Neurotech Robots
Clinical and Investor Update
Currently, the most clinically useful application for neurosurgical robots is in making spinal surgery safer and more effective. Specifically, robots are a boon for inserting screws into the spine.
Why would a surgeon implant titanium screws and rods into a patient’s spine? Lot’s of reasons. Some examples include scoliosis (twisted spine), spondylolisthesis (slipped spinal bones) and degeneration (arthritic spine). It’s big business, too. Several million screws per year are inserted into the spines in the United States. The average cost per screw is north of nine-hundred dollars.
OK, so what about the robots?
Commonly, when a screw is implanted in the spine, the surgeon is only able to visualize the surface of the vertebrae. The screw is then sunk several inches deep into the bone, beyond the visible. A short while ago, a surgeon had no choice but to place screws ‘freehand’ while taking X-rays all the while (to prevent flying completely blind).
Then came the robots. Then came the medical literature which proved Robot-assisted techniques offer superior accuracy in pedicle screw placement and reduce blood loss and radiation exposure time compared to freehand techniques.
For instance, in 2020, a group of Chinese surgeons performed a meta-analysis (examination of data from a number of independent studies of the same subject, in order to determine overall trends) comparing the accuracy of pedicle screw placement and clinical outcomes between robot-assisted techniques and conventional freehand techniques in spine surgery. The researchers reviewed data on 737 patients (3,773 pedicle screws). They reported that Robot-assisted techniques showed significantly higher accuracy, had less blood loss and reduced radiation exposure time.
In 2025, a group of Italian researchers echoed the above findings. Their meta-analysis included 1,524 patients and 10,026 pedicle screws, comparing robot-assisted systems to freehand X-ray-assisted techniques. Robot-assisted techniques demonstrated significantly higher accuracy compared to the freehand group. Robot-assisted techniques reduced radiation exposure time.
There are some downsides to using robots though. First of all, they’re expensive. The clinical benefits may not outweigh costs or training requirements in all settings. Secondly, according to the Italian study, they significantly increase operative time.
A 2025 report by a group of Chicagoans points to a future that sees these robotic limitations overcome and is filled with undreamed of potential. They explored the role of artificial intelligence (AI) and machine learning (ML) in spine surgery. The scientists discuss how AI supports robotic-assisted surgery by providing real-time navigation, improving pedicle screw accuracy, and reducing radiation exposure. AI-powered Augmented Reality overlays imaging data onto the surgical field, enhancing visualization and precision during minimally invasive procedures. What’s more, AI integrates imaging data to create 3D models of the spine, enabling precise planning of screw placement, deformity correction, and fusion strategies.
Investor Update
The spine surgery robots market is dominated by a few key players, with their robotic systems holding the largest market shares due to advanced technology, precision, and widespread adoption. Based on available data, here are the robots with the largest share of the spinal surgery market:
Medtronic (Mazor X Stealth Edition):
Market Position: Medtronic is a leading competitor in the robotic-assisted spinal surgery market, bolstered by its acquisition of Mazor Robotics. The Mazor X Stealth Edition integrates navigation and robotic guidance, enhancing precision in spinal procedures like spinal fusion.
Market Share: Medtronic holds a significant share, with North America, particularly the U.S., contributing to its dominance due to advanced healthcare infrastructure and high adoption rates. The company led the spinal surgery robotics market in 2023.
Key Features: Combines robotic arm technology with intraoperative navigation, used primarily for pedicle screw placement and spinal fusion. It’s noted for reducing complications and improving outcomes.
Globus Medical (ExcelsiusGPS):
Market Position: Globus Medical is another major player, with its ExcelsiusGPS robotic navigation platform gaining significant traction. The platform is lauded for increasing accuracy and reducing radiation exposure.
Market Share: Globus is considered a top competitor alongside Medtronic, with a strong presence in the U.S. market. Its acquisition of NuVasive in 2023 further strengthened its position in the spinal device market.
Key Features: Offers real-time imaging and navigation, supports minimally invasive procedures, and integrates with 2D/3D imaging systems. Costs approximately $1.5 million.
Zimmer Biomet (Rosa ONE Spine):
Market Position: Zimmer Biomet’s Rosa ONE Spine system is a notable contender, blending robotic and navigation technologies. It has a strong presence in the market due to its versatility and FDA clearance in 2019.
Market Share: While not as dominant as Medtronic or Globus, Zimmer Biomet holds a significant share, particularly in hospitals adopting robotic systems for spinal fusion and other procedures.
Key Features: Features 3D intraoperative planning software and supports a range of spinal procedures, including minimally invasive surgeries.
Market Context:
Spinal Fusion Dominance: The spinal fusion segment accounts for the largest application share (around 50%) in the spine surgery robots market, driving demand for these systems.
North America’s Lead: North America holds approximately 40-45% of the global market, with the U.S. being the largest contributor due to high prevalence of spinal disorders and robust healthcare infrastructure.
Market Growth: The global spine surgery robots market was valued at USD 201.3 million in 2023 and is projected to grow at a CAGR of 12.68-14% through 2031-2032, reaching USD 525.3-682.47 million.
Other Notable Systems:
Brainlab (Cirq): A passive robotic arm with FDA clearance for spinal applications, holding a smaller but growing share. It’s cost-effective, ranging from $100,000 to $250,000.
eCential Robotics: Gained FDA clearance in 2022 for its 3D imaging and robotic guidance system, used in over 2,000 European cases. It’s an emerging player with an open system compatible with various implants.
Curexo (Cuvis-spine): FDA-licensed in 2021, this system is gaining global traction for pedicle screw insertion but has a smaller market share compared to the top players.
NB: While Medtronic and Globus Medical are the clear leaders, exact market share percentages for individual robots are not publicly disclosed in the provided data. Their dominance is inferred from their leadership in revenue, unit sales, and market presence. Always cross-reference with primary sources like company reports or market research for precise figures, as market dynamics can shift with new FDA approvals or technological advancements.
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