{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T20:00:35Z","timestamp":1772827235617,"version":"3.50.1"},"reference-count":66,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,17]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The implementation of robotics and spinal anesthesia (SA) in spine surgery is rapidly expanding, offering significant benefits for an increasingly complex and aging patient population with degenerative spinal disease. Here, the authors present the largest cohort to date evaluating the combined use of these two techniques in minimally invasive (MIS) transforaminal lumbar interbody fusion (TLIF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors retrospectively analyzed surgical outcomes of a series of patients who underwent robot-assisted (RA)\u2013MIS TLIF under SA and general anesthesia (GA) at their institution from 2018 to 2024. Primary outcomes included operative times and postoperative pain intensity. Secondary outcomes included estimated blood loss, intraoperative complications, postoperative functional status, length of stay (LOS), and discharge status. To address potential confounders, a 1:1 propensity score\u2013matching and regression analysis was implemented. Statistical analyses were conducted using Python.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 209 patients underwent RA-MIS TLIF, with 31 (14.83%) receiving SA and 178 (85.17%) GA. After propensity score matching, the SA cohort demonstrated significantly shorter median total operating room (OR) time, total procedure time, time from entering the OR to skin incision, and time from closure to leaving the OR (all p &lt; 0.01). Additionally, postoperative pain scores were significantly lower (p &lt; 0.01), and LOS was significantly shorter (p &lt; 0.01) in the SA cohort. Regression analysis, adjusting for potential confounders, further supported these findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>RA-MIS TLIF fusion under SA is a safe and effective approach that significantly reduces operative time, postoperative pain, and hospital LOS in patients undergoing surgery for degenerative lumbar spine disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.6.spine25442","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T20:52:47Z","timestamp":1763412767000},"page":"99-107","source":"Crossref","is-referenced-by-count":0,"title":["Spinal versus general anesthesia in robotic minimally invasive transforaminal lumbar interbody fusion: a comparative study on surgical outcomes"],"prefix":"10.3171","volume":"44","author":[{"given":"Juan P.","family":"Navarro-Garcia de Llano","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Rios-Zermeno","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew P.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harshvardhan G.","family":"Iyer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesus E.","family":"Sanchez-Garavito","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Safa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Martin del Campo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Graepel","sequence":"additional","affiliation":[{"name":"Division of Biomedical and Scientific Visualization, Department of Education, Mayo Clinic, Rochester, Minnesota; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer S.","family":"Patterson","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Mayo Clinic, Jacksonville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate E.","family":"White","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Mayo Clinic, Jacksonville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elird","family":"Bojaxhi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Mayo Clinic, Jacksonville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo","family":"Navarro-Ramirez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo","family":"Qui\u00f1ones-Hinojosa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oluwaseun O.","family":"Akinduro","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian A.","family":"Buchanan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Selby G.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kingsley","family":"Abode-Iyamah","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"Ann Transl Med","first-page":"299","article-title":"Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017","volume":"8","author":"Wu A","year":"2020","unstructured":"Wu A, March L, Zheng X,  Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Ann Transl Med. 2020;8(6):299."