Robot‐Assisted Screw Fixation Combined With Endoscopic Bone Graft in the Minimally Invasive Treatment of Lumbar Spondylolysis: A Single‐Center Retrospective Study

ABSTRACT Objective Spondylolysis, often progressing to spondylolisthesis, commonly defies conservative treatment in refractory cases, indicating a need for surgery. Robot‐assisted techniques may provide a stable and effective minimally invasive approach for the treatment of lumbar spondylolysis. To...

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Main Authors: Guanjie Zeng, Zongze Li, Juedong Hou, Liu Yu, Yuhui Cui, Yongjian Zhu, Ling Yao, Jiarui Chen, Yongquan Cheng, Jianting Chen
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Orthopaedic Surgery
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Online Access:https://doi.org/10.1111/os.14368
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author Guanjie Zeng
Zongze Li
Juedong Hou
Liu Yu
Yuhui Cui
Yongjian Zhu
Ling Yao
Jiarui Chen
Yongquan Cheng
Jianting Chen
author_facet Guanjie Zeng
Zongze Li
Juedong Hou
Liu Yu
Yuhui Cui
Yongjian Zhu
Ling Yao
Jiarui Chen
Yongquan Cheng
Jianting Chen
author_sort Guanjie Zeng
collection DOAJ
description ABSTRACT Objective Spondylolysis, often progressing to spondylolisthesis, commonly defies conservative treatment in refractory cases, indicating a need for surgery. Robot‐assisted techniques may provide a stable and effective minimally invasive approach for the treatment of lumbar spondylolysis. To compare the clinical efficacy between robot‐assisted percutaneous screw fixation combined with endoscopic bone graft and conventional open screw fixation with bone graft in the treatment of lumbar spondylolysis. Methods A cohort study involving 43 individuals with lumbar spondylolysis who underwent surgical treatment was conducted. From January 2022 to June 2023, 20 patients underwent percutaneous screw fixation combined with endoscopic bone graft while 23 patients underwent conventional open screw fixation with bone graft. The demographic data, parameters related to robotic surgery, perioperative indicators, VAS and ODI scores, pedicle screw accuracy, radiographic fusion outcomes, and follow‐up results were systematically recorded, analyzed, and then compared between the two groups. Categorical variables were analyzed using chi‐square tests, and continuous variables were evaluated with t‐tests or Mann–Whitney U tests following normality assessment, with statistical significance at p < 0.05. Results Compared with the conventional surgery group, the robot‐assisted surgery group had significantly less intraoperative blood loss, less postoperative drainage, shorter hospital stay, less intraoperative fluoroscopy times, and radiation exposure dose (p < 0.05). Nevertheless, the duration of the surgery was longer. Postoperative imaging findings showed high screw accuracy in both groups, with a grade A rate of 95% in the robot‐assisted group compared with 91.4% in the conventional open surgery group according to the Gertzbein–Robbins scale. Both groups achieved similar improvements in VAS and ODI during 1‐year follow‐up, and both groups achieved good bone graft fusion (97.5% fusion rate in the robot‐assisted group versus 93.5% in the conventional open surgery group). Conclusion Robot‐assisted screw fixation combined with endoscopic bone graft provides a safe and reliable minimally invasive treatment of lumbar spondylolysis, with high accuracy of pedicle screw implantation and less radiation exposure dose, less intraoperative trauma, and quicker recovery than conventional open surgery.
