TY  - BOOK
AU  - Asdourian, Paul
AU  - Brooks, Daina M
AU  - Cunningham, Bryan W
AU  - Lemma, Mesfin
AU  - McAfee, Paul C
AU  - Moatz, Bradley
AU  - Soda, Mosope
AU  - Stewart, Jeffrey
TI  - The contribution of E3D imaging integrated with robotic navigation: analysis of the first 80 consecutive posterior spinal fusion cases
SN  - 1863-2483
PY  - 2024///
KW  - *Imaging, Three-Dimensional
KW  - *Operative Time
KW  - *Robotic Surgical Procedures
KW  - *Spinal Fusion
KW  - *Tomography, X-Ray Computed
KW  - Adult
KW  - Aged
KW  - Aged, 80 and over
KW  - Female
KW  - Fluoroscopy/mt [Methods]
KW  - Humans
KW  - Imaging, Three-Dimensional/mt [Methods]
KW  - Male
KW  - Middle Aged
KW  - Postoperative Complications/et [Etiology]
KW  - Retrospective Studies
KW  - Robotic Surgical Procedures/mt [Methods]
KW  - Spinal Fusion/is [Instrumentation]
KW  - Spinal Fusion/mt [Methods]
KW  - Surgery, Computer-Assisted/mt [Methods]
KW  - Tomography, X-Ray Computed/mt [Methods]
KW  - Young Adult
KW  - Automated
KW  - MedStar Union Memorial Hospital
KW  - MedStar Georgetown University Hospital/MedStar Washington Hospital Center
KW  - Neurosurgery Residency
KW  - Orthopaedic Surgery
KW  - Spine Center
KW  - Journal Article
N2  - Eighty consecutive complex spinal robotic cases utilizing intraoperative 3D CT imaging (E3D, Group 2) were compared to 80 age-matched controls using the Excelsius robot alone with C-arm Fluoroscopic registration (Robot Only, Group 1). The demographics between the two groups were similar-severity of deformity, ASA Score for general anesthesia, patient age, gender, number of spinal levels instrumented, number of patients with prior spinal surgery, and amount of neurologic compression. The intraoperative CT scanning added several objective factors improving patient safety. There were significantly fewer complications in the E3D group with only 3 of 80 (4%) patients requiring a return to the operating room compared to 11 of 80 (14%) patients in the Robot Only Group requiring repeat surgery for implant related problems (Chi squared analysis = 5.00, p = 0.025). There was a significant reduction the amount of fluoroscopy time in the E3D Group (36 s, range 4-102 s) compared to Robot only group (51 s, range 15-160 s) (p = 0.0001). There was also shorter mean operative time in the E3D group (257 +/- 59.5 min) compared to the robot only group (306 +/- 73.8 min) due to much faster registration time (45 s). A longer registration time was required in the Robot only group to register each vertebral level with AP and Lateral fluoroscopy shots. The estimated blood loss was also significantly lower in Group 2 (mean 345 +/- 225 ml) vs Group 1 (474 +/- 397 ml) (p = 0.012). The mean hospital length of stay was also significantly shorter for Group 2 (3.77 +/- 1.86 days) compared to Group 1 (5.16 +/- 3.40) (p = 0.022). There was no significant difference in the number of interbody implants nor corrective osteotomies in both groups-Robot only 52 cases vs. 42 cases in E3D group.Level of evidence: IV, Retrospective review. Copyright © 2024. The Author(s)
UR  - https://dx.doi.org/10.1007/s11701-024-02014-5
ER  -