The impact of robotic assistance for lumbar fusion surgery on 90-day surgical outcomes and 1-year revisions

Jeremy C Heard; Yunsoo A Lee; Nicholas D D'Antonio; Rajkishen Narayanan; Mark J Lambrechts; John Bodnar; Caroline Purtill; Joshua D Pezzulo; Dominic Farronato; Pat Fitzgerald; Jose A Canseco; Ian David Kaye; Alan S Hilibrand; Alexander R Vaccaro; Christopher K Kepler; Gregory D Schroeder

doi:10.4103/jcvjs.jcvjs_145_23

The impact of robotic assistance for lumbar fusion surgery on 90-day surgical outcomes and 1-year revisions

J Craniovertebr Junction Spine. 2024 Jan-Mar;15(1):15-20. doi: 10.4103/jcvjs.jcvjs_145_23. Epub 2024 Mar 13.

Authors

Jeremy C Heard¹, Yunsoo A Lee¹, Nicholas D D'Antonio¹, Rajkishen Narayanan¹, Mark J Lambrechts¹, John Bodnar¹, Caroline Purtill¹, Joshua D Pezzulo¹, Dominic Farronato¹, Pat Fitzgerald¹, Jose A Canseco¹, Ian David Kaye¹, Alan S Hilibrand¹, Alexander R Vaccaro¹, Christopher K Kepler¹, Gregory D Schroeder¹

Affiliation

¹ Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA.

Abstract

Objectives: To evaluate the (1) 90-day surgical outcomes and (2) 1-year revision rate of robotic versus nonrobotic lumbar fusion surgery.

Methods: Patients >18 years of age who underwent primary lumbar fusion surgery at our institution were identified and propensity-matched in a 1:1 fashion based on robotic assistance during surgery. Patient demographics, surgical characteristics, and surgical outcomes, including 90-day surgical complications and 1-year revisions, were collected. Multivariable regression analysis was performed. Significance was set to P < 0.05.

Results: Four hundred and fifteen patients were identified as having robotic lumbar fusion and were matched to a control group. Bivariant analysis revealed no significant difference in total 90-day surgical complications (P = 0.193) or 1-year revisions (P = 0.178). The operative duration was longer in robotic surgery (287 + 123 vs. 205 + 88.3, P ≤ 0.001). Multivariable analysis revealed that robotic fusion was not a significant predictor of 90-day surgical complications (odds ratio [OR] = 0.76 [0.32-1.67], P = 0.499) or 1-year revisions (OR = 0.58 [0.28-1.18], P = 0.142). Other variables identified as the positive predictors of 1-year revisions included levels fused (OR = 1.26 [1.08-1.48], P = 0.004) and current smokers (OR = 3.51 [1.46-8.15], P = 0.004).

Conclusion: Our study suggests that robotic-assisted and nonrobotic-assisted lumbar fusions are associated with a similar risk of 90-day surgical complications and 1-year revision rates; however, robotic surgery does increase time under anesthesia.

Keywords: Complications; lumbar vertebrae; outcomes; robot-assisted surgery; robotic surgery.