Comparison between robot-assisted and navigation-guided minimally invasive transforaminal lumbar interbody fusion: a multicenter study.

Autor:	Heath DC; 1Department of Neurosurgery, Shuang-Ho Hospital, Taipei Medical University, New Taipei City.; 2Taipei Neuroscience Institute, Taipei Medical University, Taipei., Chang HK; 3College of Medicine, National Yang Ming Chiao Tung University, Taipei.; 5Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei., Chang CC; 3College of Medicine, National Yang Ming Chiao Tung University, Taipei.; 4Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei., Yang HC; 1Department of Neurosurgery, Shuang-Ho Hospital, Taipei Medical University, New Taipei City.; 2Taipei Neuroscience Institute, Taipei Medical University, Taipei., Tu TH; 3College of Medicine, National Yang Ming Chiao Tung University, Taipei.; 4Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei., Hsu BH; 1Department of Neurosurgery, Shuang-Ho Hospital, Taipei Medical University, New Taipei City.; 2Taipei Neuroscience Institute, Taipei Medical University, Taipei., Lin MC; 2Taipei Neuroscience Institute, Taipei Medical University, Taipei.; 6Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei.; 8Graduate Institute of Biomedical Informatics, College of Medicine Science and Technology, Taipei Medical University, Taipei; and., Wu JC; 3College of Medicine, National Yang Ming Chiao Tung University, Taipei.; 4Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei.; 9Institute of Pharmacology, National Yang Ming Chiao Tung University, Taipei, Taiwan., Lin CM; 1Department of Neurosurgery, Shuang-Ho Hospital, Taipei Medical University, New Taipei City.; 2Taipei Neuroscience Institute, Taipei Medical University, Taipei.; 6Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei., Huang WC; 3College of Medicine, National Yang Ming Chiao Tung University, Taipei.; 4Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei., Liu HW; 1Department of Neurosurgery, Shuang-Ho Hospital, Taipei Medical University, New Taipei City.; 2Taipei Neuroscience Institute, Taipei Medical University, Taipei.; 6Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei.
Jazyk:	angličtina
Zdroj:	Neurosurgical focus [Neurosurg Focus] 2024 Dec 01; Vol. 57 (6), pp. E12.
DOI:	10.3171/2024.9.FOCUS24521
Abstrakt:	Objective: Both robot and computer navigation have significantly improved the accuracy and safety of percutaneous pedicle screw placement compared with a freehand fluoroscopy-guided technique. However, how the two new technologies compare with each other is unknown. The aim of this study was to investigate the accuracy and safety of robot-assisted and navigation-guided percutaneous pedicle screw placement in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Methods: A multicenter, retrospective study was conducted with patients who underwent 1- to 3-level MIS-TLIF from 2019 to 2022. The surgical indication was symptomatic spinal stenosis and spondylolisthesis that failed conservative management. Screw accuracy and safety were compared between robot and computer navigation systems by obtaining postoperative CT images in all patients. The screw accuracy was determined by the Gertzbein and Robbins classification. Results: A total of 100 patients were divided into robot-assisted (RA; n = 42) and O-arm navigation (ON; n = 58) groups, with 514 percutaneous pedicle screws placed. Clinically satisfactory accuracy was achieved in 100% of the RA group and 92.1% of the ON group (p < 0.001). There were no medial breaches or revision surgeries for screw malposition in either group. The RA group showed similar overall operation time to the ON group (263.54 ± 114.33 vs 243.4 ± 68.96 minutes, p = 0.2821). Subgroup analyses showed that there was no difference in 1-level MIS-TLIF, but the RA group had significantly more operative time for 2-level MIS-TLIF than the ON group (324.67 ± 101.25 vs 266.4 ± 66.38 minutes, p = 0.0264). Conclusions: Screw accuracy was significantly better in the RA group, with slightly more operation time, compared with the navigation group. Neither group required revision surgery or reoperation for screw malposition.
Databáze:	MEDLINE
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