Amelia High School graduate Justin Weeks shattered three vertebrae, his jaw and his sternum in a Motocross accident in Michigan in August 2009. He spent two-and-a-half weeks in intensive care. Doctors told him he likely wouldn't walk again. The 19-year-old proved them all wrong with the help of a robot.

Justin is just one of an increasing number of Greater Cincinnatians benefiting from advancements in the burgeoning field of medical robotics.

Cincinnati Children's Hospital Medical Center has embraced the new technology, using the Pediatric Lokomat gait robot to transform lives. The hospital was the third in North America to get the robot for pediatric use.

Physical Therapist Jenny Schmit, co-director of Children's program with Amy Wenz, is sold on the technology.

"Robotics has a tremendous place of importance in the future of rehabilitation," Schmit says.

The robot, an exoskeleton attached to the legs, hips and ankles by straps, with the chest supported by a pulley system, prods the patient in a natural walking motion. A computer programmed by a therapist controls the pace and measures the body's response to the movement. The goal is to almost overtrain the muscles in patients with moderate to severe motor impairments.

The results have been noteworthy.

"I can see tons of improvement using this," Justin said. "I have just been working my butt off every day."

That fierce determination "” personified by the tattoo he got on the inside of his left forearm shortly after the accident that reads, "Never Give Up" "” combined with the Lokomat's technology has helped him make great progress. In the early spring he rode a road bike six miles and even walked to the end of his street.

Justin isn't the only patient Schmit sees improving using the Lokomat.

"Across the board we're at least seeing a trend in improvement," Schmit says.

The Lokomat, which costs $350,000, was a gift of the Association of Volunteers, Convalescent Hospital for Children, which raised the money primarily through its annual Cincinnati Antiques Festival.

Another robot making a splash locally is the RIO Robotic Arm Interactive Orthopedic System made by MAKO Surgical Corp.

Dr. Michael Swank, medical director of the Jewish Hospital Joint Replacement Center, has been at the
forefront of this technology. Swank has been a pioneer in computer-assisted knee and hip surgery since 1995.

The RIO, used in a procedure called MAKOplasty, could revolutionize knee replacement. The procedure is an innovative option for adults with early-to-midstage osteoarthritis. The diseased portion of the knee is resurfaced by the robotic arm under the guidance of the surgeon, sparing the healthy bone and surrounding tissue. The robot, which provides real-time visual and audio feedback, limits the surgeon's motion so he can't make a mistake, allowing precise cuts to match the contours of the implants to be placed in the knee.

Swank is one of two surgeons in the area doing the procedure. Jewish Hospital received the second version of the robot in 2009 with the help of a grant from the Jewish Foundation, which contributed $500,000 of the $750,000 cost. The hospital, which performs more total joint surgeries than any other in Greater Cincinnati, was the 11th in the nation to begin using the robot.

Besides the accuracy, another benefit is a more rapid recovery compared to traditional knee surgery because of a smaller incision, usually 3-4 inches compared to two-to-three times that for traditional surgery.

Swank estimates around 30 percent of people who need total knee replacements could be candidates for the procedure, which requires a functioning anterior cruciate ligament and is capable of fixing two of the three knee compartments. The classic prospective patient would be someone who cannot walk long distances or for a long time but can otherwise get around. The goal is to help people before their knees completely deterioriate or they begin having excruciating pain.

Swank says robotics ultimately will be utilized more widely, but it might take some time.

"Right now things change very slowly in medicine," Swank says. "It's not like iPhones, and the reason is cost models are difficult in medicine. Standalone robots that cost three-quarters of a million dollars aren't all over the country. I think robots in general and computer navigation in general are going to increase and take traction. But there's a lot that needs to happen before generalized adoptions "” actually, just making it cheaper, better, faster."

One area of robotics "” surgery using the revolutionary da Vinci machine, which offers better precision, less blood loss and faster, less painful recoveries "” is taking off locally.

Over the past couple of years, most of the region's hospitals adopted the technology and began performing surgeries with the $1.2 million, minimally invasive system, which a surgeon guides from a nearby console. The final two to join the revolution were St. Elizabeth Healthcare and Mercy Health Partners. St. Elizabeth began its program in August 2009 and Mercy followed in December.

St. Elizabeth has hit the ground running "” 148 surgeries (75 hysterectomies, 63 prostate-related, 10 kidney-related) through February at its Edgewood location, where its only machine is located. Six of its surgeons are trained on the machine and six more will train this year. Still, they could do a lot more surgeries, says Ellen Ash, specialty resources nurse for gynecology and robotic surgery.

"There is room for growth, still," Ash says. "We need another system. We're hoping to get a second by trying to get more donations."

At Mercy Health Partners, twelve doctors are trained on the da Vinci, six each at Mercy Fairfield and Jewish Hospital. Both sites have one da Vinci.

One of those surgeons is Dr. Julia Lee, who was the first doctor with Obstetrics & Gynecology Associates Inc. to embrace the da Vinci. She performs surgeries at Mercy Fairfield. After seeing her successes and learning more, four more at her practice have decided to train on the machine.

How fast is the technology taking root? Consider: University Hospital performed almost three times as many da Vinci surgeries in 2009 as it did 2008 "” 367 to 145. By far the most popular surgeries are gynecological and urological.

TriHealth has long been the leader among area hospitals in robotic surgery, having performed more than 2,500 procedures, including the first duo-surgeon robotic-assisted surgery in the U.S.

At Jewish Hospital, Dr. Elliott Fegelman is the only surgeon trained in Greater Cincinnati to perform gastric bypass surgery on the da Vinci. He's now performing all of his gastric bypass cases with robotic assistance.

"More and more doctors are wanting to get trained," says Lee, who estimates she has done two da Vinci surgeries a month since December. "I think basically (robotic-assisted surgery) is here to stay. I don't know that it's going to pick up and spread very fast, but it's only going to get more in demand."

More major technological advancements are happening at University Hospital in the area of imaging.

University is the only area hospital using the $3.5 million Varian Trilogy system, a major advancement in cancer treatment technology.

A CT planning simulation establishes the exact contours of the tumor and its locations during the breathing cycle. The Varian then takes a 3D virtual simulation of it. Using real-time imaging data, and with the help of a medical physicist who helps determine the best paths to the tumor, radiation is delivered at 20 angles, like the spokes of a wheel with the tumor in the center. Dynamic targeting gives the tumor the heaviest doses of radiation. During traditional radiation therapy, beams are aimed an inch around the tumor. With the Varian, it's possible to treat tumors within millimeters. Higher, concentrated doses mean fewer treatments.

"The Varian can treat patients too sick for traditional surgery or whose lungs are in too bad of shape," says University's Dr. Kevin Redmond, who said in April the hospital had been using the machine for six months. "We'll proceed at a careful pace to know whether it is better than surgery."

Yet another imaging advancement is happening at University: Digital Subtraction Chest X-rays, where the bones, or tissues, depending on what needs to be seen, can be removed from the image. Sometimes a lesion is hiding behind a bone, or is on one, and the dual energy X-ray helps find it. University is the only area hospital doing the dual energy X-rays on the $500,000 machine made by General Electric.

One thing is certain: It won't be the last advancement in robotics or imaging spearheaded by the local medical community.