ExcelsiusGPS Spine Surgery (Globus Medical)
Robotic navigation system combining robotic arm positioning with real-time imaging for pedicle screw placement and other spinal procedures.
What This Technology Is
ExcelsiusGPS is a robotic navigation system for spine surgery developed by Globus Medical. The platform combines robotic arm positioning with real-time navigation to assist surgeons in placing spinal implants, particularly pedicle screws used in spinal fusion procedures.
System components:
- Robotic arm: Positions and holds instruments at calculated trajectories
- Navigation system: Uses intraoperative imaging to create 3D visualization of patient anatomy
- Planning software: Allows surgeons to pre-plan screw trajectories based on patient imaging
- Integrated imaging: Compatible with C-arm fluoroscopy and intraoperative CT
The surgeon plans screw trajectories preoperatively or intraoperatively, and the robotic arm positions a guide tube along the planned path. The surgeon then manually inserts screws through the guided trajectory.
Where It Is Deployed
ExcelsiusGPS systems are installed in hospitals and spine surgery centers in the United States and internationally. Applications include:
- Pedicle screw placement in lumbar, thoracic, and cervical spine
- Interbody fusion procedures
- Tumor resection
- Deformity correction surgery
The platform competes with Medtronic's Mazor X system, Zimmer Biomet's ROSA One Spine, and other spine surgery robotic platforms.
Known and Documented Failure Modes
Spine surgery robots share common failure patterns:
Navigation and accuracy
- Registration errors between planned trajectory and actual anatomy
- Patient movement after registration invalidating planned trajectories
- Reference frame displacement during surgery
- Imaging artifacts affecting navigation accuracy
Mechanical and hardware
- Robotic arm positioning errors
- Guide tube stability during screw insertion
- Calibration issues
- System software errors
Clinical consequences documented in literature and adverse event reports
- Pedicle screw misplacement despite robotic guidance (screws breaching pedicle wall or entering spinal canal)
- Procedures converted to conventional technique
- Extended operative time for troubleshooting
- Screw repositioning required
Spine-specific risks
- Proximity to spinal cord and nerve roots
- Radiation exposure from navigation imaging
- Learning curve effects
Oversight and Regulatory Context
ExcelsiusGPS has FDA 510(k) clearance. Like other spine robots, it faces regulatory considerations around:
- Demonstrating accuracy improvement over non-robotic techniques
- Post-market surveillance of clinical outcomes
- Learning curve documentation
Spine surgery robotics represent a growing market with multiple competing platforms, each making accuracy claims that may be difficult for patients to evaluate independently.
Why This Matters
Spinal fusion is a common procedure, with hundreds of thousands performed annually in the United States. Pedicle screw misplacement can lead to nerve injury, vascular injury, or the need for revision surgery. Robotic systems promise improved accuracy.
Whether this promise is realized depends on:
- Quality of imaging and registration
- Surgeon skill in using the system
- Whether improved radiographic accuracy translates to better clinical outcomes
Some studies show improved screw placement accuracy with robotics; whether this translates to reduced revision rates, improved pain outcomes, or better function remains under investigation.
External Resources
- Globus Medical — ExcelsiusGPS — Manufacturer information (commercial source)
- FDA MAUDE Database
Related Coverage
Report an Incident
If you have direct knowledge of an ExcelsiusGPS system malfunction, screw placement complication, or safety concern, you can submit documentation to Safety Ledger.