C-OnSite enhancement added to Renaissance robotic guidance system for spine procedures

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Mazor Robotics has announced the global launch of the C-OnSite enhancement to its Renaissance robotic guidance system for spine procedures.  

The incorporation of C-OnSite facilitates planning, through surgical execution to verification. This enhancement enables fast, low-radiation, intra-operative 3D verification of implant placement, based on imagery from any standard 2D C-Arm which is available in almost every operating room.

“C-OnSite is a quantum leap forward for spine surgeons and their patients,” said Neville Alleyne, orthopaedic spine surgeon, Orthopaedic and Spine Institute at TriCity Medical Center, Oceanside, California, USA.

“The patient gets the equivalent of a post-op CT before leaving the operating room without the high radiation levels, and does not have to wait to rule out the need for revision surgery,” said Payam Moazzaz, orthopaedic spine surgeon also at TriCity Medical Center.


Currently, the most common way to accurately verify the placement of pedicle screws is by post-operative CT. But it occurs after the surgery has been completed, so significant misplacements necessitate a revision surgery. Intra-operative imaging systems are usually 2 dimensional, which is not sensitive enough for verification purposes, and 3D systems are not common and are very expensive.


C-OnSite utilises imagery from existing 2D C-arms, which are standard equipment in spine operating rooms. A 15 second C-arm scan is performed after screw positioning, and these images are fused with high-quality images from the preoperative CT. This produces an intra-operative 3D axial view of the spine, showing the exact location of each pedicle screw and its relationship to the spinal canal, without additional, expensive intra-operative 3D systems for spine surgery. So if a repositioning is necessary it can be done immediately, rather than as a revision case a few days later. The process requires no more than five to 10 minutes of additional OR time.


“Renaissance C-OnSite combines the enhanced accuracy of robotic guidance with actionable, intra-operative 3D image-based verification of screw positioning for immediate evaluation and correction,” said Ori Hadomi, CEO, Mazor Robotics.

“This offers the potential to reduce revision cases due to the misplacement of pedicle screws. By delivering post-op information during the surgical procedure, C-OnSite makes Renaissance a full solution for the spine surgeon, from pre-op planning through surgical guidance to verification. We expect the integration of C-OnSite with Renaissance will increase the overall clinical value of robotic guidance.”


According to a company release, all Renaissance systems sold after 28 May 2012 will include the C-OnSite application.


Mazor will display C-OnSite at SpineWeek (Amsterdam, The Netherland, 28 May–1 June 2012).

C-OnSite is CE-marked and cleared by the FDA  (under the former name of InCT). 

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