1. Prentice - Marketing Version 1 1
4/20/2017
4/20/2017
Hello I am ______ from Mazor Robotics. I’m excited about the opportunity to educate you on Renaissance. In this short presentation I will expose you to the value that Renaissance has brought to patients, surgeons, and hospitals.
NOTE: This is a generic opening – and would only be used in situations where you are put on the spot and are briefing an unknown audience (rare situation). The “art” of this presentation would be to create an opening statement specific to the who, what, and why of the specific situation and audience. This is where you differentiate yourself as the presenter and make the most impact. A recommendation – people like stories, they are reasons to believe.
MKC Rev.A
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2. Renaissance® Value in Spine Surgery
4/20/2017
Renaissance® Value in Spine Surgery
Improves Patient Care
What is Renaissance?
I will elaborate on what Renaissance is, but most importantly, why Renaissance matters to patients, surgeons, and hospitals.
Renaissance has translated pre-operative three-dimensional planning into highly precise intra-operative mechanical guidance in thousands of spine procedures at over 30 sites worldwide.
Patients experience lower complication rates, less revisions, shorter length of stay, and less post operative pain.
Surgeons enjoy the comfort of pre-planning their surgery, executing the procedure with unparalleled accuracy, and a safer OR environment with less fluoroscopy.
Hospitals gain increased patient satisfaction, improved operating efficiencies, and the potential for significant market share gain.
So, what exactly is Renaissance?
Enhance Surgeon Capabilities & Safety
Enhances hospital offering
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3. Planning Software Workstation Guidance Unit 4/20/2017
Mazor Robotics Renaissance is a streamlined surgical system with a minimal footprint in the operating room.
The three main components of Renaissance are the software, the guidance unit, and the workstation.
The planning software is loaded on the workstation’s touch screen computer and can also be used on a laptop or desktop computer.
The guidance unit, which is small enough to be held in one hand, enters into the surgical field to provide the surgeon with the precise trajectories that were planned pre-operatively.
How does Renaissance work?
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4. Spine Surgery with How It Works Tools and implants are guided to the
4/20/2017
Spine Surgery with
How It Works
Step 1:
Preoperative plan
Step 2:
Mount
Step 3:
3D Sync
Renaissance works in four steps:
Pre-operative plan: The patient’s CT scan is uploaded to Renaissance’s advanced software to create a detailed 3D model of the patient’s spine. This enables the surgeon to accurately visualize the patient’s spinal condition and plan the ideal, customized surgery in a virtual 3D environment.
Mounting the guidance unit: All mounting platforms rigidly attach to the patient’s spine to ensure that maximum accuracy is maintained throughout the procedure even if patient movement occurs. The most commonly used mounts are the clamp mount and bed mounts.
Anatomic matching: Once the mounting platform is in place, matching of the intra-operative anatomy to the preoperative anatomic blueprint can be achieved. A 3D marker is attached to the mount and two fluoroscopic images are taken – an AP and an oblique. Renaissance then automatically matches these intra-operative images to their corresponding location on the pre-operative CT.
Operate: Renaissance will direct the guidance unit to the exact position according to the plan. Surgeons then pass the surgical tools through the guided cannula. This process continues until all trajectories have been reached and implants are safely placed in the planned location. Fluoroscopy use is minimized – thus saving time and reducing radiation exposure.
In what type of spine procedures is Renaissance used?
-or- (IF A SURGEON AUDIENCE) Let’s take a closer look at the mounting options…
NOTE: for audiences that are not surgeons, this slide can be quickly summed up “Renaissance has 4 simple steps – preplanning the surgery, attaching the guidance unit, matching the intraoperative anatomy to the pre-operative blueprint, and implant placement.”
Tools and implants are guided to the
planned trajectory with 1.5mm accuracy
Step 4:
Operate
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5. 4 mounting platforms ̶ Clamp Mount Bed Mount Hover T Mount
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4 mounting platforms ̶
Clamp Mount
Bed Mount
Hover T Mount
Multi-directional Bed Mount
NOTE: Slide should only be used for surgeon audiences.
Renaissance has versatility in mounting options, selection of the mount is dependent on the type of procedure and surgeon preference:
The clamp mount is used both in minimally invasive percutaneous cases as well as open cases such as scoliosis correction.
The bed mount and multi-directional bed mounts is the least invasive of all mounting options, with only one pin attached to a spinous process.
The multi-directional bed mount moves laterally to allow for even greater versatility in selecting trajectory and insertion points.
The Hover-T mount is secured to the anatomy in three locations – making it the most rigid of the mounting options.
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6. Applications in Spine Surgery
4/20/2017
Applications in Spine Surgery
Posterior approaches (open, MIS, percutaneous)
Spinal fixation
Pedicle screws
Transfacet, translaminar- facet screws
Sacroiliac screws
Spinal deformities
Scoliosis posterior spinal fusion, osteotomies
Cement augmentations
Kyphoplasty and vertebroplasty
Oncological applications
Biopsies, tumor resections
Revisions
Renaissance has wide application in the many types of spine procedures.
Utilizing Renaissance can improve execution and outcomes in minimally invasive degenerative repair and deformity correction, in percutaneous procedures, and in open complex deformity cases.
Renaissance has been proven effective in these procedures worldwide…
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7. Surgeons’ experience Over 7,500 successful procedures worldwide
4/20/2017
Surgeons’ experience
Over 7,500 successful procedures worldwide
Over 45,000 implants placed
Patient Care
Clinical Challenges
Human Factor
Occupational Risk
