more minimally invasive and reducing some of the risks associated with freeing up the nerves.”
Before surgery begins, detailed CT scans are loaded into the computer system; these images are merged for accuracy during surgery while high-speed cameras track patient movement throughout the procedure.
“The technology is almost like a back-up camera for your car,” said Dr. Sanfilippo. “It’s easier, we can see a wider field, and we can see how close we are to surrounding structures.”
A key feature is its ability to set alerts or automatically stop instruments if they approach sensitive areas such as nerve openings or abnormal anatomy caused by conditions like scoliosis or tumors.
“We can outline the spinal canal or openings where nerves come out of the spine, and how much space we want to leave,” Dr. Sanfilippo explained. “We can set the system to alert us or shut off the drill automatically if we reach a safe zone.”
He emphasized that advanced navigation helps achieve high accuracy: “The margins around the spinal cord are very small – half a millimeter – so the highest level of accuracy is needed… Robotic-assisted spine surgery with advanced navigation software gives us that capability, which leads to better outcomes for our patients.”
Robotic spine surgery is now offered at Virtua Voorhees Hospital and Virtua Mount Holly Hospital; many cases qualify for same-day outpatient care.
