• World Neurosurg · Aug 2021

    Comparative Study

    Robotic-Assisted vs. Conventional Posterior Lumbar Fusion - An Analysis of 90-day Complications & Readmissions.

    • Azeem Tariq Malik, Joseph P Drain, Jeremy Jones, Jonathan Karnes, James Brewster, Robert Ryu, Varun Singh, Jeffery Kim, Safdar N Khan, and Elizabeth Yu.
    • Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
    • World Neurosurg. 2021 Aug 1; 152: e168-e174.

    ObjectiveTo evaluate medical and surgical complication rates between robotic-assisted versus conventional elective posterior lumbar fusions.MethodsThe Symphony Integrated DataVerse was queried using International Classification of Diseases, 10th Edition, Clinical Modification procedure codes to identify patients undergoing elective posterior lumbar fusions for degenerative spine pathologies between 2015 and 2018. International Classification of Diseases, 10th Edition, Clinical Modification procedure codes (8E0W4CZ, 8E0W0CZ, 8E0W3CZ) were used to identify patients undergoing a robotic-assisted spinal fusion. Outcome measures were 90-day medical and surgical complications, 1-year pseudarthrosis, and 1-year revision surgery rates. Multivariate logistic regression analyses were used to assess whether undergoing a robotic-assisted fusion (vs. conventional fusion) was associated with differences in wound complications, medical complications, pseudarthrosis, revision surgery, and readmissions within 90 days of surgery.ResultsA total of 39,387 patients undergoing elective posterior lumbar fusions were included in the cohort-of whom 245 (0.62%) patients underwent a robotic-assisted fusion. Multivariate analysis showed that robotic-assisted fusion (vs. conventional fusion) was not associated with significant differences in 90-day rates of wound complications (P = 0.299), urinary tract infections (P = 0.648), acute myocardial infarctions (P = 0.209), acute renal failure (P = 0.461), pneumonia (P = 0.214), stroke (P = 0.917), deep venous thrombosis (P = 0.562), pulmonary embolism (P = 0.401), and readmissions (P = 0.985). In addition, there were no significant differences in the 1-year rates of revision fusions (P = 0.316) and pseudarthrosis (P = 0.695).ConclusionsPatients who underwent a robotic-assisted fusion had similar rates of surgical and medical complications compared with those who underwent a conventional fusion. Further studies are warranted to better understand the future role of robots in spine surgery.Copyright © 2021 Elsevier Inc. All rights reserved.

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