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

Author:

Heard Jeremy C.1,Lee Yunsoo A.1,D’Antonio Nicholas D.1,Narayanan Rajkishen1,Lambrechts Mark J.1,Bodnar John1,Purtill Caroline1,Pezzulo Joshua D.1,Farronato Dominic1,Fitzgerald Pat1,Canseco Jose A.1,Kaye Ian David1,Hilibrand Alan S.1,Vaccaro Alexander R.1,Kepler Christopher K.1,Schroeder Gregory D.1

Affiliation:

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

Abstract

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.

Publisher

Medknow

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