Many surgeons and their patients have already experienced the benefit of Renaissance and Mazor Robotics’ technology.
The experience has also been documented in peer-reviewed clinical literature…
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8. Mazor Robotics Technology: Clinical Evidence
4/20/2017
98.3% Accuracy of 3,271 implants in cases in 14 medical centers
with 49% of implants placed percutaneously
(typically 10%-20% of spine surgeries are MIS)
Devito DP, Kaplan L, Dietl R, et al. Clinical acceptance and accuracy assessment of spinal implants guided with SpineAssist surgical robot: retrospective study. Spine J. 2010;35(24):
In a 14 site multi-center study the use of Mazor Robotics technology yielded 98.3% accuracy with about half the cases being done percutaneously.
Nationwide, only 10%-15% of all cases are done percutaneously due to the challenges in executing the approach safely and effectively.
The technology was also tested in some of the most challenging deformity procedures…
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9. Mazor Robotics Clinically Validated Technology: Clinical Evidence
4/20/2017
99.7% Clinical Acceptance of 1,815 implants in 120 scoliotic adolescents
Devito DP, Gaskill T, Erikson M, Fernandez M. Robotic based guidance for pedicle screw instrumentation of the scoliotic spine. Presented at Pediatric Society of North America (POSNA); May 2011; Montreal, Canada.
Using Mazor Robotics technology - Dr. Dennis Devito of Children’s Healthcare of Atlanta gained 99.7% accuracy in 120 of his adolescent scoliosis correction cases – over 1800 implants in small abnormal anatomy. In spine surgery the margin for error is small, in pediatric spine surgery, the margin for error is even smaller.
Accuracy translates into better outcomes – one study looked at the patient outcomes of using the technology….
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10. Mazor Robotics Technology: Clinical Evidence
4/20/2017
Mazor Robotics Technology: Clinical Evidence
Compared to freehand surgery, in 112 cases Mazor Robotics technology:
Improved implant accuracy
Reduced fluoroscopy by 56%
Reduced complication rates by 48%
Reduced re-operations 46%
Reduced average length of stay 27%
Kantelhardt SR, Martinez R, Baerwinkel S, Burger R, Giese
A, Rohde V. Perioperative course and accuracy of screw
positioning in conventional, open robotic-guided and
percutaneous robotic-guided, pedicle screw placement.
Eur Spine J. 2011;20(6):
In a direct look at using the Mazor Robotics technology versus the freehand approach, the following was found:
Improved accuracy
Radiation exposure decreased by over 50%
Complication rates and re-operations decreased by almost half
And length of stay was significantly reduced.
Precision in spine surgery results in better patient outcomes.
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11. Mazor Robotics Technology: Clinical Evidence
4/20/2017
Mazor Robotics Technology: Clinical Evidence
98.9% “successful and accurate” screw placement in deformity and revision surgeries
960 screws in 95 patients
Hu, X, Ohnmeiss D. Lieberman,I. Robotic-assisted pedicle screw placement: lessons learned from the first 102 patients. Eur Spine J (2013) 22:
A very recent publication demonstrates the precision of Mazor Robotics surgery in the most complicated of cases – adult deformity correction and revision surgery – where the anatomy has deviations and a surgeon cannot rely on “where structures should be.”
Many spine programs worldwide have incorporated Mazor Robotics technology due to the benefits of the technology to surgeons, patients, and the hospital….
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12. Mazor Robotics Technology: Clinical Evidence
4/20/2017
Mazor Robotics Technology: Clinical Evidence
Compared to previously published results on vertebral augmentation, procedures performed using Mazor Robotics technology in this study demonstrated 74 percent reduction in radiation exposure when compared to using fluoroscopic guidance, and a 50 percent reduction in radiation exposure when compared to using navigation technology.
33 Consecutive patients with 60 vertebral compression fractures
Barzilay, Schroeder, Hiller, Singer, Hasharoni, Safran, Liebergall, Itshayek, Kaplan. Robotic assisted vertebral body augmentation - a radiation reduction tool. Spine Journal: Volume 39, Number 2, pp
A very recent publication demonstrates the precision of Mazor Robotics surgery in the most complicated of cases – adult deformity correction and revision surgery – where the anatomy has deviations and a surgeon cannot rely on “where structures should be.”
Many spine programs worldwide have incorporated Mazor Robotics technology due to the benefits of the technology to surgeons, patients, and the hospital….
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13. Mazor Robotics Technology: Clinical Evidence
4/20/2017
Mazor Robotics Technology: Clinical Evidence
100 percent of screws placed in the 2mm safe zone
Study of 12 cases utilizing Renaissance with varying indications: sagittal and coronal plane deformity, DDD, revision surgery (100 percent performed percutaneously after stage 1 anterolateral interbody fusion).
Graham M, Murtough R, James C, Castellvi E. Accuracy, Safety, & Intraoperative Radiation in Robot Guided Percutaneous Screw Placement. Presented at Current Solutions in Spine Surgery; May 2013; Duck Key, Florida, USA.
A very recent publication demonstrates the precision of Mazor Robotics surgery in the most complicated of cases – adult deformity correction and revision surgery – where the anatomy has deviations and a surgeon cannot rely on “where structures should be.”
Many spine programs worldwide have incorporated Mazor Robotics technology due to the benefits of the technology to surgeons, patients, and the hospital….
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14. Mazor Robotics Technology: Clinical Evidence
Adolescent Idiopathic Scoliosis (AIS) data presented at the International Meeting on Advanced Spine Techniques (IMAST) 2014
Multi-site (Five centers)
223 AIS patients, 3,274 screws placed with Mazor Robotics system
3,252 of 3,274 screws were considered accurate = 99.3%
1.58 seconds of fluoroscopy per screw
Devito D, Hegde S, Lieberman I, Bederman S, Woo, R. Retrospective, Five-Center Analysis of 3,270 Pedicle Screws Placed with Robotic Guidance in Adolescent Idiopathic Scoliosis (AIS). Presented at International Meeting on Advanced Spine Techniques; July 2014; Valencia, Spain.

