Do robot-related complications influence 1 year reoperations and other clinical outcomes after robot-assisted lumbar arthrodesis? A multicenter assessment of 320 patients

Journal of Orthopaedic Surgery and Research

John Pollina¹  Avery L. Buchholz²  Justin Mathew³  Ian A. Buchanan³  Eric Leung³  Ronald A. Lehman³  Nathan J. Lee³  Venkat Boddapati³  Joseph M. Lombardi³  Paul J. Park³  Gerard Marciano³  Ehsan Jazini⁴  Christopher R. Good⁴  Colin Haines⁴  Thomas C. Schuler⁴ 

[1] Department of Neurosurgery, State University of New York, Buffalo, NY, USA;Department of Neurosurgery, University of Virginia Health System, Charlottesville, VA, USA;Department of Orthopaedics, Columbia University Medical Center, The Och Spine Hospital at New York-Presbyterian, 161 Fort Washington Avenue, 10032, New York, NY, USA;Department of Orthopaedics, Virginia Spine Institute, Reston, VA, USA;

关键词: Robot-assisted spine surgery;    Lumbar fusion;    Mazor X;    Complications;    Reoperations;   

DOI  :  10.1186/s13018-021-02452-z

来源: Springer

【 摘 要 】

BackgroundRobot-assisted platforms in spine surgery have rapidly developed into an attractive technology for both the surgeon and patient. Although current literature is promising, more clinical data is needed. The purpose of this paper is to determine the effect of robot-related complications on clinical outcomesMethodsThis multicenter study included adult (≥18 years old) patients who underwent robot-assisted lumbar fusion surgery from 2012-2019. The minimum follow-up was 1 year after surgery. Both bivariate and multivariate analyses were performed to determine if robot-related factors were associated with reoperation within 1 year after primary surgery.ResultsA total of 320 patients were included in this study. The mean (standard deviation) Charlson Comorbidity Index was 1.2 (1.2) and 52.5% of patients were female. Intraoperative robot complications occurred in 3.4% of patients and included intraoperative exchange of screw (0.9%), robot abandonment (2.5%), and return to the operating room for screw exchange (1.3%). The 1-year reoperation rate was 4.4%. Robot factors, including robot time per screw, open vs. percutaneous, and robot system, were not statistically different between those who required revision surgery and those who did not (P>0.05). Patients with robot complications were more likely to have prolonged length of hospital stay and blood transfusion, but were not at higher risk for 1-year reoperations. The most common reasons for reoperation were wound complications (2.2%) and persistent symptoms due to inadequate decompression (1.5%). In the multivariate analysis, robot related factors and complications were not independent risk factors for 1-year reoperations.ConclusionThis is the largest multicenter study to focus on robot-assisted lumbar fusion outcomes. Our findings demonstrate that 1-year reoperation rates are low and do not appear to be influenced by robot-related factors and complications; however, robot-related complications may increase the risk for greater blood loss requiring a blood transfusion and longer length of stay.

【 授权许可】

CC BY