5G-Enabled remote Robotic-Assisted percutaneous pedicle screw fixation in single thoracolumbar fractures: initial...

The integration of 5G and robotics technology has been initially introduced in orthopedic surgeries. Research on 5G remote robot-assisted (RA) spinal surgery remains limited, with the existing literature notably lacking comparative analyses of outcomes between 5G remote and conventional robotic procedures. Herein, this study aims to investigate the clinical feasibility and safety of 5G remote RA percutaneous pedicle screw fixation, and compare the clinical and radiographic outcomes between 5G remote and conventional RA pedicle screw placement in single thoracolumbar fracture surgery.

A total of 61 consecutive patients with single thoracolumbar fracture who undergoing pedicle screw placement using 5G remote (26 patients) and conventional (35 patients) RA techniques with a 1:1.3 ratio were retrospectively included. Matching was based on age, gender, and body mass index (BMI) to ensure comparability between the two groups. The clinical outcomes were mainly comprised of VAS and ODI scores, surgical time, and intraoperative blood loss; the radiographic outcomes included the preoperative and postoperative anterior vertebral height (AVH), middle vertebral height (MVH), posterior vertebral height (PVH), accuracy of pedicle screw placement assessed using Gertzbein-Robbins scale, and cranial facet joint violation (FJV) assessed using Babu scale.

When compared to conventional RA techniques, the 5G remote RA techniques demonstrated comparable clinical outcomes in terms of postoperative VAS score, ODI scores, surgical durations, and intraoperative blood loss. Regarding the radiographic outcomes, the 5G remote RA techniques exhibited similar postoperative results to conventional RA techniques, including AVH, MVH, PVH, improvement ratios for AVH, MVH, and PVH compression. Moreover, the rates of optimal pedicle screw placement accuracy were 77.6% in the 5G remote group and 76.9% in the conventional group, indicating no significant difference. Similarly, the rates of cranial FJV in 5G remote and conventional RA groups were 19.0% and 18.3%, respectively, revealing no statistically significant difference.

The 5G remote RA techniques demonstrated comparable clinical and radiographic outcomes to conventional RA techniques, including relief from back pain (VAS scores), restoration of functional status (ODI scores), maintenance of vertebral height in the injured vertebra, accuracy of pedicle screw placement, and the incidence rate of cranial FJV. The integration of 5G and robotics technology is safe and feasible, yielding promising clinical and radiographic outcomes in thoracolumbar screw fixation surgery.