Retrospective study assessing the learning curve and the accuracy of minimally invasive robot-assisted pedicle screw placement during the first 41 robot-assisted spinal fusion surgeries

Abstract

Aim: The purpose of this study was to assess the learning curve and the accuracy of robot-assisted pedicle screw placement in the first 41 cases. Methods: This retrospective study investigated the first 41 patients undergoing spinal fusion, whereby 250 pedicle screws were inserted with robotic assistance in a private hospital by a single surgeon. The pedicle screw accuracy was evaluated by computed tomography scan by an orthopedic surgeon according to the Gertzbein and Robbins classification. Planning time and screw placement time were noted. In addition, data about any screw malposition, a return to the operating theatre, and intraoperative repositioning were collected. The data were analyzed with Microsoft Excel. Results: The results show a high degree of accuracy (98%) of pedicle screw placement with a minimally invasive robot-assisted spinal fusion with no screw malposition requiring a return to the operating theatre. The learning curve improved with time, reaching a plateau at around 25 cases. Conclusion: This study shows a high degree of accuracy of pedicle screw placement with the robot and it shows a surgeon’s improved experience with the robot with time. Further comparative studies are needed to better assess the robot’s accuracy and its future in spine surgery.