Navigation · Robotics · Instrumentation

Surgical technology & navigation

Navigation, robotics, ultrasonic bone cutting, and continuous neuromonitoring — used to plan and execute spine procedures precisely, and to know during the operation that the nerves are still doing what they should.

Licensed illustration

O-Arm intraoperative CT
Suggested: O-Arm imaging system in the operating room, or a sample intraoperative CT scan.

Where it's used

Complex deformity cases Revision spine surgery MIS fusion Cervical & lumbar instrumentation Decompression near the cord Any case where a nerve is at risk

The systems

  1. 01

    O-Arm CT-guided navigation

    Real-time 3D intraoperative imaging. A CT is taken with the patient already positioned and draped, and instruments are tracked against that scan live, so screw trajectories are verified against your actual anatomy on the table rather than estimated from landmarks and pre-operative films.

  2. 02

    Globus robotic-assisted surgery

    A robotic arm holds the planned trajectory rigidly while the screw is placed. Its value is reproducibility — it resists the drift that happens when an instrument is guided freehand along dense cortical bone, which matters most through minimally invasive corridors where the anatomy is not directly visible.

  3. 03

    Misonix ultrasonic BoneScalpel

    An ultrasonic blade that oscillates at high frequency across a microscopic distance. It cuts mineralised bone efficiently while being markedly less aggressive toward soft tissue than a high-speed burr — so it can be worked closer to the dura and nerve roots during laminectomy, osteotomy, and decompression.

  4. 04

    Intraoperative neuromonitoring

    A neurophysiologist monitors nerve and spinal cord function continuously throughout the operation, so a change is caught while it is still reversible. Three signals are used together — see below.

  5. 05

    Tubular retractor systems

    Sequential dilators separate the paraspinal muscle along its fibres and a tube holds that corridor open, so the muscle is spread rather than stripped off the bone. How minimally invasive surgery works →

Fig. 04

How the navigation knows where the instrument is

Schematic of optical surgical navigation A stereo camera watches two marker arrays at once: one clamped to the patient's spine and one on the instrument. Because both are tracked together, the system reports the instrument's position relative to the bone itself, and stays correct even if the patient moves. Stereo camera Reference frame clamped to the bone Instrument array Planned trajectory
The camera tracks two arrays, not one. Because the reference frame is clamped to the spine itself, the system reports where the instrument sits relative to your bone rather than relative to the table — so the patient breathing, or the table being nudged, does not invalidate it. The trajectory it is checking against comes from a CT taken with you already positioned and draped, not from a pre-operative film.

Neuromonitoring, in detail

The point of monitoring is early warning. Nerve tissue tolerates a certain amount of retraction and pressure for a certain amount of time; the value of watching it live is that the surgeon finds out before an injury becomes permanent, and can change what they are doing.

EMG

Electrodes in the muscles a nerve root supplies. Free-running EMG listens continuously and reacts if a root is being irritated or stretched. Triggered EMG stimulates a screw directly — a response at a low threshold suggests the screw may be sitting too close to the nerve, and it can be repositioned before closing.

Motor evoked potentials

The motor pathway is stimulated at the scalp and the resulting muscle response is recorded. This watches the motor tracts of the spinal cord specifically — the pathways that carry strength — and it is the signal that matters most during cervical work near the cord.

Somatosensory evoked potentials

A peripheral nerve is stimulated at the wrist or ankle and the signal is recorded as it arrives at the brain. This tracks the sensory pathways running up the back of the cord, and complements the motor signal by covering a different part of the anatomy.

Neuromonitoring reduces the chance that a neurological injury goes unnoticed during surgery. It does not eliminate the risk of one, and it is not used in every case — whether it is warranted depends on the procedure, the level, and your anatomy.

Fig. 05

What the monitoring is watching for

Schematic neuromonitoring traces showing a signal change during surgery Three monitored signals run across the operation. At the marked moment the sensory and motor responses lose amplitude and the free-running EMG breaks into bursts — the pattern that prompts the team to stop and change what they are doing. SSEP sensory MEP motor EMG root Signal change Baseline, recorded before the operation Surgeon told, and acts
Schematic traces, not a patient record. The usual alarm criterion is roughly a 50% drop in amplitude or a 10% increase in latency against that case's own baseline — which is why the baseline is recorded before anything is done. The point of watching live is that a change is caught while it is still reversible.
Licensed illustration or clinical photo

Intraoperative neuromonitoring
Suggested: neuromonitoring console with EMG / MEP / SSEP traces, or electrode placement on a draped patient. A screenshot of live traces works well here and needs no anatomy licence.

Licensed illustration

Globus robotic system
Suggested: Globus robotic arm positioned during a spine procedure, or a robotic screw-placement planning screen.

What it changes

Precision

Reduces reliance on anatomical landmarks alone.

Smaller incisions

Supports minimally invasive approaches across procedures.

Consistency

Pre-operative planning carries through to intraoperative execution.

Fig. 06

Why an ultrasonic blade cuts bone and not the nerve beside it

Schematic showing an ultrasonic bone blade against bone and against soft tissue The blade oscillates over a very short stroke at high frequency. Mineralised bone is rigid, so the stroke fractures it at the point of contact. Elastic soft tissue deflects and travels with the blade instead of being cut. A · Mineralised bone stroke of tens of microns Rigid: the stroke fractures it B · Dura and nerve same stroke, same blade Elastic: it moves with the stroke
The selectivity is mechanical, not magical, and it is a margin rather than a guarantee — soft tissue held taut against the blade can still be injured. What it buys is the ability to work closer to the dura and the nerve roots during a laminectomy or osteotomy than a high-speed burr comfortably allows.
Licensed illustration or product photo

Misonix ultrasonic BoneScalpel
Suggested: the handpiece and blade in use during a laminectomy, or a manufacturer product image. Misonix may license a photo directly — worth asking the rep before buying stock art.

Coming next

In development

Endoscopic spine surgery

Endoscopic technique takes the minimally invasive corridor further again — a working channel a few millimetres across, with the surgeon operating from a camera rather than through a tube under direct vision. For the right disc herniation it can mean a smaller incision and a faster return to activity than tubular technique.

This is a planned addition to the practice rather than something currently offered. This section will become its own page when it does, following the same format as the other procedures.

At a glance

Used across
Cervical & lumbar cases
Primary benefit
Placement accuracy
Pairs with
MIS technique

Every one of these systems is an instrument in the surgeon's hands, and the judgment behind each decision remains his. Whether navigation or robotic assistance is used depends on the procedure, the anatomy, and the specifics of your case.

What patients say

I chose to walk away from a different surgeon and instead have Dr. Zaidi operate on my spine based off of recommendations from friends in the medical field. Every good thing you hear about him is absolutely true.
Brent M. · Google review
He told me exactly what he could do for me, and he did just that. Dr Zaidi has an excellent skill set and I would trust him for any future surgery I might need.
Danny C. · Google review
A very polite and professional doctor. Explains things so they are easy to understand. Answers questions courteously. Alleviates concerns. He is a skilled surgeon.
Renee B. · Google review

Verbatim from public Google reviews, shown with first name and last initial. Individual experiences, not a guarantee of outcome. More patient reviews →

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