},{"issue":"1","key":"b2","series-title":"Sci Rep","first-page":"5389","article-title":"Prevalence of spine degeneration diagnosis by type, age, gender, and obesity using Medicare data","volume":"11","author":"Parenteau CS","year":"2021","unstructured":"Parenteau CS, Lau EC, Campbell IC, Courtney A. Prevalence of spine degeneration diagnosis by type, age, gender, and obesity using Medicare data. Sci Rep. 2021;11(1):5389."},{"key":"b3","article-title":"U.S. older population grew from 2010 to 2020 at fastest rate since 1880 to 1890","author":"Caplan Z","year":"2023","unstructured":"Caplan Z. U.S. older population grew from 2010 to 2020 at fastest rate since 1880 to 1890. May 25, 2023.Accessed July 7, 2025. https:\/\/www.census.gov\/library\/stories\/2023\/05\/2020-census-united-states-older-population-grew.html"},{"issue":"1","key":"b4","series-title":"Ochsner J. Spring","first-page":"32","article-title":"Minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis grades 1-2: patient-reported clinical outcomes and cost-utility analysis","volume":"14","author":"Sulaiman WA","year":"2014","unstructured":"Sulaiman WA, Singh M. Minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis grades 1-2: patient-reported clinical outcomes and cost-utility analysis. Ochsner J. Spring. 2014;14(1):32\u201337."},{"issue":"1","key":"b5","series-title":"Neurosurg Focus","first-page":"E2","article-title":"Minimally invasive versus open transforaminal lumbar interbody fusion for grade I lumbar spondylolisthesis: 5-year follow-up from the prospective multicenter Quality Outcomes Database registry","volume":"54","author":"Chan AK","year":"2023","unstructured":"Chan AK, Bydon M, Bisson EF,  Minimally invasive versus open transforaminal lumbar interbody fusion for grade I lumbar spondylolisthesis: 5-year follow-up from the prospective multicenter Quality Outcomes Database registry. Neurosurg Focus. 2023;54(1):E2."},{"issue":"6","key":"b6","series-title":"Neurosurg Focus","first-page":"E3","article-title":"Spinal versus general anesthesia for minimally invasive transforaminal lumbar interbody fusion: implications on operating room time, pain, and ambulation","volume":"51","author":"De Biase G","year":"2021","unstructured":"De Biase G, Gruenbaum SE, West JL,  Spinal versus general anesthesia for minimally invasive transforaminal lumbar interbody fusion: implications on operating room time, pain, and ambulation. Neurosurg Focus. 2021;51(6):E3."},{"issue":"6","key":"b7","series-title":"Neurosurg Focus","first-page":"E4","article-title":"Single-level awake transforaminal lumbar interbody fusion: a Mayo Clinic institutional experience and national analysis","volume":"51","author":"Abode-Iyamah K","year":"2021","unstructured":"Abode-Iyamah K, Ghaith AK, Bhandarkar AR,  Single-level awake transforaminal lumbar interbody fusion: a Mayo Clinic institutional experience and national analysis. Neurosurg Focus. 2021;51(6):E4."},{"issue":"5","key":"b8","series-title":"J Clin Orthop Trauma","first-page":"749","article-title":"Awake spinal fusion","volume":"11","author":"Garg B","year":"2020","unstructured":"Garg B, Ahuja K, Sharan AD. Awake spinal fusion. J Clin Orthop Trauma. 2020;11(5):749\u2013752."},{"issue":"Suppl 3","key":"b9","series-title":"Surg Neurol Int","first-page":"S83","article-title":"More nerve root injuries occur with minimally invasive lumbar surgery, especially extreme lateral interbody fusion: a review","volume":"7","author":"Epstein NE","year":"2016","unstructured":"Epstein NE. More nerve root injuries occur with minimally invasive lumbar surgery, especially extreme lateral interbody fusion: a review. Surg Neurol Int. 2016;7(Suppl 3):S83-S95."},{"issue":"Suppl 1","key":"b10","series-title":"J Pediatr Orthop","first-page":"S80","article-title":"Screw malposition: are there long-term repercussions to malposition of pedicle screws?","volume":"41","author":"Amaral TD","year":"2021","unstructured":"Amaral TD, Hasan S, Galina J, Sarwahi V. Screw malposition: are there long-term repercussions to malposition of pedicle screws?. J Pediatr Orthop. 2021;41(Suppl 1):S80-S86."