Learning Curve of ROSA ONE Spine System for Transpedicular Screw Placement

Bing-Hung Hsu; Heng-Wei Liu; Kha-Liang Lee; Ming-Chin Lin; Gao Chen; Jang Yu; Chiao-Ling Chen; I-Chang Su; Chien-Min Lin

doi:10.14245/ns.2143126.563

Learning Curve of ROSA ONE Spine System for Transpedicular Screw Placement

Neurospine. 2022 Jun;19(2):367-375. doi: 10.14245/ns.2143126.563. Epub 2022 May 12.

Authors

Bing-Hung Hsu^{1

2}, Heng-Wei Liu^{1

2

3}, Kha-Liang Lee^{1

2}, Ming-Chin Lin^{1

2

3

4

5}, Gao Chen^{1

2}, Jang Yu^{1

2}, Chiao-Ling Chen¹, I-Chang Su^{1

2

3}, Chien-Min Lin^{1

2

3}

Affiliations

¹ Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
² Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan.
³ Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
⁴ Medical Director of AI and Robotic Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
⁵ Graduate Institute of Biomedical Informatics, College of Medicine Science and Technology, Taipei Medical University, Taipei, Taiwan.

Abstract

Objective: The study investigated our institutional learning curve for the ROSA ONE spine system (ROSA) based on ROSA usage time.

Methods: ROSA was designed to provide high accuracy for spinal pedicle screw placement through a built-in tracking technique. This study was conducted from November 2018 to January 2021. The time taken to complete each step of the robotic workflow was recorded. Patient demographics, comorbidities, surgical indications, and number of screw placements were examined in subgroup analysis. The Curve Fitting-General package (a part of NCSS 2021 software) was used to fit a mathematical model to the learning curve. Patient demographics, imaging data, and surgical time were reviewed retrospectively.

Results: A total of 167 patients who had undergone surgery were included. The mean total ROSA usage time was 107.1 ± 27.3 minutes. The estimated learning rate was 90.4%, and the largest slope change occurred close to the time of the 20th surgery. The observed overall learning trend in the 4-screw group could be attributed to screw planning. The presence of scoliosis (p = 0.73) or spondylolisthesis (p = 0.70) did not significantly influence the mean total time (TT) for all patients; however, the mean TT differed significantly (p < 0.01) among subgroups stratified by body mass index, screw number placement, and thoracic spine involvement.

Conclusion: To the best of our knowledge, this is the first study to examine the learning curve for the various crucial steps of ROSA-guided pedicle screw placement. The indicative learning curve involved 20 patients who had undergone surgery.

Keywords: Learning curve; ROSA ONE spine system; Spinal fusion; Transpedicular screw.