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Archive June 2019 XX, No. 6

The Economics of Robot-assisted Spine Surgery

The massive upfront cost is offset by fewer revision surgeries, lower infection rates, reduced lengths of stay and shorter OR times.

Joe Paone

Joe Paone


Texas Back Institute
PRECISION MEDICINE Isador Lieberman, MD, MBA, FRCSC, says the robot improves the accuracy and speed of his screw placements, enabling him to see more patients and perform fewer revisions.

Isador Lieberman, MD, MBA, FRCSC, was involved in the development of the original Mazor robot, and has been one of the pioneers and champions of robotic spine surgeries ever since. After a half-decade of trial and error in the product's development, he began using a robot for live surgeries in 2007.

"The first year I had 10 surgeries," he says. "The next year, I did probably 30 surgeries. And then every year after that it's been between 150 and 200 surgeries using robotics." He estimates 10% to 15% of spine surgeons currently use robots.

Dr. Lieberman has gained ample experience in the real-world economics of spinal robotics. Here's how he crunches the numbers on purchasing a $1 million robot: Let's say the average spine surgeon does 300 spinal procedures a year, and that 1 in 10 patients runs into an issue because of misplaced screws. The cost of a complication with spine surgery is about $35,000. So at 10%, you've got 30 cases with complications — which amounts to $1,050,000.

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