Excelsius® Prone Lateral Hospital Highlight: Danbury Hospital

Surgeon inserting implant
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During the first week of April, Danbury Hospital became the first hospital in Connecticut to perform robotic prone lateral surgery. Dr. Joshua Marcus performed the first case, followed by Dr. Scott Sanderson just two days later.

Making History

Both surgeons utilized ExcelsiusGPS® and the new Prone Lateral Patient Positioning System to perform Globus’ innovative surgical solution, Excelsius® Prone Lateral.

Excelsius® Prone Lateral is a comprehensive, robotic navigation assisted lateral solution that enables a single-position, single-stage approach for both direct and indirect decompression.

First Robotic Prone Lateral Case with Dr. Marcus

The first patient to undergo robotic prone lateral lumbar interbody fusion (LLIF) had a synovial cyst, stenosis and DDD with a Grade I retrograde spondylolisthesis at L2-3.

Dr. Joshua Marcus wanted posterior and anterior column support as the patient had very small 4.5mm pedicles at both levels. He utilized ExcelsiusGPS® to help plan and place CREO MIS® screws before navigating a RISE®-L lateral expandable spacer.

Pre-Op Fluoro (AP)

Fluoro

Pre-Op Fluoro (LAT)

Fluoro

Post-Op Fluoro (AP)

Fluoro

Post-Op Fluoro (LAT)

Fluoro

Dr. Marcus utilized the ExcelsiusGPS® preoperative workflow. He merged a preoperative CT scan to the robot and placed CREO MIS® 4.5mm and 5.0mm screws at L2 and L3. Using the Patient Positioning System, he rotated the patient approximately 30° to enable the placement of the MARS™3VL retractor using navigated dilators. Dr. Marcus performed a complete discectomy with navigated instruments and placed the RISE®-L expandable spacer to match the preoperative plan on ExcelsiusGPS®. He then rotated the patient back to the level prone position and completed the decompression and fusion.

“Previously this would have been a two-stage procedure: the RISE®-L cage would need to be placed in the lateral position, and then the patient would need to be rolled over to the prone position for a direct decompression and screw placement. The new Globus patient positioner and ExcelsiusGPS® enabled us to accomplish both procedures in one prone position, helping us save time, reduce blood loss, and dramatically minimize the need for intraoperative fluoroscopy and radiation.”

Dr. Joshua Marcus, Neurosurgeon

Second Robotic Prone Lateral Case with Dr. Sanderson

Dr. Scott Sanderson performed his first robotic prone LLIF (the second at Danbury Hospital) with his new neurosurgeon partner Dr. Jeff Gilligan just two days after Dr. Marcus’ successful case.

Dr. Sanderson’s patient had a previously successful L3-L5 fusion with instrumentation, but had since developed severe stenosis and a large right sided disc herniation.

Dr Sanderson performing surgery
Dr. Sanderson navigating a lateral Cobb (left) and a RISE®-L trial (right)

To avoid subjecting the older patient to a two-stage lateral and posterior procedure, Dr. Sanderson used Globus’ new Patient Positioning System and ExcelsiusGPS® with CREO MIS® screws and RISE®-L cage for a one-stage prone lateral procedure. He utilized the navigated dilators to position his MARS™3VL retractor and then placed the RISE®-L lateral expandable spacer followed by a direct posterior decompression and in situ fusion with pedicle screws and rods.

“Having extensive experience with lateral surgery was very helpful to make the adjustment to the Excelsius® Prone Lateral technique. The navigated dilators for retractor placement and navigated disc prep and cage insertion instruments used to place the RISE®-L cage were game changing.”

Dr. Scott Sanderson, Neurosurgeon

The surgery was performed in less time than the patient’s previous staged procedure, with less recorded blood loss and with almost no additional intraoperative fluoroscopy and radiation.

More About Danbury Hospital

For more than 130 years, Danbury Hospital has delivered mission-driven services to the community. Danbury Hospital is committed to providing safe, convenient care to meet their community’s personal healthcare needs.

Robotic Surgery center of excellence badge

Danbury Hospital is part of Nuvance Health®, a network of seven community hospital locations and numerous outpatient facilities in the Hudson Valley and Western Connecticut.

Danbury Hospital offers both minimally invasive and robot-assisted surgery and is designated by the Surgical Review Corporation (SRC) as a Robotic Center of Excellence.

More About Excelsius® Prone Lateral

Patient in Prone Lateral Patient Positioner

Excelsius® Prone Lateral is an innovative surgical solution that offers more options than any other competitor, including:

  • An ergonomic approach to lateral surgery with a dynamic positioning system
  • Simultaneous access for anterior-to-psoas, transpsoas, and posterior approaches, eliminating the need to reposition the patient
  • Powerful correction to help maximize segmental lordosis with the use of Globus’ navigated expandable lateral interbody spacers, including RISE®-L and ELSA®
  • Maximum stability with a dynamic Patient Positioning System equipped with a variety of features including a backstop bolster, a coronal bend function, and a 15° built-in tilt

Excelsius® Prone Lateral is The Innovative Prone