Robotic-assisted Spine Surgery: A Review of its Development, Outcomes, and Economics on Practice

Abstract

Purpose: Improper pedicle screw placement can lead to increased complications and the need for revision surgery. The purpose of this article is to review the history of robotic assistance in spine surgery, along with the current data on its clinical outcomes, potential advantages, and economics on practice. Methods: Review of the literature. Results: A review of the current literature demonstrated that intrapedicular accuracy has shown to be either superior or equivalent to a free-hand technique. Radiation exposure with robotic assistance is generally similar to free-hand, with a trend toward a lesser exposure following increased experience. Operative times, outcomes, and complication rates have been variable between prospective and retrospective studies, with mostly equivalent results when compared with free-hand screw placement. Conclusions: Higher-level studies (level I and II) have demonstrated similar clinical outcomes and pedicle screw accuracy when compared with the free-hand technique. As with most new technology, a learning curve is apparent, with the potential for a decrease in radiation exposure and economic benefit over time.