A mentorship model for robotic-assisted navigation in pediatric spine surgery

Robotic-assisted navigation (RAN) systems improve pedicle screw placement accuracy, yet a significant learning curve persists. We implemented a mentorship model, pairing a single early-career attending spine surgeon (mentee) with an experienced, attending spine surgeon (mentor). This study evaluates the feasibility and safety of implementing a structured mentorship model for pediatric robotic-assisted spinal fusion. A retrospective review of patients ≤ 21 years with idiopathic scoliosis undergoing robot-assisted posterior spinal fusion was performed over 38 months. Operative outcomes were compared between mentor-led and mentee-led cases with a minimum of 90-day follow-up. 55 cases were included (39 mentor-primary, 16 mentee-primary cases). Total procedure time was not different between mentor-primary and mentee-primary cases (324 ± 58 and 332 ± 29, p = 0.38) nor was the number of robotically-placed screws per case (22 ± 6 and 22 ± 3, p = 0.11), robotically planned screws converted to freehand per case (1 ± 3 and 0 ± 1, p = 0.33), or abandoned robotic screws per case (1 ± 1 and 1 ± 1, p = 0.67). There was no difference between groups in the number of breaches per case (0.3 ± 0.7 and 0.3 ± 0.4, p = 0.84) nor percentage of patients with intraoperative neuromonitoring changes (2% and 6%, p = 0.50). There was no difference in readmission (both 0%) or surgical site infection (both 0%). One mentor-primary patient developed pseudoarthrosis requiring reoperation. These findings suggest that a structured mentorship model is a feasible approach for integration of robotic assisted navigation into a new attending's practice while maintaining acceptable safety and efficiency.Level of Evidence: IV.