Menu
Menu
19 Harley St, London, W1G 9QJ, UK

Minimally Invasive, Robotic-vs. Open Fluoroscopic-guided Spinal Instrumented Fusions-a Randomized, Controlled Trial.

Minimally Invasive, Robotic-vs. Open Fluoroscopic-guided Spinal Instrumented Fusions-a Randomized, Controlled Trial.

Spine (Phila Pa 1976). 2016 Jul 7;

Authors: Hyun SJ, Kim KJ, Jahng TA, Kim HJ

Abstract
STUDY DESIGN: A prospective randomized clinical trial.
OBJECTIVE: Compare the impact of robotic guidance in a minimally-invasive spine surgery (MIS) to a fluoroscopy-guided, open approach, in lumbar fusions.
SUMMARY OF BACKGROUND DATA: MIS requires a protracted learning curve and excessively exposes the patient and surgical team to harmful radiation. Robotic-guidance has been shown to improve accuracy and radiation in most studies, but there is conflicting prospective data.
METHODS: Patients indicated to undergo a 1 or 2 level spinal fusion were randomized between robotic-guided MIS (RO) and fluoroscopic-guided open surgery (FA). Patient demographics and outcomes were recorded.
RESULTS: Thirty patients were recruited to each arm. Average age was 66.7, 71.5% were females, average BMI was 25.2. Thirty-five levels were instrumented with 130 pedicle screws in RO vs. 40 levels with 140 screws in FA, or 4.3 and 4.7 screws per surgery, respectively. Use of fluoroscopy was 3.5 vs. 13.3?seconds in the RO and FA respectively (p?<?0.001). C-arm output in mSv was 0.13 vs. 0.27 in the RO and FA respectively (p?=?0.015). By thermo-luminescent dosimeters, the average per-screw radiation in the RO arm was 37.5% of that in the FA arm, demonstrating a mean reduction of 62.5% in use of radiation. There was no difference in the improvement in VAS scores for back and leg or the ODI. All screws were accurate in RO while 2 breached (>2?mm and >4?mm) in FA (p?=?0.500). One proximal facet violation occurred in the study, it was in FA (p?=?1.000). The average distance from the proximal facets was 5.8 vs. 4.6?mm in the RO and FA respectively (p?<?0.001). The average length of stay was 6.8 vs. 9.4 days in RO compared with FA (p?=?0.020).
CONCLUSION: MIS using Robotic-guidance significantly reduced radiation exposure and length of stay. Patient outcomes were not affected by the surgical technique.
LEVEL OF EVIDENCE: 1.

PMID: 27398897 [PubMed – as supplied by publisher]

Share to care...

Share on facebook
Facebook
Share on twitter
Twitter
Share on pinterest
Pinterest
Share on google
Google+
Share on linkedin
LinkedIn
Share on skype
Skype

What we do...

The Harley Street Hospital

Testimonials

What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

We treat all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

What our patients say about us ......