},{"key":"b11","series-title":"World Neurosurg","first-page":"123478","article-title":"Awake minimally invasive surgery transforaminal lumbar interbody fusion under spinal anesthesia: screw placement accuracy and 1 year follow-up","volume":"194","author":"De Biase G","year":"2025","unstructured":"De Biase G, Gruenbaum BF, Bojaxhi E,  Awake minimally invasive surgery transforaminal lumbar interbody fusion under spinal anesthesia: screw placement accuracy and 1 year follow-up. World Neurosurg. 2025;194:123478."},{"issue":"Suppl 1","key":"b12","series-title":"Neurosurgery","first-page":"12","article-title":"Spinal robotics: current applications and future perspectives","volume":"72","author":"Roser F","year":"2013","unstructured":"Roser F, Tatagiba M, Maier G. Spinal robotics: current applications and future perspectives. Neurosurgery. 2013;72 Suppl 1:12\u201318."},{"issue":"10","key":"b13","series-title":"Clin Spine Surg","first-page":"431","article-title":"Decreasing the pedicle screw misplacement rate in the thoracic spine with robot-guided navigation","volume":"36","author":"Vardiman AB","year":"2023","unstructured":"Vardiman AB, Wallace DJ, Booher GA, Toossi N, Bucklen BS. Decreasing the pedicle screw misplacement rate in the thoracic spine with robot-guided navigation. Clin Spine Surg. 2023;36(10):431\u2013437."},{"key":"b14","series-title":"Front Surg","first-page":"578674","article-title":"Robotics in spine surgery: a technical overview and review of key concepts","volume":"8","author":"Farber SH","year":"2021","unstructured":"Farber SH, Pacult MA, Godzik J,  Robotics in spine surgery: a technical overview and review of key concepts. Front Surg. 2021;8:578674."},{"issue":"6","key":"b15","series-title":"Front Med","first-page":"723","article-title":"New spinal robotic technologies","volume":"13","author":"Jiang B","year":"2019","unstructured":"Jiang B, Azad TD, Cottrill E,  New spinal robotic technologies. Front Med. 2019;13(6):723\u2013729."},{"key":"b16","series-title":"World Neurosurg","first-page":"e745","article-title":"Robot-assisted versus fluoroscopy-assisted cortical bone trajectory screw instrumentation in lumbar spinal surgery: a matched-cohort comparison","volume":"120","author":"Le X","year":"2018","unstructured":"Le X, Tian W, Shi Z,  Robot-assisted versus fluoroscopy-assisted cortical bone trajectory screw instrumentation in lumbar spinal surgery: a matched-cohort comparison. World Neurosurg. 2018;120:e745\u2013e751."},{"issue":"21","key":"b17","series-title":"Chin Med J (Engl)","first-page":"2527","article-title":"Percutaneous sacroiliac screw placement: a prospective randomized comparison of robot-assisted navigation procedures with a conventional technique","volume":"130","author":"Wang J-Q","year":"2017","unstructured":"Wang J-Q, Wang Y, Feng Y,  Percutaneous sacroiliac screw placement: a prospective randomized comparison of robot-assisted navigation procedures with a conventional technique. Chin Med J (Engl). 2017;130(21):2527\u20132534."},{"key":"b18","series-title":"Clin Neurol Neurosurg","first-page":"106313","article-title":"Awake minimally invasive transforaminal lumbar interbody fusion with a pedicle-based retraction system","volume":"200","author":"De Biase G","year":"2021","unstructured":"De Biase G, Bechtle P, Leone B, Quinones-Hinojosa A, Abode-Iyamah K. Awake minimally invasive transforaminal lumbar interbody fusion with a pedicle-based retraction system. Clin Neurol Neurosurg. 2021;200:106313."},{"key":"b19","series-title":"World Neurosurg","first-page":"e941","article-title":"Awake robotic minimally invasive transforaminal lumbar interbody fusion under spinal anesthesia: a prospective study with 1-year follow-up","volume":"189","author":"De Biase G","year":"2024","unstructured":"De Biase G, Akinduro OO, Garcia D,  Awake robotic minimally invasive transforaminal lumbar interbody fusion under spinal anesthesia: a prospective study with 1-year follow-up. World Neurosurg. 2024;189:e941\u2013e947."},{"issue":"2","key":"b20","series-title":"Neurosurgery","first-page":"192","article-title":"Robotic-assisted vs nonrobotic-assisted minimally invasive transforaminal lumbar interbody fusion: a cost-utility analysis","volume":"90","author":"Garcia D","year":"2022","unstructured":"Garcia D, Akinduro OO, De Biase G,  Robotic-assisted vs nonrobotic-assisted minimally invasive transforaminal lumbar interbody fusion: a cost-utility analysis. Neurosurgery. 2022;90(2):192\u2013198."