P108. Propensity-matched comparison of open, navigated and robotic-assisted TLIF

Abstract

BACKGROUND CONTEXT Transforaminal Lumbar Interbody Fusion (TLIF) techniques have evolved from open approaches with dissection to the lateral gutters, to navigation to improve pedicle screw placement accuracy, to robotic assistance to further minimize soft tissue dissection. It is unclear if these technologies improve process measures and minimize variability in surgical technique. PURPOSE To determine if Blood Loss, Operative Time and Length of Stay will be lower with less variability with Robotic, followed by Navigated and Open TLIF. STUDY DESIGN/SETTING Propensity matched longitudinal cohort. PATIENT SAMPLE Consecutive series of patients undergoing primary single-level TLIF. OUTCOME MEASURES Blood Loss, Operative Time and Length of Stay. METHODS A consecutive series of patients undergoing primary single-level Robotic-Assisted TLIFs (RA-TLIF, N=40) were propensity matched to patients undergoing Navigated (NavTLIF, N=51) and Open TLIF (OpTLIF, N=44) using age, sex, smoking status, BMI and ASA grade. RESULTS After propensity matching, 34 cases were included in each cohort. OR Time (184±37 vs 197±48 vs 219±50, p=0.007) was lowest and had the least variability in RA-TLIFs followed by NavTLIF and OpTLIF. Length of Stay (1.5±0.9 vs 2.5±1.2 vs 4.2±1.7, p=0.000), estimated blood loss (254±259 vs 325±288 vs 489±328, p=0.004), drain output (234±257 vs 250±137 vs 653±407, p CONCLUSIONS Operative time was lowest and had the least variability in RA-TLIFs followed by NavTLIF and OpTLIF. Length of stay, blood loss, drain output, total visible blood loss, and total volume of blood products transfused was lowest in RA-TLIFs followed by NavTLIF and OpTLIF. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.