Reduction in complication and revision rates for robotic-guided short-segment lumbar fusion surgery: results of a prospective, multi-center study

Jason I. Liounakos, Vignessh Kumar, Aria Jamshidi, Zmira Silman, Christopher R. Good, Samuel R. Schroerlucke, Andrew Cannestra, Victor Hsu, Jae Lim, Faissal Zahrawi, Pedro M. Ramirez, Thomas M. Sweeney, Michael Y. Wang

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Studies evaluating robotic guidance in lumbar fusion are limited primarily to evaluation of screw accuracy and perioperative complications. This is the first study to evaluate granular differences in short and long-term complication and revision rate profiles between robotic (RG) fluoroscopic (FG) guidance for minimally invasive short-segment lumbar fusions. A retrospective analysis of a prospective, multi-center database was performed. Complications were subdivided into surgical (further subcategorized into adjacent segment disease, new-onset back pain, radiculopathy, motor-deficit, hardware failure, pseudoarthrosis), wound, and medical complications. Complication and revision rates were compared between RG and FG groups cumulatively at 30, 90 days, and 1 year. 374 RG and 111 FG procedures were performed. RG was associated with an 86.25, 83.20, and 69.42% cumulative reduction in complication rate at 30, 90 days, and 1 year, respectively, compared to FG (p < 0.001). At all follow-up points, new-onset radiculopathy and medical complications were most prevalent in both groups. The greatest reductions in complication rates were seen for new-onset back pain (88.13%; p = 0.001) and wound complications (95.05%; p < 0.001) at 30 days, new-onset motor deficits (90.11%; p = 0.004) and wound complications (85.16%; p < 0.001) at 90 days, and new-onset motor deficits (85.16%; p = 0.002), wound (85.16%; p < 0.001), and medical complications (75.72%; p < 0.001) at 1 year. RG was associated with a 92.58% (p = 0.002) reduction in revision rate at 90 days and a 66.08% (p = 0.026) reduction at 1 year. RG was associated with significant reductions in postoperative complication rates at all follow-up time points and significant reductions in revision rates at 90 days and 1 year.

Original languageEnglish (US)
Pages (from-to)793-802
Number of pages10
JournalJournal of Robotic Surgery
Volume15
Issue number5
DOIs
StatePublished - Oct 2021

Keywords

  • Complications
  • Minimally invasive surgery
  • Pedicle screws
  • Revision surgery
  • Robotic-guided surgery
  • Spinal fusion

ASJC Scopus subject areas

  • Surgery
  • Health Informatics

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