Comparison between robot-assisted and navigation-guided minimally invasive transforaminal lumbar interbody fusion: a multicenter study

作者：Dennis Chen Heath, Hsuan-Kan Chang, Chih-Chang Chang, Hao-Chien Yang, Tsung-Hsi Tu, Bing-Hung Hsu, Ming‐Chin Lin, Jau‐Ching Wu, Chien‐Min Lin, Wen‐Cheng Huang, Heng-Wei Liu · 发表于：Neurosurgical FOCUS · 年份：2024 · DOI：10.3171/2024.9.focus24521 · 被引用次数：15 · 研究领域：Spinal Fractures and Fixation Techniques、Spine and Intervertebral Disc Pathology、Scoliosis diagnosis and treatment

OBJECTIVE: Both robot and computer navigation have significantly improved the accuracy and safety of percutaneous pedicle screw placement compared with a freehand fluoroscopy-guided technique. However, how the two new technologies compare with each other is unknown. The aim of this study was to investigate the accuracy and safety of robot-assisted and navigation-guided percutaneous pedicle screw placement in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). METHODS: A multicenter, retrospective study was conducted with patients who underwent 1- to 3-level MIS-TLIF from 2019 to 2022. The surgical indication was symptomatic spinal stenosis and spondylolisthesis that failed conservative management. Screw accuracy and safety were compared between robot and computer navigation systems by obtaining postoperative CT images in all patients. The screw accuracy was determined by the Gertzbein and Robbins classification. RESULTS: A total of 100 patients were divided into robot-assisted (RA; n = 42) and O-arm navigation (ON; n = 58) groups, with 514 percutaneous pedicle screws placed. Clinically satisfactory accuracy was achieved in 100% of the RA group and 92.1% of the ON group (p < 0.001). There were no medial breaches or revision surgeries for screw malposition in either group. The RA group showed similar overall operation time to the ON group (263.54 ± 114.33 vs 243.4 ± 68.96 minutes, p = 0.2821). Subgroup analyses showed that there was no difference in 1-level MI...