15. Mazor Robotics in the United States
Mazor Robotics System
Grouped
Multi-System Accounts
Training Center

16. US Locations by State
California____________________________________________
Desert Regional Medical Center, Palm Springs
Fountain Valley Regional Hospital, Fountain Valley
Tri-City Medical Center, Oceanside (2)
University of California, Irvine Medical Center
Colorado____________________________________________
Parker Adventist Hospital, Denver
Littleton Adventist Hospital, Littleton
Florida______________________________________________
Baptist Health Jacksonville, Jacksonville (2)
Delray Medical Center, Delray Beach
Doctors Hospital of Sarasota
Florida Hospital Carrollwood, Tampa
Florida Hospital Celebration Health, Celebration
Florida Hospital for Children, Orlando
Florida Hospital Orlando
Lawnwood Regional Medical Center, Fort Pierce

17. US Locations by State
Georgia_______________________________________________________________
Children’s Orthopaedics of Atlanta
North Fulton Hospital, Roswell
Savannah Memorial Hospital, Savannah
The Medical Center of Central Georgia, Macon
Michigan_____________________________________________________________
Michigan Surgical Hospital, Detroit
Metro Health Hospital, Grand Rapids
Nebraska____________________________________________________________
Bryan Medical Center, Lincoln
New York____________________________________________________________
St. Mary’s Healthcare, Amsterdam
Nathan Littauer Hospital, Gloversville
North Carolina______________________________________________________
New Hanover Regional Medical Center, Wilmington
Ohio__________________________________________________________________
Bethesda North Hospital, Cincinnati

18. US Locations by State
Pennsylvania___________________________________________________
Geisinger Health System, Danville
South Carolina_________________________________________________
Spartanburg Regional Healthcare System, Spartanburg
Tennessee______________________________________________________
St. Francis Hospital, Memphis
Texas____________________________________________________________
Foundation Surgical Hospital of San Antonio
Houston Orthopaedic & Spine Hospital
Humble Surgical Hospital, Humble
Southwest NeuroSpine Institute, El Paso
Texas Health Presbyterian, Plano
Trinity Mother Francis, Tyler
Westside Surgical Hospital, Houston (2)

19. US Locations by State
Virginia__________________________________________________________
Reston Hospital Center, Reston

