Under general anesthesia with the patient lying on prone position, the patient will be monitor nerve function with intraoperative neuromonitoring. The surgeon makes a midline incision on back to expose the spine. The spine will be scan with O-arm navigator and images will transfer to robot computer. Planning for pedicle screws will be done with the software for the most accuracy of pedicle screw placement. Surgeon will perform surgery with the robotic guidance along with surgical planning and with real time navigation of O-arm navigator. After all pedicle screws are placed, the spine will be realigning into designed position. Spinal fusion will be done with bone graft. Surgery usually takes about 4 to 6 hours.

Surgery for scoliosis may be recommended when:

• A curve continues to worsen and there is significant growth left in the spine.
• Brace treatment has failed.
• A curve of the thoracic spine greater than 45 -50 degrees.
• A curve of the lumbar spine greater than 35-40 degrees.

As with any spinal surgery, the risks include:

• Bleeding occurring after surgery
• Infections could happen; however, it generally can be managed and cured effectively.
• Complication related to instruments, e.g. malpositioning and loosening
• Blood clot in the legs (deep vein thrombosis), which can dislodge and move to the lungs (pulmonary embolism)
• Nerve root damage
• Paralysis would be extremely rare with intraoperative neuromonitoring.
• Blindness is an uncommon complication
• Anesthetic complications