Robotic Systems in Spinal Surgery: A Review of Accuracy, Radiation Exposure, Hospital Readmission Rate, Cost, and Adverse Events
Nadia V Haik, Alison E. Burgess, Norris C Talbot, Patrick Luther, James P. Bridges, Michael Folse, Elizabeth Jee, Jamie Toms
Abstract
BACKGROUND: Recent advances within the last decade have allowed robotics to become commonplace in the operating room. In the field of neurosurgery, robotics assist surgeons in pedicle screw placement and vertebral fusion procedures. The purpose of this review is to look at currently used spinal robots available in the market and compare their overall accuracy, cost, radiation exposure, general adverse events, and hospital readmission rates. METHODS: The authors searched databases including PubMed and Google Scholar for studies on robotic spine surgery using robotic systems: Mazor X/Mazor Renaissance, Cirq, ExcelsiusGPS, and ROSA ONE Spine. The literature was examined for robot accuracy, hospital readmission rates, adverse events, radiation exposure, and cost of the robots. RESULTS: In general, many studies recognize that robot-assisted spinal surgery is of equal or greater accuracy compared to freehand surgical techniques. Limited and conflicting data exist regarding radiation exposure and overall adverse events. The upfront cost of robotic spine-based surgery tends to be more than freehand, but minimal data evaluate the cost-effectiveness among robotic systems. CONCLUSIONS: This review summarizes the findings comparing the individual robotic systems and their comparison to freehand surgery. As robotics become more popular in clinical practice, additional research is needed to assist hospitals and surgeons in making an informed decision about implementing robotics in spinal surgery.