Taylor Furst, Aman Singh, Prasanth Romiyo, Jonathan Stone, Tyler Schmidt
{"title":"比较选择性机器人辅助与非机器人辅助腰椎后路椎间融合术的短期临床结果:NSQIP分析。","authors":"Taylor Furst, Aman Singh, Prasanth Romiyo, Jonathan Stone, Tyler Schmidt","doi":"10.23736/S0390-5616.25.06535-X","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Symptomatic lumbar degenerative changes impact millions of patients per year. Recent technological advances have increased the usability of robot-assisted spinal fusions to treat this pathology. Although the safety profile of robotic systems appears favorable, the impact of robotics on surgical outcomes and efficiency remains unclear.</p><p><strong>Methods: </strong>The American College of Surgeons National Surgical Quality Improvement Project (NSQIP) database was queried for cases of elective posterior lumbar interbody fusions in adult patients with data available regarding the use of robotics. Univariate and multivariate analyses were performed. The purpose of this study is to compare rates of 30-day unplanned readmissions, unplanned reoperation (return to operating room [RTOR]), postoperative complications, non-home discharges, operative time, blood transfusions and length of stay (LOS) in adult elective robot-assisted (robot-assisted posterior lumbar interbody fusion [rPLIF] / transforaminal lumbar interbody fusion [TLIF]) vs. non-robotic PLIF/TLIF (nPLIF/TLIF).</p><p><strong>Results: </strong>There was no statistically significant difference in rates of 30-day readmissions (6.0% vs. 4.4%, P=0.48), RTOR (4.0% vs. 3.0%, P=0.66), postoperative complications (10.0% vs. 11.2%, P=0.51) nor need for blood transfusion (6.0% vs. 6.5%, P=0.59) between rPLIF/TLIF and nPLIF/TLIF cohorts, respectively. There were no differences in LOS or operative time between groups (LOS: rPLIF/TLIF = 3.5±3.3 days, nPLIF/TLIF = 3.6±2.8 days, P=0.29; operative time: rPLIF/TLIF = 208.7±101.1 minutes, nPLIF/TLIF = 225.1±100.4 minutes, P=0.087).</p><p><strong>Conclusions: </strong>rPLIF/TLIF and nPLIF/TLIF 30-day readmissions, RTOR, non-home discharges, need for blood transfusion, LOS and operative times are similar within these data, though results should be interpreted with caution given study limitations. Ongoing data on surgical outcomes of robot-assisted lumbar fusions are needed.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":""},"PeriodicalIF":1.2000,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparing short term clinical outcomes of elective robot-assisted vs. non-robot assisted posterior lumbar interbody fusions: a NSQIP analysis.\",\"authors\":\"Taylor Furst, Aman Singh, Prasanth Romiyo, Jonathan Stone, Tyler Schmidt\",\"doi\":\"10.23736/S0390-5616.25.06535-X\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Symptomatic lumbar degenerative changes impact millions of patients per year. Recent technological advances have increased the usability of robot-assisted spinal fusions to treat this pathology. Although the safety profile of robotic systems appears favorable, the impact of robotics on surgical outcomes and efficiency remains unclear.</p><p><strong>Methods: </strong>The American College of Surgeons National Surgical Quality Improvement Project (NSQIP) database was queried for cases of elective posterior lumbar interbody fusions in adult patients with data available regarding the use of robotics. Univariate and multivariate analyses were performed. The purpose of this study is to compare rates of 30-day unplanned readmissions, unplanned reoperation (return to operating room [RTOR]), postoperative complications, non-home discharges, operative time, blood transfusions and length of stay (LOS) in adult elective robot-assisted (robot-assisted posterior lumbar interbody fusion [rPLIF] / transforaminal lumbar interbody fusion [TLIF]) vs. non-robotic PLIF/TLIF (nPLIF/TLIF).</p><p><strong>Results: </strong>There was no statistically significant difference in rates of 30-day readmissions (6.0% vs. 4.4%, P=0.48), RTOR (4.0% vs. 3.0%, P=0.66), postoperative complications (10.0% vs. 11.2%, P=0.51) nor need for blood transfusion (6.0% vs. 6.5%, P=0.59) between rPLIF/TLIF and nPLIF/TLIF cohorts, respectively. There were no differences in LOS or operative time between groups (LOS: rPLIF/TLIF = 3.5±3.3 days, nPLIF/TLIF = 3.6±2.8 days, P=0.29; operative time: rPLIF/TLIF = 208.7±101.1 minutes, nPLIF/TLIF = 225.1±100.4 minutes, P=0.087).