P32. Trends in robotic spine surgery: a six-year analysis of morbidity and mortality

Abstract

BACKGROUND CONTEXT There have been few investigations into national trends in the use or outcomes of patients treated with robotic assisted surgery. PURPOSE To evaluate if incorporation of robotic assisted procedures will lead to a rise in suboptimal outcomes. STUDY DESIGN/SETTING Retrospective review of a national patient database between 2010-2016. PATIENT SAMPLE A total of 4,109 weighted hospital discharges. OUTCOME MEASURES Length of stay, complications, invasiveness. METHODS Inclusion criteria: elective spine surgery procedures as defined by ICD-9-CM and ICD-10-CM codes. Descriptive statistics assessed demographic information for the cohort. Rates of open and MIS robot assisted procedures were assessed, as well as trends in postoperative complications, and length of stay. Propensity score matching was performed between robotic spine surgery patients and non-robotic spine surgery patients for levels fused. Regression analysis was used to assess robot assisted procedures as a predictor of complications and extended LOS (LOS above 75th percentile), unfavorable discharge, and death during hospitalization. RESULTS A total of 4,109 discharges were included. The overall trends in robotic surgery show a significant increase from 2010 to 2016, increasing from 11 recorded cases to 1,535 in 2016 (p 0.05). Robot assisted surgery was predictive of bleeding complications (hemorrhage and hematoma) compared to non-robot surgery patients (OR: 2.05 [1.10-3.82], p=0.02). CONCLUSIONS Robot assisted surgery is an increasing implemented technique in spine surgery, with a significant rise from 2010 to 2016. However, during that period there has been a concurrent rise in postoperative complications. Invasiveness matched robot assisted patients were at significantly higher odds of bleeding complications compared to non-robotic patients. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.