Robot-Assisted Screw Fixation Combined With Endoscopic Bone Graft in the Minimally Invasive Treatment of Lumbar Spondylolysis: A Single-Center Retrospective Study.

Publisher: Wiley on behalf of the Chinese Orthopedic Association Country of Publication: Australia NLM ID: 101501666 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1757-7861 (Electronic) Linking ISSN: 17577853 NLM ISO Abbreviation: Orthop Surg Subsets: MEDLINE

Publication: 2013- : Richmond, Vic. Wiley on behalf of the Chinese Orthopedic Association
Original Publication: Richmond, Vic. : Tianjin : Blackwell Pub. Asia ; Tianjin Hospital, 2009-

Robotic Surgical Procedures*/methods ; Lumbar Vertebrae*/surgery ; Bone Transplantation*/methods ; Spondylolysis*/surgery ; Endoscopy*/methods; Humans ; Retrospective Studies ; Male ; Female ; Middle Aged ; Adult ; Minimally Invasive Surgical Procedures/methods ; Pedicle Screws ; Aged ; Bone Screws

Objective: Spondylolysis, often progressing to spondylolisthesis, commonly defies conservative treatment in refractory cases, indicating a need for surgery. Robot-assisted techniques may provide a stable and effective minimally invasive approach for the treatment of lumbar spondylolysis. To compare the clinical efficacy between robot-assisted percutaneous screw fixation combined with endoscopic bone graft and conventional open screw fixation with bone graft in the treatment of lumbar spondylolysis.
Methods: A cohort study involving 43 individuals with lumbar spondylolysis who underwent surgical treatment was conducted. From January 2022 to June 2023, 20 patients underwent percutaneous screw fixation combined with endoscopic bone graft while 23 patients underwent conventional open screw fixation with bone graft. The demographic data, parameters related to robotic surgery, perioperative indicators, VAS and ODI scores, pedicle screw accuracy, radiographic fusion outcomes, and follow-up results were systematically recorded, analyzed, and then compared between the two groups. Categorical variables were analyzed using chi-square tests, and continuous variables were evaluated with t-tests or Mann-Whitney U tests following normality assessment, with statistical significance at p < 0.05.
Results: Compared with the conventional surgery group, the robot-assisted surgery group had significantly less intraoperative blood loss, less postoperative drainage, shorter hospital stay, less intraoperative fluoroscopy times, and radiation exposure dose (p < 0.05). Nevertheless, the duration of the surgery was longer. Postoperative imaging findings showed high screw accuracy in both groups, with a grade A rate of 95% in the robot-assisted group compared with 91.4% in the conventional open surgery group according to the Gertzbein-Robbins scale. Both groups achieved similar improvements in VAS and ODI during 1-year follow-up, and both groups achieved good bone graft fusion (97.5% fusion rate in the robot-assisted group versus 93.5% in the conventional open surgery group).
Conclusion: Robot-assisted screw fixation combined with endoscopic bone graft provides a safe and reliable minimally invasive treatment of lumbar spondylolysis, with high accuracy of pedicle screw implantation and less radiation exposure dose, less intraoperative trauma, and quicker recovery than conventional open surgery.
(© 2025 The Author(s). Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.)

Clin Spine Surg. 2021 Oct 1;34(8):E466-E476. (PMID: 34050044)
J Am Acad Orthop Surg. 2006 Aug;14(8):488-98. (PMID: 16885480)
J Bone Joint Surg Br. 1992 May;74(3):426-30. (PMID: 1587895)
Chin Med J (Engl). 2017 Nov 5;130(21):2527-2534. (PMID: 29067950)
Orthop Surg. 2021 Oct;13(7):1960-1968. (PMID: 34516712)
J Spinal Disord Tech. 2012 Jul;25(5):241-8. (PMID: 21602728)
J Orthop Translat. 2019 Sep 16;20:73-79. (PMID: 31908936)
Orthop Surg. 2019 Jun;11(3):373-379. (PMID: 31124300)
J Bone Joint Surg Br. 2011 Oct;93(10):1296-9. (PMID: 21969424)
J Am Acad Orthop Surg. 2006 Jul;14(7):417-24. (PMID: 16822889)
J Hand Surg Am. 2022 Dec;47(12):1172-1179. (PMID: 36253198)
Acta Neurochir (Wien). 2024 Feb 2;166(1):58. (PMID: 38302625)
Spine (Phila Pa 1976). 2003 May 15;28(10):1027-35; discussion 1035. (PMID: 12768144)
J Am Board Fam Med. 2022 Dec 23;35(6):1204-1216. (PMID: 36526328)
Orthop Surg. 2022 Nov;14(11):2955-2963. (PMID: 36177873)
Int Orthop. 2009 Oct;33(5):1335-40. (PMID: 18679680)
Am J Sports Med. 1996 Jan-Feb;24(1):94-8. (PMID: 8638762)
Orthopedics. 2005 Nov;28(11):1331-3. (PMID: 16295191)
Spine (Phila Pa 1976). 1990 Jan;15(1):11-4. (PMID: 2326693)
J Bone Joint Surg Am. 1997 Jun;79(6):818-25. (PMID: 9199377)
Orthop Surg. 2024 Feb;16(2):401-411. (PMID: 38151861)

2017B010110012 Science and Technology Planning Project of Guangdong Province; 82172492 National Natural Science Foundation of China

Keywords: lumbar spondylolysis; minimally invasive surgery; pedicle screw; robot‐assisted surgery; spinal endoscopy

Date Created: 20250210 Date Completed: 20250402 Latest Revision: 20250404

20250407

PMC11962271

10.1111/os.14368

39924766