Objective:

To evaluate medical and surgical complication rates between robotic-assisted vs. conventional elective posterior lumbar fusions.

Methods:

The Symphony Integrated DataVerse was queried using International Classification of Diseases 10^th Edition (ICD-10) procedure codes to identify patients undergoing elective posterior lumbar fusions for degenerative spine pathologies between 2015 and 2018. ICD-10 procedure codes (8E0W4CZ, 8E0W0CZ, 8E0W3CZ) were used to identify patients undergoing a robotic-assisted spinal fusion. Outcome measures were 90-day medical and surgical complications, 1-year pseudarthrosis and 1-year revision surgery rates. Multivariate logistic regression analyses were used to assess whether undergoing a robotic-assisted fusion (vs. conventional fusion) was associated with differences in wound complications, medical complications, pseudarthrosis, revision surgery and readmissions within 90 days of surgery.

Results:

A total of 39,387 patients undergoing elective posterior lumbar fusions were included in the cohort – out of which 245 (0.62%) patients underwent a robotic-assisted fusion. Multivariate analysis showed that robotic-assisted fusion (vs. conventional fusion) was not associated with significant differences in 90-day rates of wound complications (p=0.299), urinary tract infections (p=0.648), acute myocardial infarctions (p=0.209), acute renal failure (p=0.461), pneumonia (p=0.214), stroke (p=0.917), deep venous thrombosis (p=0.562), pulmonary embolism (p=0.401) and readmissions (p=0.985). In addition, there were no significant differences in the 1-year rates of revision fusions (p=0.316) and pseudarthrosis (p=0.695).

Conclusions:

Patients who underwent a robotic-assisted fusion had similar rates of surgical and medical complications, as compared to those who underwent a conventional fusion. Further studies are warranted to better understand the future role of robots in spine surgery.