{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T12:02:45Z","timestamp":1764331365331,"version":"3.46.0"},"reference-count":43,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Screw placement accuracy with robotic guidance shows better results than freehand techniques, yet there is scant data for region-specific outcomes, fusion rates, and complication profiles in different populations. The purpose of this study is to assess and describe screw-rod accuracy, fusion rates, and complications of robot-assisted pedicle screw placement in a Spanish cohort. Methods: Robotic-guided technique for thoracolumbar fusion in 115 patients (July 2020\u2013January 2025) using ExcelsiusGPS\u00ae platform (Globus Medical Inc., Audubon, PA, USA). Inclusion criteria: adults (\u226518 years) with postoperative CT to assess accuracy. Primary outcomes were screw accuracy (assessed on the Gertzbein\u2013Robbins scale), fusion rates, and complications (infection, osteolysis, and subsidence). Jamovi 2.6 was employed for statistical analysis. Results: Of a total of 726 screws implanted, 590 screws (95 patients) were studied: 584 (99%) Grade A, 5 (0.8%) Grade B, and 1 (0.2%) Grade C. Fusion was achieved in 85 out of 95 patients (89.5%). Complications included superficial infections (3\/115 patients, 2.6%) and asymptomatic osteolysis (8\/95 patients, 8.4%, mostly at S1). There was no screw subsidence or removal. Conclusions: Robotic-guided pedicle screw placement demonstrated exceptional accuracy (99% Grade A), high fusion success (89.5%), and minimal complications in this Spanish cohort, supporting its clinical utility for spinal instrumentation.<\/jats:p>","DOI":"10.3390\/jcm14238425","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T11:19:51Z","timestamp":1764328791000},"page":"8425","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Accuracy of Robotic-Guided Pedicular Screw Insertion in Thoracolumbar Spinal Surgery"],"prefix":"10.3390","volume":"14","author":[{"given":"Ignacio","family":"Dominguez","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Hospital Cl\u00ednico San Carlos, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8658-2600","authenticated-orcid":false,"given":"Rafael","family":"Luque","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Hospital Cl\u00ednico San Carlos, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2231-8346","authenticated-orcid":false,"given":"Angela","family":"Carrascosa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Cl\u00ednico San Carlos, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6824-3813","authenticated-orcid":false,"given":"Juan Pablo","family":"Casta\u00f1o","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Cl\u00ednico San Carlos, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia","family":"Collado","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Hospital Cl\u00ednico San Carlos, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Alonso Lera","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Cl\u00ednico San Carlos, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Marco","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Hospital Cl\u00ednico San Carlos, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"291","DOI":"10.4103\/0019-5413.96386","article-title":"Prevalence of hip pathology in patients over age 50 with spinal conditions requiring surgery","volume":"46","author":"Lee","year":"2012","journal-title":"Indian J. 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