Abstract

Rising patient demand for minimally invasive surgery and increased payer emphasis on quality-based payment schema have created a need for technologies that provide consistent, high-quality outcomes for patients undergoing spine surgery. Robotic assistance is one such technology. Here we report our early experience with a novel real-time, image-guided robot system for use in short-segment lumbar fusion in patients diagnosed with degenerative disease.A consecutive series of patients undergoing robot-assisted 1- or 2-level lumbar fusion procedures were compared to matched controls who underwent free-hand surgery. Screw accuracy, intraoperative outcomes, and 30-day outcomes were compared.We identified 56 patients who underwent 1- or 2-level lumbar fusion during the study period: 28 who underwent robot-assisted procedures and 28 matched controls who underwent freehand instrumentation placement. No significant differences were found between the robot-assisted surgery cohort and the freehand surgery cohort with respect to matched variables. Patients who underwent robot-assisted surgery had less intraoperative blood loss (266.1±236.8 vs. 598.8±360.2mL; p < 0.001) and shorter hospitalizations (3.5±1.8 vs. 4.5±2.0d; p = 0.01). No differences were noted in complication rates, 30-day outcomes or screw accuracy. Profiling of our initial series revealed an average reduction in operation duration of 4.6 minutes with each additional case.Patients undergoing robot-assisted fusion experienced less intraoperative blood loss and shorter hospitalizations. The results of this initial experience suggest that an image-guided robotic system may provide similar short-term outcomes compared with freehand instrumentation placement.

View details for DOI 10.1016/j.wneu.2020.01.119

View details for PubMedID 32001398