Exoscope in Spine Surgery

The exoscope presents a viable substitute for the microscope in spine surgery cases. Spine surgeries are often lengthy and physically demanding, making it crucial to ensure surgeon comfort and confidence in the operating room. The exoscope can improve the surgical experience for all parties involved, including patients. However, the current literature on its effectiveness in spine surgery is limited.

According to a study published in World Neurosurgery, the exoscope demonstrated superiority in terms of shorter operative time, reduced blood loss, shorter hospital stay, and positive clinical outcomes compared to the operative microscope. They added that neurosurgeons should consider incorporating this ergonomically advanced visual technology in spinal surgeries.

Exoscope use in spinal neurosurgery offers promising surgical options by enhancing operative field visibility and ergonomics. Despite the benefits, there needs to be more data on its application in spine surgery in the literature. To compare the intraoperative outcomes, researchers conducted a retrospective review of spinal surgeries performed using an exoscope and an equal number of operative microscope cases by two senior surgeons at a single institution between 2016 and 2023. The analysis included demographic information, clinical presentation, surgical treatment, and operative outcomes.

Key Findings from the Study

• A total of 123 exoscope spinal surgeries were performed on 116 unique patients of a mean age of 67 ± 14 years, including 52% women.
• The microscope group included 126 surgeries on 120 unique patients with a mean age of 62 ± 14 years, with 45% being women.
• Comparing the exoscope and microscope group, mean blood loss (28 mL vs. 132 mL), operative time (83 minutes vs. 103 minutes), and length of stay (1.04 days vs. 1.73 days) were less for the exoscope.

They said that using an exoscope in neurosurgical spine procedures led to shorter operation times, reduced blood loss, shorter hospital stays, and positive clinical results compared to the control group who underwent similar procedures with a microscope. Spine surgeons should consider incorporating the exoscope into their practice to enhance the operative experience and improve patient outcomes.

Reference

Nawabi, N. L. et al. Intraoperative Performance with the Exoscope in Spine Surgery: An Institutional Experience. World Neurosurgery. https://doi.org/10.1016/j.wneu.2023.12.004