A teenager has become the first NHS patient to have her spine straightened with pioneering robotic surgery.
Emma Mayamine, 14, was diagnosed four years ago with scoliosis, a condition in which the spine starts to grow unevenly and curves to one side.
Scoliosis is thought to affect thousands of people in Britain, including Princess Eugenie. She suffered the condition as a child, and on her wedding day in 2018 wore a dress that showed a long scar down her back from surgery.
She was praised for giving courage to other sufferers by doing so.
Emma Mayamine (above), 14, has become the first NHS patient to have her spine straightened with pioneering robotic surgery. She was diagnosed four years ago with scoliosis – a condition in which the spine starts to grow unevenly and curves to one side
Known as the Mazor X Stealth EditionTM, the robot surgeon can be used to plan the spinal operation in detail in advance. It also uses real-time 3D images during the procedure, automatically moving the robot’s arm exactly where it is needed to secure the screws safely to the vertebrae
The new robotic operation is being offered at the Royal National Orthopaedic Hospital in London, where Eugenie, then 12, was successfully treated using an older method.
Schoolgirl Emma was severely affected by scoliosis and had to wear a brace around the clock to hold her spine in place.
Doctors warned that without intervention, she could be left with agonising pain. She underwent the procedure last November and is now 2in taller – standing at 5ft 7in thanks to her straightened spine.
‘Emma was incredibly self-conscious while wearing the brace and it really knocked her confidence,’ says her mother Lisa, 48.
‘Now she is much more confident and can wear fashionable clothes that fit her. She is a happier person all round.’
Doctors still do not fully understand why scoliosis happens, but it is often first picked up during puberty – a time of rapid growth – and mainly affects girls.
Many patients can be treated using physiotherapy or by wearing a rigid brace that corrects the growth. Surgery is necessary in severe cases and involves placing two rigid titanium alloy rods almost 8in long either side of the spine.
These are fixed with screws to the vertebrae, the 33 individual bones that form the spinal column, to straighten the spine and stop it twisting.
Emma is now much more confident and can wear fashionable clothes that fit her. She is a happier person all round
The procedure is complex and carried out very close to the spinal cord. It means that any damage could result in paralysis, stopping messages being delivered from the brain to the rest of the body.
Now a new robot specially designed for spinal surgery is helping experts perform the complex procedure with greater precision than ever before.
The Royal National Orthopaedic Hospital is the first in the NHS to have the device. ‘The robot gives an unprecedented level of accuracy during spinal surgery,’ says Sean Molloy, a consultant spinal surgeon at the hospital.
Known as the Mazor X Stealth EditionTM, it can be used to plan the operation in detail in advance. It also uses real-time 3D images during the procedure, automatically moving the robot’s arm exactly where it is needed to secure the screws safely to the vertebrae.
‘We can design a surgical plan before the patient goes into theatre, just as you might put a postcode into a satnav to plan a specific route,’ Mr Molloy explains.
‘Once surgery is under way, the robotic arm guides us to place spinal implants precisely.’
Scoliosis is thought to affect thousands of people in Britain, including Princess Eugenie. She suffered the condition as a child, and on her wedding day in 2018 wore a dress that showed a long scar down her back from surgery (pictured, with now-husband Jack Brooksbank)
He adds: ‘Spinal surgery has well recognised risks of nerve damage, and by using the Mazor X we can perform safer surgery on our patients.’
Lisa, a nursery manager, first noticed that her daughter’s right shoulder was slightly higher than the left when she was aged ten. Scans revealed that Emma had scoliosis.
For three years, she had to wear a rigid plastic back brace for 23 hours a day to prevent the curve getting worse as she grew.
‘It was horrible – it was really hot and quite tight, and I had to sleep in it too,’ Emma says.
‘I had to give up trampolining, and wear loose clothes to cover it.’
Doctors had hoped the treatment would stabilise Emma’s spine, but it was still distorting.
Last November, she became the first NHS patient to undergo robotic-assisted scoliosis surgery – and the first paediatric patient in Europe.
The operation, which takes around seven hours, is carried out under general anaesthetic. Detailed scans of the back are processed and computer software is used to plan the operation.
In theatre, a long incision from the shoulder blades to the waist is made to expose the spine. A drill is used by the surgeon to create holes and screws are attached into each vertebra.
These are then fixed to the two rods, which are positioned either side of the spine. The drill is held in place by the robotic arm, which can automatically position itself according to the operation plan to ensure maximum precision.
Clamps are added to the screws and hooked to the long rod down the back. This pulls the spine straight, correcting the curve. The incision is then closed.
The implants help to hold the spine in place until it fuses with existing bone, forming a solid column.
Emma was in hospital for 11 days after the operation but she was well enough to return to school in January. ‘Hopefully I’ll be able to go trampolining again later this year, and start horse-riding again, too,’ she says.