Cargando…

Clinical Outcomes of Robotic Versus Freehand Pedicle Screw Placement After One-to Three-Level Lumbar Fusion

STUDY DESIGN: Retrospective cohort study OBJECTIVES: The purpose of this study is to compare patient-reported outcome measures (PROMs) for patients undergoing one-to three-level lumbar fusion using robotically assisted vs freehand pedicle screw placement. METHODS: Patients who underwent either robot...

Descripción completa

Detalles Bibliográficos
Autores principales: Karamian, Brian A., DiMaria, Stephen L., Sawires, Andrew N., Canseco, Jose A., Basques, Bryce A., Toci, Gregory R., Radcliff, Kris E., Rihn, Jeffrey A., Kaye, I. David, Hilibrand, Alan S., Lee, Joseph K., Kepler, Christopher K., Vaccaro, Alexander R., Schroeder, Gregory D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10556914/
https://www.ncbi.nlm.nih.gov/pubmed/34873951
http://dx.doi.org/10.1177/21925682211057491
_version_ 1785116972629884928
author Karamian, Brian A.
DiMaria, Stephen L.
Sawires, Andrew N.
Canseco, Jose A.
Basques, Bryce A.
Toci, Gregory R.
Radcliff, Kris E.
Rihn, Jeffrey A.
Kaye, I. David
Hilibrand, Alan S.
Lee, Joseph K.
Kepler, Christopher K.
Vaccaro, Alexander R.
Schroeder, Gregory D.
author_facet Karamian, Brian A.
DiMaria, Stephen L.
Sawires, Andrew N.
Canseco, Jose A.
Basques, Bryce A.
Toci, Gregory R.
Radcliff, Kris E.
Rihn, Jeffrey A.
Kaye, I. David
Hilibrand, Alan S.
Lee, Joseph K.
Kepler, Christopher K.
Vaccaro, Alexander R.
Schroeder, Gregory D.
author_sort Karamian, Brian A.
collection PubMed
description STUDY DESIGN: Retrospective cohort study OBJECTIVES: The purpose of this study is to compare patient-reported outcome measures (PROMs) for patients undergoing one-to three-level lumbar fusion using robotically assisted vs freehand pedicle screw placement. METHODS: Patients who underwent either robotically assisted or freehand pedicle screw placement for one-to three-level lumbar fusion surgery from January 1, 2014 to August 31, 2020 at a single academic institution were identified. Propensity score matching was performed based on demographic variables. Clinical and surgical outcomes were compared between groups. Recovery Ratios (RR) and the proportion of patients achieving the minimally clinically important difference (%MCID) were calculated for Oswestry Disability Index, PCS-12, MCS-12, VAS Back, and VAS Leg at 1 year. Surgical outcomes included complication and revision rates. RESULTS: A total of 262 patients were included in the study (85 robotic and 177 freehand). No significant differences were found in ΔPROM scores, RR, or MCID between patients who underwent robotically assisted vs freehand screw placement. The rates of revision (1.70% freehand vs 1.18% robotic, P = 1.000) and complications (.57% freehand vs 1.18% robotic, P = .546) were not found to be statically different between the 2 groups. Controlling for demographic factors, procedure type (robotic vs freehand) did not emerge as a significant predictor of ΔPROM scores on multivariate linear regression analysis. CONCLUSIONS: Robotically assisted pedicle screw placement did not result in significantly improved clinical or surgical outcomes compared to conventional freehand screw placement for patients undergoing one-to three-level lumbar fusion.
format Online
Article
Text
id pubmed-10556914
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-105569142023-10-07 Clinical Outcomes of Robotic Versus Freehand Pedicle Screw Placement After One-to Three-Level Lumbar Fusion Karamian, Brian A. DiMaria, Stephen L. Sawires, Andrew N. Canseco, Jose A. Basques, Bryce A. Toci, Gregory R. Radcliff, Kris E. Rihn, Jeffrey A. Kaye, I. David Hilibrand, Alan S. Lee, Joseph K. Kepler, Christopher K. Vaccaro, Alexander R. Schroeder, Gregory D. Global Spine J Original Articles STUDY DESIGN: Retrospective cohort study OBJECTIVES: The purpose of this study is to compare patient-reported outcome measures (PROMs) for patients undergoing one-to three-level lumbar fusion using robotically assisted vs freehand pedicle screw placement. METHODS: Patients who underwent either robotically assisted or freehand pedicle screw placement for one-to three-level lumbar fusion surgery from January 1, 2014 to August 31, 2020 at a single academic