Comparative analysis of robotic assisted vs. traditional spinal angiography in a large single-center experience

Spinal angiography (SA) remains the gold standard for evaluating spinal cord vasculature, but traditional approaches expose operators and patients to significant ionizing radiation. Robotic-assisted platforms offer potential advantages through enhanced precision and operator radiation shielding. This study compares radiation exposure and procedural efficiency between robotic-assisted spinal angiography (RSA) and traditional spinal angiography (TSA).

A retrospective chart review was conducted for all patients undergoing TSA or RSA via Corindus CorPath GRX system at the University of Pennsylvania from 2022 to 2024. Clinical metrics included fluoroscopy time, total radiation dose, contrast volume, blood vessels catheterized, and procedural impressions. Analysis was conducted using Microsoft Excel and R.

Among 76 patients undergoing 84 SA procedures, 71 (84.5 %) used traditional techniques and 13 (15.5 %) used robotic assistance. Patient demographics were similar between groups. Unadjusted analyses showed no significant differences in procedural metrics. However, when normalized per vessel contrasted, RSA demonstrated significant advantages: 51.7 % reduction in radiation exposure (90.1 ± 54.7 vs. 186.6 ± 169.27 mGy*cm, p < 0.001), 41.2 % reduction in contrast volume (8.41 ± 2.27 vs. 14.3 ± 5.9 mL, p = 0.005), 30.7 % shorter fluoroscopy time (1.31 ± 0.51 vs. 1.89 ± 1.44 min, p = 0.02), and 62.4 % reduction in overall procedure time (3.76 ± 1.98 vs. 9.99 ± 12.6 min, p = 0.003).

Robotic-assisted spinal angiography using the Corindus CorPath GRX system significantly reduces radiation exposure and improves procedural efficiency compared to traditional manual techniques. These findings support integrating robotic technology in spinal angiography to enhance patient safety and procedural outcomes, though larger prospective studies are needed for validation.