David Maman, Amir Abu Elhija, Assil Mahamid, Lior Laver, Eyal Behrbalk
{"title":"腰椎融合手术的并发症、费用、死亡率和住院时间的比较分析:机器人辅助与导航引导入路。","authors":"David Maman, Amir Abu Elhija, Assil Mahamid, Lior Laver, Eyal Behrbalk","doi":"10.1007/s00586-025-09060-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Navigation and robotic technologies emerge as alternatives to conventional freehand techniques for spine fusion. They aim to enhance perioperative and postoperative outcomes, yet their effectiveness remains limited by small cohort sizes in existing literature. Our study compares navigation and robotic technologies in lumbar fusion surgery across complications, costs, and mortality.</p><p><strong>Methods: </strong>This study employed data from the Nationwide Inpatient Sample. The NIS annually captures approximately 7 million unweighted admissions. The dataset spanned 2016 to 2019, comprising 58,270 patients. Exclusions included non-elective admissions, pre-admission surgeries, and cases reporting $0 hospital costs. Validation of comorbidities and complications was conducted using ICD-10 codes. Analytical techniques, such as trend identification and statistical analyses, were applied with a significance threshold of p < 0.05. Demographic and clinical characteristics, surgery types, and outcomes were assessed.</p><p><strong>Results: </strong>Navigation-guided surgeries dominated (86.7% in 2016, 77.1% in 2019), while Robotic-assisted surgeries increased steadily. Both showed minimal mortality rates. Navigation-guided surgeries had lower charges, lower risks of blood loss anemia, acute kidney injury, and blood transfusion compared to Robotic-assisted surgeries. Navigation-guided surgeries showed significantly lower risks of complications in one level lumbar fusion of vertebral joint and fusion of lumbosacral joint compared to Robotic-Assisted procedures. Additionally, Robotic-Assisted surgeries present higher risks across blood loss anemia, acute kidney injury, and blood transfusion, with risk ratios ranging from 1.24 to 1.72 times higher.</p><p><strong>Conclusion: </strong>This study highlights shifting trends in lumbar fusion surgeries, underscoring the need for tailored approaches and nuanced clinical considerations to improve patient outcomes.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparative analysis of complications, costs, mortality, and length of stay in lumbar fusion surgery: robotic-assisted versus navigation-guided approaches.\",\"authors\":\"David Maman, Amir Abu Elhija, Assil Mahamid, Lior Laver, Eyal Behrbalk\",\"doi\":\"10.1007/s00586-025-09060-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Navigation and robotic technologies emerge as alternatives to conventional freehand techniques for spine fusion. They aim to enhance perioperative and postoperative outcomes, yet their effectiveness remains limited by small cohort sizes in existing literature. Our study compares navigation and robotic technologies in lumbar fusion surgery across complications, costs, and mortality.</p><p><strong>Methods: </strong>This study employed data from the Nationwide Inpatient Sample. The NIS annually captures approximately 7 million unweighted admissions. The dataset spanned 2016 to 2019, comprising 58,270 patients. Exclusions included non-elective admissions, pre-admission surgeries, and cases reporting $0 hospital costs. Validation of comorbidities and complications was conducted using ICD-10 codes. Analytical techniques, such as trend identification and statistical analyses, were applied with a significance threshold of p < 0.05. Demographic and clinical characteristics, surgery types, and outcomes were assessed.</p><p><strong>Results: </strong>Navigation-guided surgeries dominated (86.7% in 2016, 77.1% in 2019), while Robotic-assisted surgeries increased steadily. Both showed minimal mortality rates. Navigation-guided surgeries had lower charges, lower risks of blood loss anemia, acute kidney injury, and blood transfusion compared to Robotic-assisted surgeries. Navigation-guided surgeries showed significantly lower risks of complications in one level lumbar fusion of vertebral joint and fusion of lumbosacral joint compared to Robotic-Assisted procedures. Additionally, Robotic-Assisted surgeries present higher risks across blood loss anemia, acute kidney injury, and blood transfusion, with risk ratios ranging from 1.24 to 1.72 times higher.</p><p><strong>Conclusion: </strong>This study highlights shifting trends in lumbar fusion surgeries, underscoring the need for tailored approaches and nuanced clinical considerations to improve patient outcomes.</p>\",\"PeriodicalId\":12323,\"journal\":{\"name\":\"European Spine Journal\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-07-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Spine Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00586-025-09060-z\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Spine Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00586-025-09060-z","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Comparative analysis of complications, costs, mortality, and length of stay in lumbar fusion surgery: robotic-assisted versus navigation-guided approaches.
Introduction: Navigation and robotic technologies emerge as alternatives to conventional freehand techniques for spine fusion. They aim to enhance perioperative and postoperative outcomes, yet their effectiveness remains limited by small cohort sizes in existing literature. Our study compares navigation and robotic technologies in lumbar fusion surgery across complications, costs, and mortality.
Methods: This study employed data from the Nationwide Inpatient Sample. The NIS annually captures approximately 7 million unweighted admissions. The dataset spanned 2016 to 2019, comprising 58,270 patients. Exclusions included non-elective admissions, pre-admission surgeries, and cases reporting $0 hospital costs. Validation of comorbidities and complications was conducted using ICD-10 codes. Analytical techniques, such as trend identification and statistical analyses, were applied with a significance threshold of p < 0.05. Demographic and clinical characteristics, surgery types, and outcomes were assessed.
Results: Navigation-guided surgeries dominated (86.7% in 2016, 77.1% in 2019), while Robotic-assisted surgeries increased steadily. Both showed minimal mortality rates. Navigation-guided surgeries had lower charges, lower risks of blood loss anemia, acute kidney injury, and blood transfusion compared to Robotic-assisted surgeries. Navigation-guided surgeries showed significantly lower risks of complications in one level lumbar fusion of vertebral joint and fusion of lumbosacral joint compared to Robotic-Assisted procedures. Additionally, Robotic-Assisted surgeries present higher risks across blood loss anemia, acute kidney injury, and blood transfusion, with risk ratios ranging from 1.24 to 1.72 times higher.
Conclusion: This study highlights shifting trends in lumbar fusion surgeries, underscoring the need for tailored approaches and nuanced clinical considerations to improve patient outcomes.
期刊介绍:
"European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts.
Official publication of EUROSPINE, The Spine Society of Europe