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Maalouly et al. Mini-invasive Surg 2021;5:35 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2021.57

Original Article Open Access

Retrospective study assessing the learning curve

and the accuracy of minimally invasive robot-
assisted pedicle screw placement during the first 41

robot-assisted spinal fusion surgeries

1
2
Joseph Maalouly , Mehul Sarkar , John Choi 1
1
Department of Orthopedic and Spine Surgery, Peninsula Private Hospital, Frankston, VIC 3199, Australia.
2
Department of Orthopedic and Spine Surgery, Kaslival Hospital, Nashik, Maharashtra 422001, India.
Correspondence to: Dr. Joseph Maalouly, Department of Orthopedic and Spine Surgery, Peninsula Private Hospital, 525
McClelland Dr, Frankston VIC 3199, Australia. E-mail: josephmaalouly2@gmail.com
How to cite this article: Maalouly J, Sarkar M, Choi J. Retrospective study assessing the learning curve and the accuracy of
minimally invasive robot-assisted pedicle screw placement during the first 41 robot-assisted spinal fusion surgeries. Mini-invasive
Surg 2021;5:35. https://dx.doi.org/10.20517/2574-1225.2021.57

Received: 26 Apr 2021 First Decision: 9 Jun 2021 Revised: 9 Jun 2021 Accepted: 16 Jun 2021 Available online: 17 Jun 2021
Academic Editor: Yoshihisa Kotani Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Aim: The purpose of this study was to assess the learning curve and the accuracy of robot-assisted pedicle screw
placement in the first 41 cases.

Methods: This retrospective study investigated the first 41 patients undergoing spinal fusion, whereby 250 pedicle
screws were inserted with robotic assistance in a private hospital by a single surgeon. The pedicle screw accuracy
was evaluated by computed tomography scan by an orthopedic surgeon according to the Gertzbein and Robbins
classification. Planning time and screw placement time were noted. In addition, data about any screw malposition,
a return to the operating theatre, and intraoperative repositioning were collected. The data were analyzed with
Microsoft Excel.

Results: The results show a high degree of accuracy (98%) of pedicle screw placement with a minimally invasive
robot-assisted spinal fusion with no screw malposition requiring a return to the operating theatre. The learning
curve improved with time, reaching a plateau at around 25 cases.

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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