Comparing short term clinical outcomes of elective robot-assisted vs. non-robot assisted posterior lumbar interbody fusions: a NSQIP analysis.

BACKGROUND

Symptomatic lumbar degenerative changes impact millions of patients per year. Recent technological advances have increased the usability of robot-assisted spinal fusions to treat this pathology. Although the safety profile of robotic systems appears favorable, the impact of robotics on surgical outcomes and efficiency remains unclear.

METHODS

The American College of Surgeons National Surgical Quality Improvement Project (NSQIP) database was queried for cases of elective posterior lumbar interbody fusions in adult patients with data available regarding the use of robotics. Univariate and multivariate analyses were performed. The purpose of this study is to compare rates of 30-day unplanned readmissions, unplanned reoperation (return to operating room [RTOR]), postoperative complications, non-home discharges, operative time, blood transfusions and length of stay (LOS) in adult elective robot-assisted (robot-assisted posterior lumbar interbody fusion [rPLIF] / transforaminal lumbar interbody fusion [TLIF]) vs. non-robotic PLIF/TLIF (nPLIF/TLIF).

RESULTS

There was no statistically significant difference in rates of 30-day readmissions (6.0% vs. 4.4%, P=0.48), RTOR (4.0% vs. 3.0%, P=0.66), postoperative complications (10.0% vs. 11.2%, P=0.51) nor need for blood transfusion (6.0% vs. 6.5%, P=0.59) between rPLIF/TLIF and nPLIF/TLIF cohorts, respectively. There were no differences in LOS or operative time between groups (LOS: rPLIF/TLIF = 3.5±3.3 days, nPLIF/TLIF = 3.6±2.8 days, P=0.29; operative time: rPLIF/TLIF = 208.7±101.1 minutes, nPLIF/TLIF = 225.1±100.4 minutes, P=0.087).

CONCLUSIONS

rPLIF/TLIF and nPLIF/TLIF 30-day readmissions, RTOR, non-home discharges, need for blood transfusion, LOS and operative times are similar within these data, though results should be interpreted with caution given study limitations. Ongoing data on surgical outcomes of robot-assisted lumbar fusions are needed.