},{"key":"b21","series-title":"World Neurosurg","first-page":"e570","article-title":"Perioperative comparison of robotic-assisted versus fluoroscopically guided minimally invasive transforaminal lumbar interbody fusion","volume":"149","author":"De Biase G","year":"2021","unstructured":"De Biase G, Gassie K, Garcia D,  Perioperative comparison of robotic-assisted versus fluoroscopically guided minimally invasive transforaminal lumbar interbody fusion. World Neurosurg. 2021;149:e570\u2013e575."},{"issue":"3","key":"b22","series-title":"Int J Med Robot","first-page":"e1892","article-title":"Robot-assisted vs freehand pedicle screw fixation in spine surgery\u2014a systematic review and a meta-analysis of comparative studies","volume":"14","author":"Yu L","year":"2018","unstructured":"Yu L, Chen X, Margalit A, Peng H, Qiu G, Qian W. Robot-assisted vs freehand pedicle screw fixation in spine surgery\u2014a systematic review and a meta-analysis of comparative studies. Int J Med Robot. 2018;14(3):e1892."},{"issue":"3","key":"b23","series-title":"Neurospine","first-page":"216","article-title":"A cost-effectiveness analysis of the integration of robotic spine technology in spine surgery","volume":"15","author":"Menger RP","year":"2018","unstructured":"Menger RP, Savardekar AR, Farokhi F, Sin A. A cost-effectiveness analysis of the integration of robotic spine technology in spine surgery. Neurospine. 2018;15(3):216\u2013224."},{"issue":"6","key":"b24","series-title":"Oper Neurosurg (Hagerstown)","first-page":"855","article-title":"Spinal anesthesia for multilevel awake minimally invasive transforaminal lumbar interbody fusion: single-center experience","volume":"28","author":"Navarro-Garcia de Llano JP","year":"2025","unstructured":"Navarro-Garcia de Llano JP, Fuentes-Fernandez Cueto M, Roberts AP,  Spinal anesthesia for multilevel awake minimally invasive transforaminal lumbar interbody fusion: single-center experience. Oper Neurosurg (Hagerstown). 2025;28(6):855\u2013861."},{"issue":"4","key":"b25","series-title":"J Neurosurg Spine","first-page":"435","article-title":"Awake, endoscopic lumbar interbody spinal fusion: 10 years of experience with the first 400 cases","volume":"42","author":"Wang MY","year":"2025","unstructured":"Wang MY, Grossman J. Awake, endoscopic lumbar interbody spinal fusion: 10 years of experience with the first 400 cases. J Neurosurg Spine. 2025;42(4):435\u2013442."},{"issue":"3","key":"b26","series-title":"Neurochirurgie","first-page":"101444","article-title":"Awake spinal anesthesia facilitates spine surgery in poor surgical candidates: a case series","volume":"69","author":"Sykes DAW","year":"2023","unstructured":"Sykes DAW, Tabarestani TQ, Salven DS,  Awake spinal anesthesia facilitates spine surgery in poor surgical candidates: a case series. Neurochirurgie. 2023;69(3):101444."},{"issue":"6","key":"b27","series-title":"Neurosurg Focus","first-page":"E2","article-title":"Awake spinal surgery: simplifying the learning curve with a patient selection algorithm","volume":"51","author":"Letchuman V","year":"2021","unstructured":"Letchuman V, Agarwal N, Mummaneni VP,  Awake spinal surgery: simplifying the learning curve with a patient selection algorithm. Neurosurg Focus. 2021;51(6):E2."},{"issue":"5","key":"b28","series-title":"Anesth Analg","first-page":"1733","article-title":"Chronic opioid use after surgery: implications for perioperative management in the face of the opioid epidemic","volume":"125","author":"Hah JM","year":"2017","unstructured":"Hah JM, Bateman BT, Ratliff J, Curtin C, Sun E. Chronic opioid use after surgery: implications for perioperative management in the face of the opioid epidemic. Anesth Analg. 2017;125(5):1733\u20131740."},{"issue":"4","key":"b29","series-title":"J Orthop Sci","first-page":"933","article-title":"Safety of robotic-assisted screw placement for spine surgery: experience from the initial 125 cases","volume":"29","author":"Akazawa T","year":"2024","unstructured":"Akazawa T, Torii Y, Ueno J,  Safety of robotic-assisted screw placement for spine surgery: experience from the initial 125 cases. J Orthop Sci. 2024;29(4):933\u2013938."},{"issue":"1","key":"b30","series-title":"Sci Rep","first-page":"10881","article-title":"Feasibility and safety report on robotic assistance for cervical pedicle screw fixation: a cadaveric study","volume":"14","author":"Ryu S","year":"2024","unstructured":"Ryu S, Ha B-J, Yoon S,  Feasibility and safety report on robotic assistance for cervical pedicle screw fixation: a cadaveric study. Sci Rep. 2024;14(1):10881."