Purpose:

There have been no clinical studies comparing different robotic techniques. We compare minimally invasive, robot-guided transforaminal lumbar interbody fusion (RG-TLIF) and mini-open robot-guided posterior lumbar interbody fusion (RG-PLIF).

Methods:

Using data from a prospective institutional registry, we identified 38 patients who underwent RG-PLIF. Propensity score matching using a nearest-neighbor algorithm was implemented to select RG-TLIF controls. Twelve-month PROMs are presented. A reduction of ≥30% from baseline was defined as the minimum clinically important difference (MCID).

Results:

Among the 76 included patients, there was no difference between RG-TLIF and RG-PLIF in surgical time (132.3 ± 29.4 min vs. 156.5 ± 53.0 min, p = 0.162), length of stay (55.9 ± 20.0 hrs vs. 57.2 ± 18.8 hrs, p = 0.683), and radiation dose area product (310.6 ± 126.1 mGy x cm2 vs. 287.9 ± 90.3 mGy x cm2, p = 0.370). However, while there was no difference among the two groups in terms of raw postoperative PROM scores (all p > 0.05), MCID in leg pain was greater for RG-PLIF (55.3% vs. 78.9%, p = 0.028), and MCID in Oswestry Disability Index was greater for RG-TLIF (92.1% vs. 68.4%, p = 0009). There was no difference concerning back pain (81.6% vs. 68.4%, p = 0.185).

Conclusion:

Our findings suggest that both RG-TLIF and RG-PLIF are viable and equally effective techniques in robotic spine surgery.