Robotics Reduces Radiation Exposure in Minimally Invasive Lumbar Fusion Compared With Navigation

作者：Pratyush Shahi, Avani Sudhir Vaishnav, Kasra Araghi, Daniel J. Shinn, Junho Song, Sidhant S. Dalal, Dimitra Melissaridou, Eric Mai, Marcel M. Dupont, Evan D. Sheha, James E. Dowdell, Sravisht Iyer, Sheeraz A. Qureshi · 发表于：Spine · 年份：2022 · DOI：10.1097/brs.0000000000004381 · 被引用次数：63 · 研究领域：Spinal Fractures and Fixation Techniques、Radiation Dose and Imaging、Management of metastatic bone disease

STUDY DESIGN: Retrospective cohort. OBJECTIVE: To compare robotics and navigation for minimally invasive elective lumbar fusion in terms of radiation exposure and time demand. SUMMARY OF BACKGROUND DATA: Although various studies have been conducted to demonstrate the benefits of both navigation and robotics over fluoroscopy in terms of radiation exposure, literature is lacking in studies comparing robotics versus navigation. MATERIALS AND METHODS: Patients who underwent elective one-level or two-level minimally invasive transforaminal lumbar interbody fusion (TLIF) by a single surgeon using navigation (Stryker SpineMask) or robotics (ExcelsiusGPS) were included (navigation 2017-2019, robotics 2019-2021, resulting in prospective cohorts of consecutive patients for each modality). All surgeries had the intraoperative computed tomography workflow. The two cohorts were compared for radiation exposure [fluoroscopy time and radiation dose: image capture, surgical procedure, and overall) and time demand (time for setup and image capture, operative time, and total operating room (OR) time]. RESULTS: A total of 244 patients (robotics 111, navigation 133) were included. The two cohorts were similar in terms of baseline demographics, primary/revision surgeries, and fusion levels. For one-level TLIF, total fluoroscopy time, total radiation dose, and % of radiation for surgical procedure were significantly less with robotics compared with navigation (20 vs. 25 s, P <0.001; 38 vs. 42 mGy, ...