Robot-Assisted vs Fluoroscopy-Guided Minimally Invasive Transforaminal Lumbar Interbody Fusion for Lumbar Degenerative Diseases: A Comparative Study

BACKGROUND Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) requires percutaneous insertion of pedicle screws under fluoroscopic guidance, which can lead to inaccurate screw placement and repeated fluoroscopy. This study aimed to compare the clinical efficacy of robot-assisted vs fluoroscopy-guided MIS-TLIF. MATERIAL AND METHODS A total of 80 patients were included in this study, among whom 40 received robot-assisted MIS-TLIF (RA group) and 40 received fluoroscope-guided MIS-TLIF (FG group) between January 2020 and January 2022. The visual analog scale (VAS) score for back and leg pain and Oswestry Disability Index (ODI) were evaluated before surgery, 3 days after surgery, and at the final follow-up. The operation time, blood loss, radiation exposure time, hospital stay, pedicle screw placement, facet joint violation (FJV), fusion status, and complications were also recorded. RESULTS There were no statistically significant differences between the 2 groups regarding operation time, radiation exposure time, blood loss, and intervertebral fusion rate. The hospital stay in the robot group was shorter than that in the FG group. Both groups showed reduced VAS and ODI scores at each time point after surgery compared to preoperatively. The VAS back pain score in the RA group was lower than that in the FG group at 3 days postoperatively. The RA group demonstrated more accurate screw placement compared to the FG group, whereas the FG group exhibited a significantly higher FJV rate. The 2 groups had similar complications. CONCLUSIONS Robot-assisted MIS-TLIF enhances the precision of pedicle screw placement, significantly reduces early postoperative pain, shortens hospital stays, and minimizes FJV.