• Pratyush Shahi, Tejas Subramanian, Kasra Araghi, Sumedha Singh, Tomoyuki Asada, Omri Maayan, Maximilian Korsun, Nishtha Singh, Olivia Tuma, James Dowdell, Evan Sheha, Sheeraz Qureshi, and Sravisht Iyer.
• Hospital for Special Surgery, New York, NY.
• Spine. 2023 Oct 1; 48 (19): 134213471342-1347.

Study DesignRetrospective cohort.ObjectiveTo compare navigation and robotics in terms of clinical outcomes after minimally invasive transforaminal lumbar interbody fusion (MI-TLIF).Summary Of Background DataAlthough robotics has been shown to have advantages like reduced radiation exposure, greater screw size, and slightly better accuracy over navigation, none of the studies has compared these two modalities in terms of clinical outcomes.MethodsPatients who underwent single-level MI-TLIF using robotics or navigation and had a minimum of 1-year follow-up were included. The robotics and navigation groups were compared for improvement in patient-reported outcome measures (PROMs), minimal clinically important difference, patient-acceptable symptom state, response on the global rating change scale, and screw-related complication and reoperation rates.ResultsA total of 278 patients (143 robotics, 135 navigation) were included. There was no significant difference between the robotics and navigation groups in the baseline demographics, operative variables, and preoperative PROMs. Both groups showed significant improvement in PROMs at below six and six months or above, with no significant difference in the magnitude of improvement between the two groups. Most patients achieved minimal clinically important difference and patient-acceptable symptom state and reported feeling better on the global rating change scale, with no significant difference in the proportions between the robotics and navigation groups. The screw-related complication and reoperation rates also showed no significant difference between the two groups.ConclusionsRobotics did not seem to lead to significantly better clinical outcomes compared with navigation following MI-TLIF. Although the clinical outcomes may be similar, robotics offers the advantages of reduced radiation exposure, greater screw size, and slightly better accuracy over navigation. These advantages should be considered when determining the utility and cost-effectiveness of robotics in spine surgery. Larger multicenter prospective studies are required in the future to further investigate this subject.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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