},{"issue":"1","key":"b31","series-title":"BMC Musculoskelet Disord","first-page":"328","article-title":"Accuracy and safety of robot-assisted cortical bone trajectory screw placement: a comparison of robot-assisted technique with fluoroscopy-assisted approach","volume":"23","author":"Li Y","year":"2022","unstructured":"Li Y, Chen L, Liu Y,  Accuracy and safety of robot-assisted cortical bone trajectory screw placement: a comparison of robot-assisted technique with fluoroscopy-assisted approach. BMC Musculoskelet Disord. 2022;23(1):328."},{"issue":"5","key":"b32","series-title":"J Neurosurg Spine","first-page":"841","article-title":"Ninety-day complication, revision, and readmission rates for current-generation robot-assisted thoracolumbar spinal fusion surgery: results of a multicenter case series","volume":"36","author":"Liounakos JI","year":"2022","unstructured":"Liounakos JI, Khan A, Eliahu K,  Ninety-day complication, revision, and readmission rates for current-generation robot-assisted thoracolumbar spinal fusion surgery: results of a multicenter case series. J Neurosurg Spine. 2022;36(5):841\u2013848."},{"issue":"17","key":"b33","series-title":"J Clin Med","first-page":"4989","article-title":"Robot-assisted pedicle screw placement led to lower screw loosening rate than fluoroscopy-guided technique in transforaminal lumbar interbody fusion for lumbar degenerative disease: a single-center retrospective study","volume":"11","author":"Lai YP","year":"2022","unstructured":"Lai YP, Lin YH, Wu YC,  Robot-assisted pedicle screw placement led to lower screw loosening rate than fluoroscopy-guided technique in transforaminal lumbar interbody fusion for lumbar degenerative disease: a single-center retrospective study. J Clin Med. 2022;11(17):4989."},{"issue":"6","key":"b1","series-title":"Ann Transl Med","first-page":"299","article-title":"Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017","volume":"8","author":"Wu A","year":"2020","unstructured":"Wu A, March L, Zheng X,  Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Ann Transl Med. 2020;8(6):299."},{"issue":"1","key":"b2","series-title":"Sci Rep","first-page":"5389","article-title":"Prevalence of spine degeneration diagnosis by type, age, gender, and obesity using Medicare data","volume":"11","author":"Parenteau CS","year":"2021","unstructured":"Parenteau CS, Lau EC, Campbell IC, Courtney A. Prevalence of spine degeneration diagnosis by type, age, gender, and obesity using Medicare data. Sci Rep. 2021;11(1):5389."},{"key":"b3","article-title":"U.S. older population grew from 2010 to 2020 at fastest rate since 1880 to 1890","author":"Caplan Z","year":"2023","unstructured":"Caplan Z. U.S. older population grew from 2010 to 2020 at fastest rate since 1880 to 1890. May 25, 2023.Accessed July 7, 2025. https:\/\/www.census.gov\/library\/stories\/2023\/05\/2020-census-united-states-older-population-grew.html"},{"issue":"1","key":"b4","series-title":"Ochsner J. Spring","first-page":"32","article-title":"Minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis grades 1-2: patient-reported clinical outcomes and cost-utility analysis","volume":"14","author":"Sulaiman WA","year":"2014","unstructured":"Sulaiman WA, Singh M. Minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis grades 1-2: patient-reported clinical outcomes and cost-utility analysis. Ochsner J. Spring. 2014;14(1):32\u201337."},{"issue":"1","key":"b5","series-title":"Neurosurg Focus","first-page":"E2","article-title":"Minimally invasive versus open transforaminal lumbar interbody fusion for grade I lumbar spondylolisthesis: 5-year follow-up from the prospective multicenter Quality Outcomes Database registry","volume":"54","author":"Chan AK","year":"2023","unstructured":"Chan AK, Bydon M, Bisson EF,  Minimally invasive versus open transforaminal lumbar interbody fusion for grade I lumbar spondylolisthesis: 5-year follow-up from the prospective multicenter Quality Outcomes Database registry. Neurosurg Focus. 2023;54(1):E2."},{"issue":"6","key":"b6","series-title":"Neurosurg Focus","first-page":"E3","article-title":"Spinal versus general anesthesia for minimally invasive transforaminal lumbar interbody fusion: implications on operating room time, pain, and ambulation","volume":"51","author":"De Biase G","year":"2021","unstructured":"De Biase G, Gruenbaum SE, West JL,  Spinal versus general anesthesia for minimally invasive transforaminal lumbar interbody fusion: implications on operating room time, pain, and ambulation. Neurosurg Focus. 