Introduction: Robotic-assisted spine surgery (RASS) offers significant advancements, including improved surgical accuracy, reduced complication rates, and potential economic benefits. Despite improvements in precision, workflow efficiency, and patient outcomes, evidence of these benefits remains mixed. This scoping review summarizes current literature on clinical, operational, and economic outcomes in the past ten years to identify gaps and guide future research.
Methods: A scoping review was conducted following the PRISMA guidelines to assess the literature on the clinical, technical, educational, and economic outcomes RASS. Studies from January 2014 to October 2024 were systematically screened from three databases using keywords such as “robotic-assisted spine surgery,” “clinical outcomes,” “cost-effectiveness,” and “surgical accuracy.” Data were collected on study design, patient demographics, intervention details, and outcome measures.
Results: A total of 1,136 studies were identified, with 26 meeting inclusion criteria. Patients (mean age 50-69) experienced low intraoperative complications ( < 5%) and estimated blood loss of 68-543 mL. RASS showed slightly lower complication rates than traditional methods (wound infections < 3% vs. 5-8%, failure rates 18.5% vs. 25.9%) and higher screw placement accuracy (up to 98.6%), resulting in fewer revisions. Robotic procedures involved thoracolumbar fusions for conditions like spondylolisthesis (25.9%) and spinal stenosis (40%). Economically, RASS may save up to $608,546 annually by reducing revisions and recovery times, though high setup costs remain a barrier. RASS improves workflow, with experienced surgeons becoming proficient with the system in 30-50 cases.
Conclusion : RASS offers clear clinical and operational benefits, but high costs and extended learning curves present challenges. Future research should focus on reducing these barriers, particularly by standardizing training protocols and developing cost-efficient robotic platforms.
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