A Multi-surgeon Robotic-guided Thoracolumbar Fusion Experience: Accuracy, Radiation, Complications, Readmissions, and Revisions of 3,874 Screws across Three Robotic Generations
Objective Robotic guidance provides indirect visualization of key anatomic landmarks to facilitate minimally invasive surgery (MIS) and is emerging as a reliable and accurate technique for posterior spine instrumentation. We sought to describe eight years of experience with robotic guidance at a hig...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Minimally Invasive Spine Surgery Society
2022-10-01
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| Series: | Journal of Minimally Invasive Spine Surgery and Technique |
| Subjects: | |
| Online Access: | http://www.jmisst.org/upload/pdf/jmisst-2022-00479.pdf |
| _version_ | 1828062649967968256 |
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| author | Alexandra E. Thomson Lindsay D. Orosz Colin M. Haines Ehsan Jazini Fenil R. Bhatt Julia N. Grigorian Andre D. Sabet Rita Roy Thomas C. Schuler Christopher R. Good |
| author_facet | Alexandra E. Thomson Lindsay D. Orosz Colin M. Haines Ehsan Jazini Fenil R. Bhatt Julia N. Grigorian Andre D. Sabet Rita Roy Thomas C. Schuler Christopher R. Good |
| author_sort | Alexandra E. Thomson |
| collection | DOAJ |
| description | Objective Robotic guidance provides indirect visualization of key anatomic landmarks to facilitate minimally invasive surgery (MIS) and is emerging as a reliable and accurate technique for posterior spine instrumentation. We sought to describe eight years of experience with robotic guidance at a high-volume, multi-surgeon center. We hypothesize that robotic guidance will lead to (1) low rates of complication, readmissions, and revision surgery, (2) reduced fluoroscopic radiation exposure, (3) and accurate thoracolumbar instrumentation. Methods A retrospective review of complications, revision surgery, and readmission rates in patients undergoing thoracolumbar fusion surgery utilizing three robotic generations. Secondary analysis was conducted comparing the three robotic generations for complications, revision surgery, accuracy, and readmission rates along with intraoperative fluoroscopic duration. Results A total of 628 patients (3,874 robotic-guided screws) ages 12–81 years-old (43.9% male) were included in the study. At one year, the cumulative complication incidence was 15.5% with a 10.3% incidence of surgical complications (3.7% wound, 1.2% robot-related, and 5.4% non-robot-related complications). At one year, the revision surgery incidence was 9.4%. There was no statistical difference between complications, readmission, or revision surgery after initial admission among the three robotic generations. The average intraoperative fluoroscopic duration was 53.8 seconds (11.9 seconds per screw and 17.6 seconds per instrumented level). Conclusion Robotic guidance in thoracolumbar instrumented fusions was associated with low complication, revision surgery, and readmission rates. Our results suggest robotic guidance can provide accurate guidance with minimal adverse events in thoracolumbar instrumentation. |
| first_indexed | 2024-04-10T22:30:44Z |
| format | Article |
| id | doaj.art-692fe74c69db48cd995c32b9eafc07ae |
| institution | Directory Open Access Journal |
| issn | 2508-2043 |
| language | English |
| last_indexed | 2024-04-10T22:30:44Z |
| publishDate | 2022-10-01 |
| publisher | Korean Minimally Invasive Spine Surgery Society |
| record_format | Article |
| series | Journal of Minimally Invasive Spine Surgery and Technique |
| spelling | doaj.art-692fe74c69db48cd995c32b9eafc07ae2023-01-17T04:46:10ZengKorean Minimally Invasive Spine Surgery SocietyJournal of Minimally Invasive Spine Surgery and Technique2508-20432022-10-017219320110.21182/jmisst.2022.00479150A Multi-surgeon Robotic-guided Thoracolumbar Fusion Experience: Accuracy, Radiation, Complications, Readmissions, and Revisions of 3,874 Screws across Three Robotic GenerationsAlexandra E. Thomson0Lindsay D. Orosz1Colin M. Haines2Ehsan Jazini3Fenil R. Bhatt4Julia N. Grigorian5Andre D. Sabet6Rita Roy7Thomas C. Schuler8Christopher R. Good9 Virginia Spine Institute, Reston, VA, USA National Spine Health Foundation, Reston, VA, USA Virginia Spine Institute, Reston, VA, USA Virginia Spine