Radiographic and Clinical Outcomes of Robot-Assisted Posterior Pedicle Screw Fixation: Two-Year Results from a Randomized Controlled Trial.
10.3349/ymj.2018.59.3.438
- Author:
Sang Min PARK
1
;
Ho Joong KIM
;
Se Yeon LEE
;
Bong Soon CHANG
;
Choon Ki LEE
;
Jin S YEOM
Author Information
1. Spine Center and Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. highcervical@gmail.com
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords:
Freehand technique;
posterior lumbar interbody fusion;
adjacent segment degeneration;
robot-assisted pedicle screw fixation
- MeSH:
California;
Follow-Up Studies;
Humans;
Leg;
Pedicle Screws*;
Prospective Studies;
Zygapophyseal Joint
- From:Yonsei Medical Journal
2018;59(3):438-444
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We prospectively assessed the early radiographic and clinical outcomes (minimum follow-up of 2 years) of robot-assisted pedicle screw fixation (Robot-PSF) and conventional freehand pedicle screw fixation (Conv-PSF). MATERIALS AND METHODS: Patients were randomly assigned to Robot-PSF (37 patients) or Conv-PSF (41 patients) for posterior interbody fusion surgery. The Robot-PSF group underwent minimally invasive pedicle screw fixation using a pre-planned robot-guided screw trajectory. The Conv-PSF underwent screw fixation using the freehand technique. Radiographic adjacent segment degeneration (ASD) was measured on plain radiographs, and clinical outcomes were measured using visual analogue scale (VAS) and Oswestry disability index (ODI) scores regularly after surgery. RESULTS: The two groups had similar values for radiographic ASD, including University California at Los Angeles grade, vertebral translation, angular motion, and loss of disc height (p=0.320). At final follow-up, both groups had experienced significant improvements in back VAS, leg VAS, and ODI scores after surgery (p < 0.001), although inter-group differences were not significant for back VAS (p=0.876), leg VAS (p=0.429), and ODI scores (p=0.952). In the Conv-PSF group, revision surgery was required for two of the 25 patients (8%), compared to no patients in the Robot-PSF group. CONCLUSION: There were no significant differences in radiographic ASD and clinical outcomes between Robot-PSF and Conv-PSF. Thus, the advantages of robot-assisted surgery (accurate pedicle screw insertion and minimal facet joint violation) do not appear to be clinically significant.
