title: Robotic assisted surgeries for the treatment of spine tumors.
abstract: BACKGROUND
  Surgery plays an important role in the treatment of patients with metastatic or primary spine tumors. In recent years, various new techniques, such as robotic assisted spine surgery have been developed which has shown some promising results by improving the accuracy of spinal instrumentation and reducing potential complications. The purpose of this study was to evaluate our early experience using robotic guidance in the treatment of spinal tumors.
  
  
  METHODS
  Data were collected from medical records for each surgery in which the robotic system was used to assist with biopsy, pedicle screw placement and/or vertebral augmentation in the treatment of spinal tumors. Patient's age, gender, diagnosis and surgical procedure were documented. The surgical time, estimated blood loss, peri-operative and post-operative complications were obtained. The visual analog scale (VAS) for back pain and leg pain were also recorded.
  
  
  RESULTS
  A total of 9 consecutive patients (7 female, 2 male) were included in this study, beginning with the first case experience. The mean age of the patients was 60 years (range 47-69). All patients presented with thoracic or lumbar vertebral collapse and/or myelopathy. Robotic assisted posterior instrumentation was successfully performed in all patients. Robotic assisted vertebral augmentation was performed in 4 patients. The average number of levels instrumented was 5. The average surgery time (skin to skin) was 4 hours and 24 minutes and the mean blood loss was 319 ml. There were no complications perioperatively or through the latest follow-up. Seven of the 9 patients reported improved back pain and/or leg pain at the latest follow-up and the data were not available in two patients.
  
  
  CONCLUSIONS
  The published complication rates of spinal tumor surgeries range between 5.3% and 19%. With robotic assistance, the surgical complication rate appears improved over the historical figures. Our study shows that the robotic system was safe and performed as desired in the treatment of metastatic and primary spine tumors. These results support that further evaluation in a larger series of patients.
authors.affiliation: Scoliosis and Spine Tumor Center, Texas Back Institute, Texas Health Presbyterian Hospital Plano, Plano, TX.
authors.forename: Xiaobang
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Orthpaedic Surgery, Wexner medical center/James Cancer Hospital, The Ohio State University, Columbus, OH.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Scharschmidt
authors.affiliation: Texas Back Institute Research Foundation, Plano, TX.
authors.forename: Donna D
authors.initials: DD
authors.lastname: Ohnmeiss
authors.affiliation: Scoliosis and Spine Tumor Center, Texas Back Institute, Texas Health Presbyterian Hospital Plano, Plano, TX.
authors.forename: Isador H
authors.initials: IH
authors.lastname: Lieberman
keywords: Spine tumor; augmentation; instrumentation; robotic-assisted