2021;51(6):E3."},{"issue":"6","key":"b7","series-title":"Neurosurg Focus","first-page":"E4","article-title":"Single-level awake transforaminal lumbar interbody fusion: a Mayo Clinic institutional experience and national analysis","volume":"51","author":"Abode-Iyamah K","year":"2021","unstructured":"Abode-Iyamah K, Ghaith AK, Bhandarkar AR,  Single-level awake transforaminal lumbar interbody fusion: a Mayo Clinic institutional experience and national analysis. Neurosurg Focus. 2021;51(6):E4."},{"issue":"5","key":"b8","series-title":"J Clin Orthop Trauma","first-page":"749","article-title":"Awake spinal fusion","volume":"11","author":"Garg B","year":"2020","unstructured":"Garg B, Ahuja K, Sharan AD. Awake spinal fusion. J Clin Orthop Trauma. 2020;11(5):749\u2013752."},{"issue":"Suppl 3","key":"b9","series-title":"Surg Neurol Int","first-page":"S83","article-title":"More nerve root injuries occur with minimally invasive lumbar surgery, especially extreme lateral interbody fusion: a review","volume":"7","author":"Epstein NE","year":"2016","unstructured":"Epstein NE. More nerve root injuries occur with minimally invasive lumbar surgery, especially extreme lateral interbody fusion: a review. Surg Neurol Int. 2016;7(Suppl 3):S83-S95."},{"issue":"Suppl 1","key":"b10","series-title":"J Pediatr Orthop","first-page":"S80","article-title":"Screw malposition: are there long-term repercussions to malposition of pedicle screws?","volume":"41","author":"Amaral TD","year":"2021","unstructured":"Amaral TD, Hasan S, Galina J, Sarwahi V. Screw malposition: are there long-term repercussions to malposition of pedicle screws?. J Pediatr Orthop. 2021;41(Suppl 1):S80-S86."},{"key":"b11","series-title":"World Neurosurg","first-page":"123478","article-title":"Awake minimally invasive surgery transforaminal lumbar interbody fusion under spinal anesthesia: screw placement accuracy and 1 year follow-up","volume":"194","author":"De Biase G","year":"2025","unstructured":"De Biase G, Gruenbaum BF, Bojaxhi E,  Awake minimally invasive surgery transforaminal lumbar interbody fusion under spinal anesthesia: screw placement accuracy and 1 year follow-up. World Neurosurg. 2025;194:123478."},{"issue":"Suppl 1","key":"b12","series-title":"Neurosurgery","first-page":"12","article-title":"Spinal robotics: current applications and future perspectives","volume":"72","author":"Roser F","year":"2013","unstructured":"Roser F, Tatagiba M, Maier G. Spinal robotics: current applications and future perspectives. Neurosurgery. 2013;72 Suppl 1:12\u201318."},{"issue":"10","key":"b13","series-title":"Clin Spine Surg","first-page":"431","article-title":"Decreasing the pedicle screw misplacement rate in the thoracic spine with robot-guided navigation","volume":"36","author":"Vardiman AB","year":"2023","unstructured":"Vardiman AB, Wallace DJ, Booher GA, Toossi N, Bucklen BS. Decreasing the pedicle screw misplacement rate in the thoracic spine with robot-guided navigation. Clin Spine Surg. 2023;36(10):431\u2013437."},{"key":"b14","series-title":"Front Surg","first-page":"578674","article-title":"Robotics in spine surgery: a technical overview and review of key concepts","volume":"8","author":"Farber SH","year":"2021","unstructured":"Farber SH, Pacult MA, Godzik J,  Robotics in spine surgery: a technical overview and review of key concepts. Front Surg. 2021;8:578674."},{"issue":"6","key":"b15","series-title":"Front Med","first-page":"723","article-title":"New spinal robotic technologies","volume":"13","author":"Jiang B","year":"2019","unstructured":"Jiang B, Azad TD, Cottrill E,  New spinal robotic technologies. Front Med. 2019;13(6):723\u2013729."},{"key":"b16","series-title":"World Neurosurg","first-page":"e745","article-title":"Robot-assisted versus fluoroscopy-assisted cortical bone trajectory screw instrumentation in lumbar spinal surgery: a matched-cohort comparison","volume":"120","author":"Le X","year":"2018","unstructured":"Le X, Tian W, Shi Z,  Robot-assisted versus fluoroscopy-assisted cortical bone trajectory screw instrumentation in lumbar spinal surgery: a matched-cohort comparison. World Neurosurg. 2018;120:e745\u2013e751."