Analysis of the Limitations of Robotic Systems in Spine Surgery

ABSTRACT Objective: To analyze the limitations and complications of using a robotic system in spinal surgeries during the learning curve. Methods: To evaluate the results of the application of 415 pedicle screws in 67 patients undergoing spinal surgery in which the robotic system was used. Recording time, fluoroscopy time, intraoperative radiation dose, implant accuracy, abandonment of the robotic system, problems with the system program, and clinical complications were evaluated. Results: Discrepant values were observed in recording time in 9 (13.43%) patients, in fluoroscopy time in 3 (4.47%), and in intraoperative radiation dose in 8 (11.94%). Malpositioning (vertebral pedicle wall rupture > 2 mm) occurred in 3.5% of the implants evaluated in the axial plane and 0.48% in the sagittal plane. No abandonment of the robotic system was observed. Neurological deficit was observed in one patient. Conclusions: The robotic system demonstrated effectiveness and precision in implant placement, but system limitations were observed, mainly related to the acquisition of good-quality images for system registration. Level of evidence IV; Case Series.