</p><p><strong>Conclusions: </strong>rPLIF/TLIF and nPLIF/TLIF 30-day readmissions, RTOR, non-home discharges, need for blood transfusion, LOS and operative times are similar within these data, though results should be interpreted with caution given study limitations. Ongoing data on surgical outcomes of robot-assisted lumbar fusions are needed.</p>\",\"PeriodicalId\":16504,\"journal\":{\"name\":\"Journal of neurosurgical sciences\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2025-09-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of neurosurgical sciences\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.23736/S0390-5616.25.06535-X\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of neurosurgical sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.23736/S0390-5616.25.06535-X","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景:有症状的腰椎退行性改变每年影响数百万患者。最近的技术进步增加了机器人辅助脊柱融合治疗这种病理的可用性。尽管机器人系统的安全性似乎是有利的,但机器人对手术结果和效率的影响仍不清楚。方法:查询美国外科医师学会国家外科质量改进项目(NSQIP)数据库中选择性腰椎后路椎间融合术的成人患者,并获取机器人技术的可用数据。进行单因素和多因素分析。本研究的目的是比较成人选择性机器人辅助(机器人辅助后路腰椎椎间融合术[rPLIF] /经椎间孔腰椎椎间融合术[TLIF])与非机器人PLIF/TLIF (nPLIF/TLIF)的30天意外再入院率、意外再手术(返回手术室[RTOR])、术后并发症、非家庭出院率、手术时间、输血量和住院时间(LOS)。结果:rPLIF/TLIF组与nPLIF/TLIF组在30天再入院率(6.0% vs. 4.4%, P=0.48)、RTOR (4.0% vs. 3.0%, P=0.66)、术后并发症(10.0% vs. 11.2%, P=0.51)和输血需求(6.0% vs. 6.5%, P=0.59)方面均无统计学差异。两组间LOS及手术时间无差异(LOS: rPLIF/TLIF = 3.5±3.3天,nPLIF/TLIF = 3.6±2.8天,P=0.29;手术时间:rPLIF/TLIF = 208.7±101.1分钟,nPLIF/TLIF = 225.1±100.4分钟,P=0.087)。结论:rPLIF/TLIF和nPLIF/TLIF 30天再入院、RTOR、非家庭出院、输血需求、LOS和手术时间在这些数据中是相似的,尽管考虑到研究的局限性,结果应谨慎解释。需要关于机器人辅助腰椎融合术手术结果的持续数据。
Comparing short term clinical outcomes of elective robot-assisted vs. non-robot assisted posterior lumbar interbody fusions: a NSQIP analysis.
Background: Symptomatic lumbar degenerative changes impact millions of patients per year. Recent technological advances have increased the usability of robot-assisted spinal fusions to treat this pathology. Although the safety profile of robotic systems appears favorable, the impact of robotics on surgical outcomes and efficiency remains unclear.
Methods: The American College of Surgeons National Surgical Quality Improvement Project (NSQIP) database was queried for cases of elective posterior lumbar interbody fusions in adult patients with data available regarding the use of robotics. Univariate and multivariate analyses were performed. The purpose of this study is to compare rates of 30-day unplanned readmissions, unplanned reoperation (return to operating room [RTOR]), postoperative complications, non-home discharges, operative time, blood transfusions and length of stay (LOS) in adult elective robot-assisted (robot-assisted posterior lumbar interbody fusion [rPLIF] / transforaminal lumbar interbody fusion [TLIF]) vs. non-robotic PLIF/TLIF (nPLIF/TLIF).
Results: There was no statistically significant difference in rates of 30-day readmissions (6.0% vs. 4.4%, P=0.48), RTOR (4.0% vs. 3.0%, P=0.66), postoperative complications (10.0% vs. 11.2%, P=0.51) nor need for blood transfusion (6.0% vs. 6.5%, P=0.59) between rPLIF/TLIF and nPLIF/TLIF cohorts, respectively. There were no differences in LOS or operative time between groups (LOS: rPLIF/TLIF = 3.5±3.3 days, nPLIF/TLIF = 3.6±2.8 days, P=0.29; operative time: rPLIF/TLIF = 208.7±101.1 minutes, nPLIF/TLIF = 225.1±100.4 minutes, P=0.087).
Conclusions: rPLIF/TLIF and nPLIF/TLIF 30-day readmissions, RTOR, non-home discharges, need for blood transfusion, LOS and operative times are similar within these data, though results should be interpreted with caution given study limitations. Ongoing data on surgical outcomes of robot-assisted lumbar fusions are needed.
期刊介绍:
The Journal of Neurosurgical Sciences publishes scientific papers on neurosurgery and related subjects (electroencephalography, neurophysiology, neurochemistry, neuropathology, stereotaxy, neuroanatomy, neuroradiology, etc.). Manuscripts may be submitted in the form of ditorials, original articles, review articles, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work.