Learning curves for robotic-assisted spine surgery: an analysis of the time taken for screw insertion, robot setting, registration, and fluoroscopy

PurposeThe purpose of this study was to clarify the learning curve for robotic-assisted spine surgery. We analyzed the workflow in robotic-assisted spine surgery and investigated how much experience is required to become proficient in robotic-assisted spine surgery.MethodsThe data were obtained from consecutive 125 patients who underwent robotic-assisted screw placement soon after introducing a spine robotic system at a single center from April 2021 to January 2023. The 125 cases were divided into phases 1-5 of sequential groups of 25 cases each and compared for screw insertion time, robot setting time, registration time, and fluoroscopy time.ResultsThere were no significant differences in age, body mass index, intraoperative blood loss, number of fused segments, operation time, or operation time per segment between the 5 phases. There were significant differences in screw insertion time, robot setting time, registration time, and fluoroscopy time between the 5 phases. The screw insertion time, robot setting time, registration time, and fluoroscopy time in phase 1 were significantly longer than those in phases 2, 3, 4, and 5.ConclusionIn an analysis of 125 cases after the introduction of the spine robotic system, the screw insertion time, robot setting time, registration time, and fluoroscopy time were significantly longer in the 25 cases in the period initially after introduction. The times were not significantly different in the subsequent 100 cases. Surgeons can be proficient in robotic-assisted spine surgery after their experience with 25 cases.