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Updated: Jan 22, 2026

A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
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Robot-Assisted Pedicle Screw Placement: Learning Curve Experience.

Mehdi I Siddiqui1, David J Wallace2, Luis M Salazar1

  • 1Long School of Medicine, University of Texas Health Sciences Center, San Antonio, Texas, USA.

World Neurosurgery
|June 28, 2019
PubMed
Summary

Robot-assisted spine surgery demonstrates a safe and accurate learning curve for pedicle screw placement. Experienced surgeons and fellows achieve significant accuracy improvements, with new learners adapting quickly to the robotic system.

Keywords:
Learning curveResidency trainingRobot-assisted spine surgerySpinal navigation

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Area of Science:

  • Neurosurgery
  • Robotic Surgery
  • Spine Instrumentation

Background:

  • Robot-assisted spine surgery is increasingly adopted for pedicle screw placement.
  • Understanding the learning curve is crucial for safe implementation by surgical teams.

Purpose of the Study:

  • To evaluate the learning curve of pedicle screw placement using robot-assisted spine surgery.
  • To compare the learning adaptation of an experienced neurosurgeon and two supervised fellows.

Main Methods:

  • Analysis of the first 120 robot-assisted spine surgery cases.
  • Assessment of patient, intraoperative, and postoperative variables.
  • Evaluation of screw accuracy using image overlay analysis and 2D measurements.

Main Results:

  • Both experienced surgeon and first fellow showed improved accuracy after 30 screws.
  • The second fellow demonstrated superior accuracy in initial screw placements compared to the experienced surgeon.
  • No hardware complications or revisions were reported in any group.

Conclusions:

  • Robot-assisted spine surgery is a safe and accurate technique for pedicle screw instrumentation.
  • Learning adaptation rates were similar between the experienced surgeon and the first fellow.
  • Surgical techniques were effectively transferred, enabling a faster learning curve for a new trainee.