— There are two main limitations in the conventional robot-assisted spinal fusion surgery. Since the end effector in the state of art has a role of guiding the insertion pose of a screw only, i) convenience that can be obtained when the robot intervenes in the surgery more actively could be limited. ii) The insertion pose of a screw provided by the robots could be deteriorated by surgeon’s resisting force since he should insert a screw with his own hand withstanding the large reaction force transmitted through the drilling handle. To overcome those limitations, this paper proposes a novel approach for spinal fusion, wherein the robot performs the spinal fusion using the equipped end effector following surgeon’s guide. We developed a dexterous small-sized the end effector that can perform previous gimleting and screwing tasks into the vertebrae. A five-DOF robot body that has kinematically-closed structure guides the insertion pose of a screw and resists strong reaction force fi...