Robotic Assistance in Pedicle Screw Placement for Adult Spinal Deformity
DOI:
https://doi.org/10.5281/zenodo.22310595Keywords:
Robotic surgery, Pedicle screw, Adult spinal deformity, Spine navigation, Surgical accuracyAbstract
Background: Adult spinal deformity surgery often needs long constructs placed through osteoporotic, rotated, or previously
operated pedicles. Screw malposition here risks neurologic injury and construct failure. Objective: To synthesize published evidence on robotic-assisted pedicle screw placement in adult spinal deformity. Methods: Narrative review of comparative studies, systematic reviews, meta-analyses, and cost analyses of Mazor, ROSA, ExcelsiusGPS, and related platforms. Findings: Robotic guidance achieves Gertzbein-Robbins Grade A/B accuracy above 97-99%. It modestly outperforms fluoroscopy-guided freehand technique and reduces radiation exposure. Setup time adds an early cost that shortens with experience over roughly twenty to thirty cases. Revision rates for malpositioned screws are low, and cost analyses suggest savings from avoided revisions can offset added expense. Conclusions: Robotic assistance offers a reproducible accuracy advantage relevant to long-construct deformity correction. Evidence still comes mainly from single-center series rather than deformity-specific randomized trials.
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