Robot-guided transforaminal versus robot-guided posterior lumbar interbody fusion for lumbar degenerative disease

Abstract

Objective: There have been no clinical studies comparing different robotic techniques. We compare minimally invasive, robot-guided transforaminal lumbar interbody fusion (RG-TLIF) and mini-open robot-guided posterior lumbar interbody fusion (RG-PLIF). Methods: Using data from a prospective institutional registry, we identified 38 patients who underwent RG-PLIF. Propensity score matching using a nearest-neighbor algorithm was implemented to select RG-TLIF controls. Twelve-month patient-reported outcome measures are presented. A reduction of ≥ 30% from baseline was defined as the minimum clinically important difference (MCID). Results: Among the 76 included patients, there was no difference between RG-TLIF and RG-PLIF in surgical time (132.3 ± 29.4 minutes vs. 156.5 ± 53.0 minutes, p = 0.162), length of stay (55.9 ± 20.0 hours vs. 57.2 ± 18.8 hours, p = 0.683), and radiation dose area product (310.6 ± 126.1 mGy × cm2 vs. 287.9 ± 90.3 mGy × cm2, p = 0.370). However, while there was no difference among the 2 groups in terms of raw postoperative patient-reported outcome measures scores (all p >0.05), MCID in leg pain was greater for RG-PLIF (55.3% vs. 78.9%, p = 0.028), and MCID in Oswestry Disability Index was greater for RG-TLIF (92.1% vs. 68.4%, p = 0.009). There was no difference concerning back pain (81.6% vs. 68.4%, p = 0.185). Conclusion: Our findings suggest that both RG-TLIF and RG-PLIF are viable and equally effective techniques in robotic spine surgery.