},{"issue":"21","key":"b17","series-title":"Chin Med J (Engl)","first-page":"2527","article-title":"Percutaneous sacroiliac screw placement: a prospective randomized comparison of robot-assisted navigation procedures with a conventional technique","volume":"130","author":"Wang J-Q","year":"2017","unstructured":"Wang J-Q, Wang Y, Feng Y,  Percutaneous sacroiliac screw placement: a prospective randomized comparison of robot-assisted navigation procedures with a conventional technique. Chin Med J (Engl). 2017;130(21):2527\u20132534."},{"key":"b18","series-title":"Clin Neurol Neurosurg","first-page":"106313","article-title":"Awake minimally invasive transforaminal lumbar interbody fusion with a pedicle-based retraction system","volume":"200","author":"De Biase G","year":"2021","unstructured":"De Biase G, Bechtle P, Leone B, Quinones-Hinojosa A, Abode-Iyamah K. Awake minimally invasive transforaminal lumbar interbody fusion with a pedicle-based retraction system. Clin Neurol Neurosurg. 2021;200:106313."},{"key":"b19","series-title":"World Neurosurg","first-page":"e941","article-title":"Awake robotic minimally invasive transforaminal lumbar interbody fusion under spinal anesthesia: a prospective study with 1-year follow-up","volume":"189","author":"De Biase G","year":"2024","unstructured":"De Biase G, Akinduro OO, Garcia D,  Awake robotic minimally invasive transforaminal lumbar interbody fusion under spinal anesthesia: a prospective study with 1-year follow-up. World Neurosurg. 2024;189:e941\u2013e947."},{"issue":"2","key":"b20","series-title":"Neurosurgery","first-page":"192","article-title":"Robotic-assisted vs nonrobotic-assisted minimally invasive transforaminal lumbar interbody fusion: a cost-utility analysis","volume":"90","author":"Garcia D","year":"2022","unstructured":"Garcia D, Akinduro OO, De Biase G,  Robotic-assisted vs nonrobotic-assisted minimally invasive transforaminal lumbar interbody fusion: a cost-utility analysis. Neurosurgery. 2022;90(2):192\u2013198."},{"key":"b21","series-title":"World Neurosurg","first-page":"e570","article-title":"Perioperative comparison of robotic-assisted versus fluoroscopically guided minimally invasive transforaminal lumbar interbody fusion","volume":"149","author":"De Biase G","year":"2021","unstructured":"De Biase G, Gassie K, Garcia D,  Perioperative comparison of robotic-assisted versus fluoroscopically guided minimally invasive transforaminal lumbar interbody fusion. World Neurosurg. 2021;149:e570\u2013e575."},{"issue":"3","key":"b22","series-title":"Int J Med Robot","first-page":"e1892","article-title":"Robot-assisted vs freehand pedicle screw fixation in spine surgery\u2014a systematic review and a meta-analysis of comparative studies","volume":"14","author":"Yu L","year":"2018","unstructured":"Yu L, Chen X, Margalit A, Peng H, Qiu G, Qian W. Robot-assisted vs freehand pedicle screw fixation in spine surgery\u2014a systematic review and a meta-analysis of comparative studies. Int J Med Robot. 2018;14(3):e1892."},{"issue":"3","key":"b23","series-title":"Neurospine","first-page":"216","article-title":"A cost-effectiveness analysis of the integration of robotic spine technology in spine surgery","volume":"15","author":"Menger RP","year":"2018","unstructured":"Menger RP, Savardekar AR, Farokhi F, Sin A. A cost-effectiveness analysis of the integration of robotic spine technology in spine surgery. Neurospine. 2018;15(3):216\u2013224."},{"issue":"6","key":"b24","series-title":"Oper Neurosurg (Hagerstown)","first-page":"855","article-title":"Spinal anesthesia for multilevel awake minimally invasive transforaminal lumbar interbody fusion: single-center experience","volume":"28","author":"Navarro-Garcia de Llano JP","year":"2025","unstructured":"Navarro-Garcia de Llano JP, Fuentes-Fernandez Cueto M, Roberts AP,  Spinal anesthesia for multilevel awake minimally invasive transforaminal lumbar interbody fusion: single-center experience. Oper Neurosurg (Hagerstown). 2025;28(6):855\u2013861."},{"issue":"4","key":"b25","series-title":"J Neurosurg Spine","first-page":"435","article-title":"Awake, endoscopic lumbar interbody spinal fusion: 10 years of experience with the first 400 cases","volume":"42","author":"Wang MY","year":"2025","unstructured":"Wang MY, Grossman J. Awake, endoscopic lumbar interbody spinal fusion: 10 years of experience with the first 400 cases. J Neurosurg Spine. 2025;42(4):435\u2013442."