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First robot-assisted spinal surgery performed in US

MDBR Staff Writer Published 07 May 2018

A team of neurosurgeons led by Neil Malhotra of the University of Pennsylvania School of Medicine performed the first-ever robot-assisted spinal surgery to remove a rare tumour on the patient's neck.

The surgery was completed at the Hospital of the University of Pennsylvania in August 2017 over a span of two days and over 20 hours.

Chordoma is a rare type of cancer that takes place in the bones of the skull base and spine. A chordoma tumor generally grows slowly and is often asymptomatic for years.

The specific type of chordoma is located on Pernikoff’s C2 vertebrae. Penn’s multidisciplinary team assessed the case and designed a treatment plan, including complex surgery.

The team decided to remove the tumor via a rare and complex spinal surgery approach. For better recovery, the team planned to use a trans-oral robotic (TORS) approach for the second part of the surgery.

TORS is said to be the world's first group of minimally invasive robotic surgery techniques, developed at Penn, to remove benign and malignant tumors of the mouth and throat.

Penn’s team conducted the surgery in three parts. During the first step, the neurosurgeons went through the back of Pernikoff’s neck and cut the spine around the tumor to prepare for the second stage.

The team used surgical robot to clear a path for removing tumor and part of the spinal column in the second step.

During the final step, the team reconstructed Pernikoff’s spinal column by using some portion of bone from the patient’s hip and rods.

In the case of 27-year-old Noah Pernikoff, a 2016 car accident revealed his surprising diagnosis.

Pernikoff said: “I’m lucky because they caught mine early. For a lot of people, if it’s not found and treated early, it’s lethal.

“The doctor said if I hadn’t discovered it through the car accident it probably would have kept growing until it came to a point on my spinal cord where it caused paralysis or death. I feel very lucky in that regard.”

Image: Robot-assisted spinal surgery for chordoma tumor removal. Photo: courtesy of Penn Medicine.