{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T01:26:56Z","timestamp":1769909216620,"version":"3.49.0"},"reference-count":3,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T00:00:00Z","timestamp":1720396800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T00:00:00Z","timestamp":1720396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Robotic Surg"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Eighty consecutive complex spinal robotic cases utilizing intraoperative 3D CT imaging (E3D, Group 2) were compared to 80 age-matched controls using the Excelsius robot alone with C-arm Fluoroscopic registration (Robot Only, Group 1). The demographics between the two groups were similar\u2014severity of deformity, ASA Score for general anesthesia, patient age, gender, number of spinal levels instrumented, number of patients with prior spinal surgery, and amount of neurologic compression. The intraoperative CT scanning added several objective factors improving patient safety. There were significantly fewer complications in the E3D group with only 3 of 80 (4%) patients requiring a return to the operating room compared to 11 of 80 (14%) patients in the Robot Only Group requiring repeat surgery for implant related problems (Chi squared analysis\u2009=\u20095.00, <jats:italic>p<\/jats:italic>\u2009=\u20090.025). There was a significant reduction the amount of fluoroscopy time in the E3D Group (36\u00a0s, range 4\u2013102\u00a0s) compared to Robot only group (51\u00a0s, range 15\u2013160\u00a0s) (<jats:italic>p<\/jats:italic>\u2009=\u20090.0001). There was also shorter mean operative time in the E3D group (257\u2009\u00b1\u200959.5\u00a0min) compared to the robot only group (306\u2009\u00b1\u200973.8\u00a0min) due to much faster registration time (45\u00a0s). A longer registration time was required in the Robot only group to register each vertebral level with AP and Lateral fluoroscopy shots. The estimated blood loss was also significantly lower in Group 2 (mean 345\u2009\u00b1\u2009225\u00a0ml) vs Group 1 (474\u2009\u00b1\u2009397\u00a0ml) (<jats:italic>p<\/jats:italic>\u2009=\u20090.012). The mean hospital length of stay was also significantly shorter for Group 2 (3.77\u2009\u00b1\u20091.86\u00a0days) compared to Group 1 (5.16\u2009\u00b1\u20093.40) (<jats:italic>p<\/jats:italic>\u2009=\u20090.022). There was no significant difference in the number of interbody implants nor corrective osteotomies in both groups\u2014Robot only 52 cases vs. 42 cases in E3D group.<\/jats:p><jats:p><jats:italic>Level of evidence<\/jats:italic>: IV, Retrospective review.<\/jats:p>","DOI":"10.1007\/s11701-024-02014-5","type":"journal-article","created":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T02:01:46Z","timestamp":1720404106000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The contribution of E3D imaging integrated with robotic navigation: analysis of the first 80 consecutive posterior spinal fusion cases"],"prefix":"10.1007","volume":"18","author":[{"given":"Jeffrey J.","family":"Stewart","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Asdourian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley","family":"Moatz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mosope","family":"Soda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mesfin","family":"Lemma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan W.","family":"Cunningham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daina M.","family":"Brooks","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3033-5464","authenticated-orcid":false,"given":"Paul C.","family":"McAfee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,7,8]]},"reference":[{"issue":"6","key":"2014_CR1","doi-asserted-by":"publisher","first-page":"2749","DOI":"10.1007\/s11701-023-01707-7","volume":"17","author":"B McCormick","year":"2023","unstructured":"McCormick B, Asdourian P, Johnson D, Moatz B, Duvall G, Soda M, Beaufort A, Chotikul L, McAfee PC (2023) 100 Complex posterior spinal fusion cases performed with robotic instrumentation. J Robot Surg 17(6):2749\u20132756. https:\/\/doi.org\/10.1007\/s11701-023-01707-7","journal-title":"J Robot Surg"},{"key":"2014_CR2","unstructured":"Guidance document for preparation of IDA for spinal systems\u2014guidance for industry and\/or FDA staff (January 2000) Section 9.1. FDA-2020-D-0957. https:\/\/www.fda.gov\/regulatory-information\/search-fda-guidance-documents\/guidance-document-preparation-ides-spinal-systems-guidance-industry-andor-fda-staff#_Toc472296074"},{"issue":"3","key":"2014_CR3","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1007\/s10143-015-0679-2","volume":"39","author":"XT Meng","year":"2016","unstructured":"Meng XT, Guan XF, Zhang HL, He SS (2016) Computer navigation versus fluoroscopy-guided navigation for thoracic pedicle screw placement: a meta-analysis. Neurosurg Rev 39(3):385\u2013391. https:\/\/doi.org\/10.1007\/s10143-015-0679-2","journal-title":"Neurosurg Rev"}],"container-title":["Journal of Robotic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11701-024-02014-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11701-024-02014-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11701-024-02014-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T13:06:39Z","timestamp":1735045599000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11701-024-02014-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,8]]},"references-count":3,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["2014"],"URL":"https:\/\/doi.org\/10.1007\/s11701-024-02014-5","relation":{},"ISSN":["1863-2491"],"issn-type":[{"value":"1863-2491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,8]]},"assertion":[{"value":"4 May 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Author P.M. discloses that he is on the Globus Medical Board of Directors and receives royalties from Globus Medical. Author P.A. discloses that he received royalties from Globus Medical. All other authors have no relevant financial interests to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This is an observational retrospective study. The MedStar IRB has confirmed that no further ethical or regulatory approval is required.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"282"}}