},{"issue":"3","key":"b26","series-title":"Neurochirurgie","first-page":"101444","article-title":"Awake spinal anesthesia facilitates spine surgery in poor surgical candidates: a case series","volume":"69","author":"Sykes DAW","year":"2023","unstructured":"Sykes DAW, Tabarestani TQ, Salven DS,  Awake spinal anesthesia facilitates spine surgery in poor surgical candidates: a case series. Neurochirurgie. 2023;69(3):101444."},{"issue":"6","key":"b27","series-title":"Neurosurg Focus","first-page":"E2","article-title":"Awake spinal surgery: simplifying the learning curve with a patient selection algorithm","volume":"51","author":"Letchuman V","year":"2021","unstructured":"Letchuman V, Agarwal N, Mummaneni VP,  Awake spinal surgery: simplifying the learning curve with a patient selection algorithm. Neurosurg Focus. 2021;51(6):E2."},{"issue":"5","key":"b28","series-title":"Anesth Analg","first-page":"1733","article-title":"Chronic opioid use after surgery: implications for perioperative management in the face of the opioid epidemic","volume":"125","author":"Hah JM","year":"2017","unstructured":"Hah JM, Bateman BT, Ratliff J, Curtin C, Sun E. Chronic opioid use after surgery: implications for perioperative management in the face of the opioid epidemic. Anesth Analg. 2017;125(5):1733\u20131740."},{"issue":"4","key":"b29","series-title":"J Orthop Sci","first-page":"933","article-title":"Safety of robotic-assisted screw placement for spine surgery: experience from the initial 125 cases","volume":"29","author":"Akazawa T","year":"2024","unstructured":"Akazawa T, Torii Y, Ueno J,  Safety of robotic-assisted screw placement for spine surgery: experience from the initial 125 cases. J Orthop Sci. 2024;29(4):933\u2013938."},{"issue":"1","key":"b30","series-title":"Sci Rep","first-page":"10881","article-title":"Feasibility and safety report on robotic assistance for cervical pedicle screw fixation: a cadaveric study","volume":"14","author":"Ryu S","year":"2024","unstructured":"Ryu S, Ha B-J, Yoon S,  Feasibility and safety report on robotic assistance for cervical pedicle screw fixation: a cadaveric study. Sci Rep. 2024;14(1):10881."},{"issue":"1","key":"b31","series-title":"BMC Musculoskelet Disord","first-page":"328","article-title":"Accuracy and safety of robot-assisted cortical bone trajectory screw placement: a comparison of robot-assisted technique with fluoroscopy-assisted approach","volume":"23","author":"Li Y","year":"2022","unstructured":"Li Y, Chen L, Liu Y,  Accuracy and safety of robot-assisted cortical bone trajectory screw placement: a comparison of robot-assisted technique with fluoroscopy-assisted approach. BMC Musculoskelet Disord. 2022;23(1):328."},{"issue":"5","key":"b32","series-title":"J Neurosurg Spine","first-page":"841","article-title":"Ninety-day complication, revision, and readmission rates for current-generation robot-assisted thoracolumbar spinal fusion surgery: results of a multicenter case series","volume":"36","author":"Liounakos JI","year":"2022","unstructured":"Liounakos JI, Khan A, Eliahu K,  Ninety-day complication, revision, and readmission rates for current-generation robot-assisted thoracolumbar spinal fusion surgery: results of a multicenter case series. J Neurosurg Spine. 2022;36(5):841\u2013848."},{"issue":"17","key":"b33","series-title":"J Clin Med","first-page":"4989","article-title":"Robot-assisted pedicle screw placement led to lower screw loosening rate than fluoroscopy-guided technique in transforaminal lumbar interbody fusion for lumbar degenerative disease: a single-center retrospective study","volume":"11","author":"Lai YP","year":"2022","unstructured":"Lai YP, Lin YH, Wu YC,  Robot-assisted pedicle screw placement led to lower screw loosening rate than fluoroscopy-guided technique in transforaminal lumbar interbody fusion for lumbar degenerative disease: a single-center retrospective study. J Clin Med. 2022;11(17):4989."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/44\/1\/article-p99.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/44\/1\/article-p99.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/44\/1\/article-p99.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T13:44:42Z","timestamp":1772804682000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/44\/1\/article-p99.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,17]]},"references-count":66,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2025.6.spine25442","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2025,10,17]]}}}