institution were identified. Propensity score matching was performed based on demographic variables. Clinical and surgical outcomes were compared between groups. Recovery Ratios (RR) and the proportion of patients achieving the minimally clinically important difference (%MCID) were calculated for Oswestry Disability Index, PCS-12, MCS-12, VAS Back, and VAS Leg at 1 year. Surgical outcomes included complication and revision rates. RESULTS: A total of 262 patients were included in the study (85 robotic and 177 freehand). No significant differences were found in ΔPROM scores, RR, or MCID between patients who underwent robotically assisted vs freehand screw placement. The rates of revision (1.70% freehand vs 1.18% robotic, P = 1.000) and complications (.57% freehand vs 1.18% robotic, P = .546) were not found to be statically different between the 2 groups. Controlling for demographic factors, procedure type (robotic vs freehand) did not emerge as a significant predictor of ΔPROM scores on multivariate linear regression analysis. CONCLUSIONS: Robotically assisted pedicle screw placement did not result in significantly improved clinical or surgical outcomes compared to conventional freehand screw placement for patients undergoing one-to three-level lumbar fusion. SAGE Publications 2021-12-07 2023-09 /pmc/articles/PMC10556914/ /pubmed/34873951 http://dx.doi.org/10.1177/21925682211057491 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Karamian, Brian A.
DiMaria, Stephen L.
Sawires, Andrew N.
Canseco, Jose A.
Basques, Bryce A.
Toci, Gregory R.
Radcliff, Kris E.
Rihn, Jeffrey A.
Kaye, I. David
Hilibrand, Alan S.
Lee, Joseph K.
Kepler, Christopher K.
Vaccaro, Alexander R.
Schroeder, Gregory D.
Clinical Outcomes of Robotic Versus Freehand Pedicle Screw Placement After One-to Three-Level Lumbar Fusion
title Clinical Outcomes of Robotic Versus Freehand Pedicle Screw Placement After One-to Three-Level Lumbar Fusion
title_full Clinical Outcomes of Robotic Versus Freehand Pedicle Screw Placement After One-to Three-Level Lumbar Fusion
title_fullStr Clinical Outcomes of Robotic Versus Freehand Pedicle Screw Placement After One-to Three-Level Lumbar Fusion
title_full_unstemmed Clinical Outcomes of Robotic Versus Freehand Pedicle Screw Placement After One-to Three-Level Lumbar Fusion
title_short Clinical Outcomes of Robotic Versus Freehand Pedicle Screw Placement After One-to Three-Level Lumbar Fusion
title_sort clinical outcomes of robotic versus freehand pedicle screw placement after one-to three-level lumbar fusion
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10556914/
https://www.ncbi.nlm.nih.gov/pubmed/34873951
http://dx.doi.org/10.1177/21925682211057491
work_keys_str_mv AT karamianbriana clinicaloutcomesofroboticversusfreehandpediclescrewplacementafteronetothreelevellumbarfusion
AT dimariastephenl clinicaloutcomesofroboticversusfreehandpediclescrewplacementafteronetothreelevellumbarfusion
AT sawiresandrewn clinicaloutcomesofroboticversusfreehandpediclescrewplacementafteronetothreelevellumbarfusion
AT cansecojosea clinicaloutcomesofroboticversusfreehandpediclescrewplacementafteronetothreelevellumbarfusion
AT basquesbrycea clinicaloutcomesofroboticversusfreehandpediclescrewplacementafteronetothreelevellumbarfusion
AT tocigregoryr clinicaloutcomesofroboticversusfreehandpediclescrewplacementafteronetothreelevellumbarfusion
AT radcliffkrise clinicaloutcomesofroboticversusfreehandpediclescrewplacementafteronetothreelevellumbarfusion
AT rihnjeffreya clinicaloutcomesofroboticversusfreehandpediclescrewplacementafteronetothreelevellumbarfusion
AT kayeidavid clinicaloutcomesofroboticversusfreehandpediclescrewplacementafteronetothreelevellumbarfusion
AT hilibrandalans clinicaloutcomesofroboticversusfreehandpediclescrewplacementafteronetothreelevellumbarfusion
AT leejosephk clinicaloutcomesofroboticversusfreehandpediclescrewplacementafteronetothreelevellumbarfusion
AT keplerchristopherk clinicaloutcomesofroboticversusfreehandpediclescrewplacementafteronetothreelevellumbarfusion
AT vaccaroalexanderr clinicaloutcomesofroboticversusfreehandpediclescrewplacementafteronetothreelevellumbarfusion
AT schroedergregoryd clinicaloutcomesofroboticversusfreehandpediclescrewplacementafteronetothreelevellumbarfusion