Robotic spine surgery compared with fluoroscopic-assisted surgery: advantages, disadvantages, future perspectives

Area of Science:

• Spine Surgery
• Robotics in Medicine
• Surgical Workflow Optimization

Background:

• Robotic spine surgery (RSS) presents potential advantages over traditional fluoroscopic-assisted surgery (FAS).
• Evaluating RSS benefits and the impact of specialized nursing teams on surgical efficiency is crucial.

Purpose of the Study:

• To compare the efficacy and outcomes of RSS versus FAS for thoracolumbar instability.
• To assess the influence of a dedicated nursing team on robotic surgical workflow.

Main Methods:

• Retrospective analysis of 260 adult patients with thoracolumbar instability undergoing posterior fusion.
• Comparison between 130 patients treated with robotic assistance (Medtronic Mazor X) and 130 with FAS.
• Evaluation of operative duration, accuracy, radiation exposure, complications, and patient-reported outcomes (Oswestry Disability Index).

Main Results:

• Robotic spine surgery demonstrated superior accuracy in pedicle screw placement and reduced implantation times.
• RSS led to decreased radiation exposure for surgeons and patients.
• A dedicated nursing team significantly reduced operative room entry-to-start and overall procedure times for RSS.

Conclusions:

• Robotic spine surgery offers significant advantages in accuracy and efficiency over fluoroscopic-assisted surgery.
• Reduced implantation times and postoperative pain were observed with RSS, without increased complications.
• The learning curve and integration of operating room staff are critical factors for optimizing robotic surgical procedures.