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However, its widespread adoption remains limited by the need for a substantial upfront investment. In this study, the economic impact of spinal procedures performed under the guidance of the Mazor\u2122 robotic system was compared with that of conventional techniques from an advanced Spanish hospital perspective. A 10-year budget impact analysis was conducted. The target population included all spinal surgeries potentially suitable for robot assistance, estimated from published data and expert input. Two scenarios were compared: a baseline scenario without Mazor\u2122 and a progressive Mazor\u2122 adoption scenario. Unit costs (\u20ac, 2025), obtained from Spanish sources, were applied to components of health care resource consumption. Model inputs and assumptions were validated by a panel of Spanish experts. A deterministic one-way sensitivity analysis (OWSA) was performed to assess the robustness of the results. The number of RASS-eligible patients increased from 213 to 330 annually over 10 years (2,673 total). The mean cost per patient was \u20ac10,093 for conventional surgery and \u20ac9,082 for RASS, generating average savings of \u20ac1,011 per patient. Savings were driven mainly by reductions in the length of hospital stay (\u20ac1,523), revision surgeries (\u20ac793), and complications (\u20ac261), outweighing the Mazor\u2122 acquisition cost. Over the 10-year horizon, cumulative savings reached \u20ac2.54 million, achieving full capital investment recovery within 3.83 years. OWSA confirmed the robustness of these findings. From an advanced Spanish hospital perspective, the initial investment in RASS is recouped within four years, supporting its financial sustainability and long-term economic advantage over conventional spinal surgery.<\/jats:p>","DOI":"10.1007\/s11701-026-03315-7","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T02:50:37Z","timestamp":1777863037000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Budget impact analysis of robot-assisted versus conventional spine surgery in Spain"],"prefix":"10.1007","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4675-6818","authenticated-orcid":false,"given":"Rub\u00e9n","family":"Mart\u00edn L\u00e1ez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"\u00c1lvarez-Sala Walther","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julen","family":"Monje","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1668-6978","authenticated-orcid":false,"given":"Mar\u00eda","family":"\u00c1lvarez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8930-2103","authenticated-orcid":false,"given":"Mehdi","family":"Zahra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0509-8717","authenticated-orcid":false,"given":"Sof\u00eda","family":"De Pedro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0111-8661","authenticated-orcid":false,"given":"Paula","family":"Castro Albarr\u00e1n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8743-6653","authenticated-orcid":false,"given":"Miguel \u00c1ngel","family":"Casado","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3321-983X","authenticated-orcid":false,"given":"Jos\u00e9 A.","family":"Fern\u00e1ndez Al\u00e9n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"3315_CR1","unstructured":"Spinal Implants - Market Insights - Europe | Clarivate [Internet]. 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M.Z is employee of Medtronic International Trading Sarl. SdP, PCA and MAC are employees of Pharmacoeconomics & Outcomes Research Iberia (PORIB) a consultant company specialized on evaluation and assessment of health care interventions, which has received financial support from Medtronic Ib\u00e9rica, S.A. to develop the project. RML, FASW and JAFA declare no conflict of interest.The authors hereby declare that this economic support has not interfered with development of this project. The authors state that the sponsor did not participate or influence analysis of the present study or interpretations of its results. The authors have no other relevantaffiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This study was sponsored by Medtronic Ib\u00e9rica, S.A.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Research Funding"}}],"article-number":"477"}}