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Trends in usage of navigation and robotic assistance in elective spine surgeries: a study of 105,212 cases from 2007 to 2015

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Abstract

Objective

Identify trends of navigation and robotic-assisted elective spine surgeries.

Methods

Elective spine surgery patients between 2007 and 2015 in the Nationwide Inpatient Sample (NIS) were isolated by ICD-9 codes for Navigation [Nav] or Robotic [Rob]-Assisted surgery. Basic demographics and surgical variables were identified via chi-squared and t tests. Each system was analyzed from 2007 to 2015 for trends in usage.

Results

Included 3,759,751 patients: 100,488 Nav; 4724 Rob. Nav were younger (56.7 vs 62.7 years), had lower comorbidity index (1.8 vs 6.2, all p < 0.05), more decompressions (79.5 vs 42.6%) and more fusions (60.3 vs 52.6%) than Rob. From 2007 to 2015, incidence of complication increased for Nav (from 5.8 to 21.7%) and Rob (from 3.3 to 18.4%) as well as 2–3 level fusions (from 50.4 to 52.5%) and (from 1.3 to 3.2%); respectively. Invasiveness increased for both (Rob: from 1.7 to 2.2; Nav: from 3.7 to 4.6). Posterior approaches (from 27.4 to 41.3%), osteotomies (from 4 to 7%), and fusions (from 40.9 to 54.2%) increased in Rob. Anterior approach for Rob decreased from 14.9 to 14.4%. Nav increased posterior (from 51.5% to 63.9%) and anterior approaches (from 16.4 to 19.2%) with an increase in osteotomies (from 2.1 to 2.7%) and decreased decompressions (from 73.6 to 63.2%).

Conclusions

From 2007 to 2015, robotic and navigation systems have been performed on increasingly invasive spine procedures. Robotic systems have shifted from anterior to posterior approaches, whereas navigation computer-assisted procedures have decreased in rates of usage for decompression procedures.

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Data availability

The data used in this study is publicly available.

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Funding

The authors have not disclosed any funding.

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Authors and Affiliations

  1. Department of Orthopedic and Neurosurgery, Division of Spine, NYU Langone Orthopedic Hospital, New York Spine Institute, 301 East 17th St, New York, NY, 10003, USA

    Sara Naessig, Ashok Para, Nicholas Kummer, Oscar Krol, Lara Passfall, Waleed Ahmad, Katherine Pierce & Peter Passias

  2. Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, TX, USA

    Shaleen Vira

  3. Department of Orthopedic Surgery, SUNY Downstate Medical Center, Brooklyn, NY, USA

    Bassel Diebo

  4. Department of Orthopedic Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Brian Neuman, Amit Jain & Daniel Sciubba

Authors
  1. Sara Naessig
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  2. Ashok Para
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  3. Nicholas Kummer
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  4. Oscar Krol
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  5. Lara Passfall
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  6. Waleed Ahmad
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  7. Katherine Pierce
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  8. Shaleen Vira
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Contributions

PGP has been a paid consultant for terumo, spinewave, globus medical and medicrea, has received research support from the Cervical Scoliosis Research Society and Allosource, and has been a paid presenter for Globus Medical and Zimmer. BN has received research support from DePuy, A Johnson & Johnson Company and has been a paid presenter for Medtronic. DS has been a paid consultant for Baxter, K2M, Medtronic, DePuy, A Johnson & Johnson Company, Nuvasive, and Stryker. Amit Jain MD has received research support from DePuy, A Johnson & Johnson Company and has been a paid consultant for Stryker.

Corresponding author

Correspondence to Peter Passias.

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The authors have not disclosed any competing interests.

Ethical approval

Institutional Review Board was waived, as this study uses a de-identified nationwide database.

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Naessig, S., Para, A., Kummer, N. et al. Trends in usage of navigation and robotic assistance in elective spine surgeries: a study of 105,212 cases from 2007 to 2015. J Robotic Surg 17, 2855–2860 (2023). https://doi.org/10.1007/s11701-023-01682-z

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  • DOI: https://doi.org/10.1007/s11701-023-01682-z

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