Joseph Jon Yin Wan, Jonathan Yeo, Zhihong Chew, Shree Kumar Dinesh
{"title":"论文题目：导航机器人辅助平台与o型臂导航在微创椎间孔椎间融合术（MIS-TLIF）中的成本-效果比较分析。","authors":"Joseph Jon Yin Wan, Jonathan Yeo, Zhihong Chew, Shree Kumar Dinesh","doi":"10.1016/j.spinee.2025.05.027","DOIUrl":null,"url":null,"abstract":"<p><strong>Background context: </strong>Minimal invasive Transforaminal Lumbar Interbody Fusion (TLIF) is an increasingly common procedure used in treating degenerative lumbar spine conditions. Advancement of robot-assisted technology has improved accuracy of instrumentation with smaller incisions, resulting in better surgical outcomes and shorter hospital stay.</p><p><strong>Purpose: </strong>This study aims to assess cost effectiveness of robot-assisted minimally invasive TLIF (RA-TLIF) in our institution; and compare patient outcomes with conventional O-arm navigated minimally invasive TLIF (ON-TLIF).</p><p><strong>Design: </strong>Single-center, retrospective case cohort series between elective RA-TLIF and ON-TLIF groups.</p><p><strong>Patient sample: </strong>About 27 patients who underwent elective RA-TLIF and control group of 50 elective ON-TLIF.</p><p><strong>Outcome measures: </strong>Operative duration, length of inpatient stay, postoperative ambulation, rates of intraoperative and postoperative complications and inpatient costs.</p><p><strong>Methods: </strong>Patient demographics (age, gender, Charlson Co-morbidity Index (CCI), BMI), postoperative outcomes and inpatient costs were used in comparative analysis.</p><p><strong>Results: </strong>No significant differences were found in patient demographics, baseline CCI, operative duration, length of inpatient stay, and postoperative ambulation. Rates of intraoperative and postoperative complications were similar between the 2 groups (OR=0.93, p=.112). Inpatient hospitalization costs were not significantly different between both groups.</p><p><strong>Conclusion: </strong>RA-TLIF has shown similar cost-effectiveness and surgical outcomes in comparison with conventional ON-TLIF. While not demonstrated in this study, RA-TLIF has been associated with a longer operative duration due to higher learning curve, set-up time and possible hardware/ software errors. Ultimately, more case numbers are required for the operating staff to overcome this learning curve to achieve optimal results. Spine surgical centers evaluating both techniques may consider either with confidence.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9000,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparative cost-effectiveness analysis between navigated robot-assisted platforms and O-arm navigation in minimally invasive transforaminal interbody fusion (MIS-TLIF).\",\"authors\":\"Joseph Jon Yin Wan, Jonathan Yeo, Zhihong Chew, Shree Kumar Dinesh\",\"doi\":\"10.1016/j.spinee.2025.05.027\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background context: </strong>Minimal invasive Transforaminal Lumbar Interbody Fusion (TLIF) is an increasingly common procedure used in treating degenerative lumbar spine conditions. Advancement of robot-assisted technology has improved accuracy of instrumentation with smaller incisions, resulting in better surgical outcomes and shorter hospital stay.</p><p><strong>Purpose: </strong>This study aims to assess cost effectiveness of robot-assisted minimally invasive TLIF (RA-TLIF) in our institution; and compare patient outcomes with conventional O-arm navigated minimally invasive TLIF (ON-TLIF).</p><p><strong>Design: </strong>Single-center, retrospective case cohort series between elective RA-TLIF and ON-TLIF groups.</p><p><strong>Patient sample: </strong>About 27 patients who underwent elective RA-TLIF and control group of 50 elective ON-TLIF.</p><p><strong>Outcome measures: </strong>Operative duration, length of inpatient stay, postoperative ambulation, rates of intraoperative and postoperative complications and inpatient costs.</p><p><strong>Methods: </strong>Patient demographics (age, gender, Charlson Co-morbidity Index (CCI), BMI), postoperative outcomes and inpatient costs were used in comparative analysis.</p><p><strong>Results: </strong>No significant differences were found in patient demographics, baseline CCI, operative duration, length of inpatient stay, and postoperative ambulation. Rates of intraoperative and postoperative complications were similar between the 2 groups (OR=0.93, p=.112). Inpatient hospitalization costs were not significantly different between both groups.</p><p><strong>Conclusion: </strong>RA-TLIF has shown similar cost-effectiveness and surgical outcomes in comparison with conventional ON-TLIF. While not demonstrated in this study, RA-TLIF has been associated with a longer operative duration due to higher learning curve, set-up time and possible hardware/ software errors. Ultimately, more case numbers are required for the operating staff to overcome this learning curve to achieve optimal results. Spine surgical centers evaluating both techniques may consider either with confidence.</p>\",\"PeriodicalId\":49484,\"journal\":{\"name\":\"Spine Journal\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.9000,\"publicationDate\":\"2025-05-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Spine Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.spinee.2025.05.027\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.spinee.2025.05.027","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Comparative cost-effectiveness analysis between navigated robot-assisted platforms and O-arm navigation in minimally invasive transforaminal interbody fusion (MIS-TLIF).
Background context: Minimal invasive Transforaminal Lumbar Interbody Fusion (TLIF) is an increasingly common procedure used in treating degenerative lumbar spine conditions. Advancement of robot-assisted technology has improved accuracy of instrumentation with smaller incisions, resulting in better surgical outcomes and shorter hospital stay.
Purpose: This study aims to assess cost effectiveness of robot-assisted minimally invasive TLIF (RA-TLIF) in our institution; and compare patient outcomes with conventional O-arm navigated minimally invasive TLIF (ON-TLIF).
Design: Single-center, retrospective case cohort series between elective RA-TLIF and ON-TLIF groups.
Patient sample: About 27 patients who underwent elective RA-TLIF and control group of 50 elective ON-TLIF.
Outcome measures: Operative duration, length of inpatient stay, postoperative ambulation, rates of intraoperative and postoperative complications and inpatient costs.
Methods: Patient demographics (age, gender, Charlson Co-morbidity Index (CCI), BMI), postoperative outcomes and inpatient costs were used in comparative analysis.
Results: No significant differences were found in patient demographics, baseline CCI, operative duration, length of inpatient stay, and postoperative ambulation. Rates of intraoperative and postoperative complications were similar between the 2 groups (OR=0.93, p=.112). Inpatient hospitalization costs were not significantly different between both groups.
Conclusion: RA-TLIF has shown similar cost-effectiveness and surgical outcomes in comparison with conventional ON-TLIF. While not demonstrated in this study, RA-TLIF has been associated with a longer operative duration due to higher learning curve, set-up time and possible hardware/ software errors. Ultimately, more case numbers are required for the operating staff to overcome this learning curve to achieve optimal results. Spine surgical centers evaluating both techniques may consider either with confidence.
期刊介绍：
The Spine Journal, the official journal of the North American Spine Society, is an international and multidisciplinary journal that publishes original, peer-reviewed articles on research and treatment related to the spine and spine care, including basic science and clinical investigations. It is a condition of publication that manuscripts submitted to The Spine Journal have not been published, and will not be simultaneously submitted or published elsewhere. The Spine Journal also publishes major reviews of specific topics by acknowledged authorities, technical notes, teaching editorials, and other special features, Letters to the Editor-in-Chief are encouraged.
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