A tale of two robots: Operating times and learning curves in robot-assisted lumbar fusion

•MIS-TLIF (minimally invasive transforaminal lumbar interbody fusion) is a spinal operation used to treat one of the largest contributors to disability-adjusted life years in Australia – lower back pain and its neurologic sequelae.•The MIS technique has many advantages over the open technique, but a notable disadvantage is the vast amount of fluoroscopic radiation involved.•Robot assistance can reduce the radiation load but is difficult to incorporate into surgical workflow and can increase the operation duration.•This study investigates the operating times and learning curves in MIS-TLIF when using the Mazor Renaissance® CT to Fluoro Merge, Mazor Renaissance® Scan and Plan, and ROSA® robotic systems.•This study included 40 patients for data analysis, from one centre in the Western Sydney Local Health District, Sydney, Australia.•Primary time endpoints analysed were patient draping to final K-wire time (normalised for a single level operation), and average time per K-wire insertion.•ROSA® was found to increase both operating time endpoints significantly when compared to a similar Mazor Renaissance® system. The freehand technique was found to be quicker than the Mazor Renaissance® system.•ROSA® had a more difficult learning curve than the Mazor Renaissance® systems.•This data is crucial in informing spinal surgeons about which robotic software they can implement in their workflow, by comparing their performances and ease of learning.•A low sample size, single centre study, and high variability of data especially for ROSA® show that more and larger studies are needed in this rapidly developing field.