Risk factors analysis for pedicle screw placement deviation in robot-assisted MIS-TLIF

To investigate the potential risk factors influencing the pedicle screw placement deviation of robot-assisted minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).

Clinical data of 65 patients treated with robot-assisted MIS-TLIF from July 2020 to April 2023 in the Department of Orthopedics of Beijing Tongren Hospital were included. The research data were collected from the medical record system and the imaging system of the hospital. The potential risk factors of both patient characteristics and surgical factors for poor placement of robot-assisted pedicle screws were examined by single factor analysis. For variables statistically significant in the univariate test, logistic regression analysis was further used to identify the independent risk factors for the poor pedicle screw placement.

The total 65 cases treated with the robot-assisted surgeries included 37 males and 28 females, aged 58.85 ± 13.41 years (range, 26-81 years), and with a BMI of 25.63 ± 3.46 kg/m². Diagnoses comprised lumbar disc herniation in 26 cases, lumbar spinal stenosis in 36 cases, and lumbar spondylolisthesis in 3 cases. A total of 290 pedicle screws placed. The satisfaction rate on the placed pedicle screws was 86.21%. And the decompression operation was found to be an independent risk factor (OR, 3.156; 95% CI, 1.362-7.311; p = 0.007) influencing the accuracy of the pedicle screw placement.

The decompression is found to be an independent risk factor influencing the screw placement deviation during the robot-assisted MIS-TLIF surgeries. And special attention should be paid to the guide needle and screw orientation during the screw placement after decompression.