Our Summary

This research paper discusses the rise in the use of robotic-assisted spine surgeries, particularly for a procedure called lumbar fusion. Even though these medical robots can cost hospitals over $600,000, they are becoming increasingly popular.

The study looked at data from 2016 to 2019 and found that out of 176,377 patients who had lumbar fusion, only 1.2% had it done with robotic assistance. However, the use of this technology increased over time, with patients in 2019 four times more likely to have a robot-assisted surgery compared to 2016.

The research also showed that patients with private insurance, white patients, and those diagnosed with a certain back condition called spondylolisthesis were more likely to have robot-assisted surgeries. Additionally, surgeries involving an anterior approach (from the front of the body) were more likely to use robots.

Despite the increase in use, the study found that robot-assisted surgeries were more expensive, costing on average $31,000 more than traditional surgeries, even though the hospital stay duration was about the same.

FAQs

  1. How much has the use of robotic-assisted lumbar fusion increased from 2016 to 2019?
  2. Which patients are more likely to have robot-assisted lumbar fusion surgeries?
  3. How does the cost of robot-assisted lumbar fusion surgeries compare to traditional surgeries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about lumbar fusion is to discuss with their healthcare provider the potential benefits and risks of robot-assisted surgery compared to traditional surgery. It’s important for patients to be informed about all their options and make a decision that is best for their individual situation and preferences.

Suitable For

Patients who are typically recommended lumbar fusion are those who have severe back pain, instability in the spine, degenerative disc disease, spinal stenosis, spondylolisthesis, or other spinal conditions that have not improved with conservative treatments such as physical therapy, medication, or injections. These patients may have tried non-surgical options without success and are looking for a more permanent solution to their pain and mobility issues.

In particular, patients with spondylolisthesis, a condition where one vertebra slips forward over the one below it, may benefit from lumbar fusion surgery to stabilize the spine and reduce pain. Additionally, patients with spinal stenosis, a narrowing of the spinal canal that can cause pressure on the nerves, may also be good candidates for lumbar fusion to relieve symptoms and improve their quality of life.

Patients who are considered for lumbar fusion surgery should undergo a comprehensive evaluation by a spine specialist to determine if they are appropriate candidates for the procedure. Factors such as the severity of the spinal condition, the patient’s overall health, and their willingness to participate in post-operative rehabilitation are all important considerations in recommending lumbar fusion surgery.

Timeline

Before lumbar fusion:

  • Patient experiences chronic back pain, numbness, weakness, or other symptoms that do not improve with conservative treatments like physical therapy or medication.
  • Patient undergoes imaging tests such as X-rays, MRIs, or CT scans to determine the extent of the spinal issue.
  • Patient consults with a spine surgeon to discuss treatment options, including the possibility of lumbar fusion surgery.
  • Patient undergoes pre-operative evaluations and medical clearance for surgery.

After lumbar fusion:

  • Patient undergoes the robot-assisted lumbar fusion surgery, where the surgeon uses robotic technology to assist in the placement of screws and other hardware in the spine.
  • Patient is monitored closely in the hospital for any complications or pain management issues.
  • Patient begins physical therapy and rehabilitation to strengthen the muscles around the spine and improve mobility.
  • Patient follows up with the surgeon for post-operative appointments to monitor healing and address any concerns.
  • Patient gradually resumes normal activities and may experience improvements in back pain and function over time.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lumbar fusion, especially if considering a robot-assisted surgery, include:

  1. What are the benefits of robot-assisted lumbar fusion compared to traditional surgery?
  2. What are the potential risks and complications associated with robot-assisted lumbar fusion?
  3. How experienced is the surgical team in performing robot-assisted spine surgeries?
  4. Will my insurance cover the additional cost of a robot-assisted surgery?
  5. How will the recovery process differ between robot-assisted and traditional lumbar fusion?
  6. Are there any long-term differences in outcomes between robot-assisted and traditional lumbar fusion?
  7. How does the use of robotics affect the overall success rate of lumbar fusion surgeries?
  8. Are there any specific criteria that make a patient a good candidate for robot-assisted lumbar fusion?
  9. What alternative treatment options are available for my condition, and how do they compare to robot-assisted lumbar fusion?
  10. Can you provide more information or resources on the use of robotics in spine surgery to help me make an informed decision?

Reference

Authors: Pando A, Hanna G, Goldstein I. Journal: Eur Spine J. 2023 Jun;32(6):1966-1972. doi: 10.1007/s00586-023-07663-y. Epub 2023 Mar 31. PMID: 37000219