Institute, Reston, VA, USA Virginia Spine Institute, Reston, VA, USA National Spine Health Foundation, Reston, VA, USA Virginia Spine Institute, Reston, VA, USA National Spine Health Foundation, Reston, VA, USA Virginia Spine Institute, Reston, VA, USA Virginia Spine Institute, Reston, VA, USAObjective Robotic guidance provides indirect visualization of key anatomic landmarks to facilitate minimally invasive surgery (MIS) and is emerging as a reliable and accurate technique for posterior spine instrumentation. We sought to describe eight years of experience with robotic guidance at a high-volume, multi-surgeon center. We hypothesize that robotic guidance will lead to (1) low rates of complication, readmissions, and revision surgery, (2) reduced fluoroscopic radiation exposure, (3) and accurate thoracolumbar instrumentation. Methods A retrospective review of complications, revision surgery, and readmission rates in patients undergoing thoracolumbar fusion surgery utilizing three robotic generations. Secondary analysis was conducted comparing the three robotic generations for complications, revision surgery, accuracy, and readmission rates along with intraoperative fluoroscopic duration. Results A total of 628 patients (3,874 robotic-guided screws) ages 12–81 years-old (43.9% male) were included in the study. At one year, the cumulative complication incidence was 15.5% with a 10.3% incidence of surgical complications (3.7% wound, 1.2% robot-related, and 5.4% non-robot-related complications). At one year, the revision surgery incidence was 9.4%. There was no statistical difference between complications, readmission, or revision surgery after initial admission among the three robotic generations. The average intraoperative fluoroscopic duration was 53.8 seconds (11.9 seconds per screw and 17.6 seconds per instrumented level). Conclusion Robotic guidance in thoracolumbar instrumented fusions was associated with low complication, revision surgery, and readmission rates. Our results suggest robotic guidance can provide accurate guidance with minimal adverse events in thoracolumbar instrumentation.http://www.jmisst.org/upload/pdf/jmisst-2022-00479.pdfrobotic spine surgeryrobotic-guidanceminimally invasive surgeryminimally invasive spine surgerythoracolumbar fusioninstrumented lumbar fusion |
| spellingShingle | Alexandra E. Thomson Lindsay D. Orosz Colin M. Haines Ehsan Jazini Fenil R. Bhatt Julia N. Grigorian Andre D. Sabet Rita Roy Thomas C. Schuler Christopher R. Good A Multi-surgeon Robotic-guided Thoracolumbar Fusion Experience: Accuracy, Radiation, Complications, Readmissions, and Revisions of 3,874 Screws across Three Robotic Generations Journal of Minimally Invasive Spine Surgery and Technique robotic spine surgery robotic-guidance minimally invasive surgery minimally invasive spine surgery thoracolumbar fusion instrumented lumbar fusion |
| title | A Multi-surgeon Robotic-guided Thoracolumbar Fusion Experience: Accuracy, Radiation, Complications, Readmissions, and Revisions of 3,874 Screws across Three Robotic Generations |
| title_full | A Multi-surgeon Robotic-guided Thoracolumbar Fusion Experience: Accuracy, Radiation, Complications, Readmissions, and Revisions of 3,874 Screws across Three Robotic Generations |
| title_fullStr | A Multi-surgeon Robotic-guided Thoracolumbar Fusion Experience: Accuracy, Radiation, Complications, Readmissions, and Revisions of 3,874 Screws across Three Robotic Generations |
| title_full_unstemmed | A Multi-surgeon Robotic-guided Thoracolumbar Fusion Experience: Accuracy, Radiation, Complications, Readmissions, and Revisions of 3,874 Screws across Three Robotic Generations |
| title_short | A Multi-surgeon Robotic-guided Thoracolumbar Fusion Experience: Accuracy, Radiation, Complications, Readmissions, and Revisions of 3,874 Screws across Three Robotic Generations |
| title_sort | multi surgeon robotic guided thoracolumbar fusion experience accuracy radiation complications readmissions and revisions of 3 874 screws across three robotic generations |
| topic | robotic spine surgery robotic-guidance minimally invasive surgery minimally invasive spine surgery thoracolumbar fusion instrumented lumbar fusion |
| url | http://www.jmisst.org/upload/pdf/jmisst-2022-00479.pdf |
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