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spelling doaj-art-847f11d96c1e4a8eb719ab925205ecfc2025-08-20T01:50:59ZengWileyOrthopaedic Surgery1757-78531757-78612025-04-011741143115110.1111/os.14368Robot‐Assisted Screw Fixation Combined With Endoscopic Bone Graft in the Minimally Invasive Treatment of Lumbar Spondylolysis: A Single‐Center Retrospective StudyGuanjie Zeng0Zongze Li1Juedong Hou2Liu Yu3Yuhui Cui4Yongjian Zhu5Ling Yao6Jiarui Chen7Yongquan Cheng8Jianting Chen9Division of Spine Surgery, Department of Orthopaedics Nanfang Hospital, Southern Medical University Guangzhou ChinaDivision of Spine Surgery, Department of Orthopaedics Nanfang Hospital, Southern Medical University Guangzhou ChinaDivision of Spine Surgery, Department of Orthopaedics Nanfang Hospital, Southern Medical University Guangzhou ChinaDepartment of Human Anatomy School of Basic Medical Sciences, Southern Medical University Guangzhou ChinaDepartment of Medical Imaging Center Nanfang Hospital, Southern Medical University Guangzhou ChinaDivision of Spine Surgery, Department of Orthopaedics Nanfang Hospital, Southern Medical University Guangzhou ChinaDivision of Spine Surgery, Department of Orthopaedics Nanfang Hospital, Southern Medical University Guangzhou ChinaShenzhen Futurtec Medical Co. Ltd Shenzhen ChinaDivision of Spine Surgery, Department of Orthopaedics Nanfang Hospital, Southern Medical University Guangzhou ChinaDivision of Spine Surgery, Department of Orthopaedics Nanfang Hospital, Southern Medical University Guangzhou ChinaABSTRACT Objective Spondylolysis, often progressing to spondylolisthesis, commonly defies conservative treatment in refractory cases, indicating a need for surgery. Robot‐assisted techniques may provide a stable and effective minimally invasive approach for the treatment of lumbar spondylolysis. To compare the clinical efficacy between robot‐assisted percutaneous screw fixation combined with endoscopic bone graft and conventional open screw fixation with bone graft in the treatment of lumbar spondylolysis. Methods A cohort study involving 43 individuals with lumbar spondylolysis who underwent surgical treatment was conducted. From January 2022 to June 2023, 20 patients underwent percutaneous screw fixation combined with endoscopic bone graft while 23 patients underwent conventional open screw fixation with bone graft. The demographic data, parameters related to robotic surgery, perioperative indicators, VAS and ODI scores, pedicle screw accuracy, radiographic fusion outcomes, and follow‐up results were systematically recorded, analyzed, and then compared between the two groups. Categorical variables were analyzed using chi‐square tests, and continuous variables were evaluated with t‐tests or Mann–Whitney U tests following normality assessment, with statistical significance at p < 0.05. Results Compared with the conventional surgery group, the robot‐assisted surgery group had significantly less intraoperative blood loss, less postoperative drainage, shorter hospital stay, less intraoperative fluoroscopy times, and radiation exposure dose (p < 0.05). Nevertheless, the duration of the surgery was longer. Postoperative imaging findings showed high screw accuracy in both groups, with a grade A rate of 95% in the robot‐assisted group compared with 91.4% in the conventional open surgery group according to the Gertzbein–Robbins scale. Both groups achieved similar improvements in VAS and ODI during 1‐year follow‐up, and both groups achieved good bone graft fusion (97.5% fusion rate in the robot‐assisted group versus 93.5% in the conventional open surgery group). Conclusion Robot‐assisted screw fixation combined with endoscopic bone graft provides a safe and reliable minimally invasive treatment of lumbar spondylolysis, with high accuracy of pedicle screw implantation and less radiation exposure dose, less intraoperative trauma, and quicker recovery than conventional open surgery.https://doi.org/10.1111/os.14368lumbar spondylolysisminimally invasive surgerypedicle screwrobot‐assisted surgeryspinal endoscopy
spellingShingle Guanjie Zeng
Zongze Li
Juedong Hou
Liu Yu
Yuhui Cui
Yongjian Zhu
Ling Yao
Jiarui Chen
Yongquan Cheng
Jianting Chen
Robot‐Assisted Screw Fixation Combined With Endoscopic Bone Graft in the Minimally Invasive Treatment of Lumbar Spondylolysis: A Single‐Center Retrospective Study
Orthopaedic Surgery
lumbar spondylolysis
minimally invasive surgery
pedicle screw
robot‐assisted surgery
spinal endoscopy
title Robot‐Assisted Screw Fixation Combined With Endoscopic Bone Graft in the Minimally Invasive Treatment of Lumbar Spondylolysis: A Single‐Center Retrospective Study
title_full Robot‐Assisted Screw Fixation Combined With Endoscopic Bone Graft in the Minimally Invasive Treatment of Lumbar Spondylolysis: A Single‐Center Retrospective Study
title_fullStr Robot‐Assisted Screw Fixation Combined With Endoscopic Bone Graft in the Minimally Invasive Treatment of Lumbar Spondylolysis: A Single‐Center Retrospective Study
title_full_unstemmed Robot‐Assisted Screw Fixation Combined With Endoscopic Bone Graft in the Minimally Invasive Treatment of Lumbar Spondylolysis: A Single‐Center Retrospective Study
title_short Robot‐Assisted Screw Fixation Combined With Endoscopic Bone Graft in the Minimally Invasive Treatment of Lumbar Spondylolysis: A Single‐Center Retrospective Study
title_sort robot assisted screw fixation combined with endoscopic bone graft in the minimally invasive treatment of lumbar spondylolysis a single center retrospective study
topic lumbar spondylolysis
minimally invasive surgery
pedicle screw
robot‐assisted surgery
spinal endoscopy
url https://doi.org/10.1111/os.14368
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