20. Mazor Robotics in Europe
Mazor Robotics System

21. Europe Locations Germany_________________________________________
University Medical Center Gottingen, Gottingen
University Medical Center Mainz, Mainz
University Tuebingen, Tuebingen
HSK, Wiesbaden
Pfaffenhofen Ilmtalklinik GMBH, Pfeffenhofen
Klinikum Muenchen Schwabing, Munich
Klinikum rechts der Isar, Munich
Klinikum Grosshadern, Munich
Paracelsus Klinik Muenchen, Munich
Klinikum Nordstadt Hannover, Hannover
Italy_____________________________________________
ARS Medica, Rome
Switzerland_______________________________________
Geneva HUG-Hospitaux Universitaires, Geneva

22. Europe Locations The Netherlands___________________________________
Medisch Spectrum Enschede, Enschede
Bergman Clinics, Naarden
Turkey___________________________________________
Florence Nightingale Hospital, Istanbul

23. Mazor Robotics in Asia
Mazor Robotics System

24. Asia Locations Australia__________________________________________
North Shore Private Hospital, Sydney
India_____________________________________________
Apollo Hospital, Chennai
NOVA Orthopaedic and Spine Hospital, New Delhi
Russia____________________________________________
Federal Orthopedic Center of Cheboksary, Cheboksary
Krasnoyarsk Regional Hospital, Krasnoyarsk
Civil Aviation Hospital, Moscow
N.N. Blokhin Cancer Research Center, Moscow
City Clinical Hospital, #67, Moscow
Taiwan__________________________________________
Kaohsiung Medical University Memorial Hospital (KMUH), Kaohsiung Vietnam_________________________________________
Viet Duc, Hanoi

25. Mazor Robotics in Middle East
Mazor Robotics System

26. Middle East Locations Israel__________________________________________
Bnai Zion Medical Center, Haifa
Carmel Medical Center, Haifa
Hadassah Medical Center, Jerusalem
Meir Medical Center, Kfar Saba
Shaare Zedek Medical Center, Jerusalem

27. Renaissance® Value in Spine Surgery
4/20/2017
Renaissance® Value in Spine Surgery
Improves Patient Care
• Safer1
• Fewer complications and revisions4,5
• Less post-operative pain4
• Shorter recovery time3
Overcomes Clinical Challenges
• CT-based 3D planning
• Accuracy independent of anatomical challenges and field-of-view1,3,5
• Optimize implant location
Increase Occupational Safety
• May reduce fluoroscopy4
Enhances hospital offering
• Differentiates spine program
• Attracts new surgeons and new patients
• May increase operating room efficiencies
Enhance Surgeon Capabilities
• 98.3 % accuracy5
• 99.7% clinical acceptance1
• Short Learning Curve2,5
….are the core of Renaissance’s value.
By enhancing the surgeon’s capabilities, Renaissance allows for improved patient outcomes – which yields higher patient satisfaction – and the ability for healthcare institutions to attract more patients.
Spine programs that incorporate Renaissance are clearly differentiated as those that are committed to advancing spine surgery by improving the experience for the caregiver and the patient.
I’d now like to discuss how you can join the Renaissance in spine surgery.
REFERENCES
1. Devio DP, Gaskill T, Erikson M, Fernandez M. Robotic based guidance for pedicle screw instrumentation of the scoliotic spine. Presented at: Pediatric Society of North America (POSNA); May 2011; Montreal, Canada.
2. Pechlivanis I, Kiriyanthan G, Engelhardt M, et al. Percutaneous placement of pedicle screws in the lumbar spine using a bone mounted miniature robotic system, _ rst experiences and accuracy of screw placement. Spine. 2009;34(4):392–398.
3. Silberstein, B. Bruskin, A. Alexandrovskii, V. Robot guided surgery in treatment of osteoporotic fractures. [CD-ROM] Presented at: European Federation of National Associations of Orthopaedics and Traumatology (EFORT) 2011 Annual Congress; June 1-4, 2011:abs 1097.
4. Kantelhardt, SR, Martinez R, Baerwinkel S, Burger R, Giese A, Rohde V. Perioperative course and accuracy of screw positioning in conventional, open robotic-guided and percutaneous robotic-guided, pedicle screw placement. Eur Spine J. 2011;20(6):
5. Devito, DP, Kaplan, L, Dietl R, et al. Clinical acceptance and accuracy assessment of spinal implants guided with SpineAssist surgical robot: retrospective study. Spine. 2010;35(24):
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28. www.MazorRobotics.com http://www.youtube.com/user/MazorRobotics
4/20/2017
Questions?
Please visit Mazor Robotics for more information – and view one of the many videos available on the Mazor Robotics channel of YouTube.
Thank you!
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