992 Pioneering Robot-Assisted Spine Surgery in the United Kingdom

Abstract

Abstract Aim The placement of a large interbody implant allows for a larger fusion area. Retroperitoneal approaches, like anterior, antero-lateral, and lateral fusion, facilitate the placement of these implants. At the same time, robot-navigation facilitate complex, minimally invasive spine surgery for posterior screw fixation. This is a single-surgeon, single-centre report on the experience of the first procedures ever performed for navigated robot-assisted spine surgery in the United Kingdom. Method Between October 2019 and May 2021, we identified 34 consecutive patients who underwent robot-assisted spine surgery. The demographic, intra-operative, and peri-operative data were reviewed. Results Of the 34 patients, 65 levels were treated in total (204 screws). 21 patients (60%) underwent single-level fixation, 14 of them (67%) were treated at the L5/S1 level, 3 at L3/L4, 3 at L4/L5 and 1 at L2/L3 level, 13 patients (40%) underwent multi-level fixation, with 4 of them treated for adult scoliosis. Eight patients underwent a supine ALALIF approach and one a lateral decubitus AL-ALIF, 7 had a pure ALIF approach, 8 patients underwent combined XLIF and AL-ALIF approach in a lateral decubitus, 6 underwent pure XLIF approach, 1 patient had previous TLIF surgery, and 3 patients underwent single position lateral surgery (lateral decubitus fusion and posterior screw fixation). Conclusions Minimally invasive spine surgery using robot-assisted navigation yields an improved level of accuracy, decreased radiation exposure, minimal muscle disruption, decreased blood loss, shorter operating theatre time, length of stay, and lower complication rates. Further follow-up of the patients treated will help compare the clinical outcomes with other techniques.