Robotic-assisted vs. fluoroscopy-assisted MIS-TLIF: improved screw accuracy and reduced early opioid use with comparable long-term outcomes - Report - MDSpire

Robotic-assisted vs. fluoroscopy-assisted MIS-TLIF: improved screw accuracy and reduced early opioid use with comparable long-term outcomes

  • By

  • Daniel W. Griepp

  • Bryce Sarcar

  • Hepzibha Alexander

  • Rabia Ahmed

  • Andrew Beggs

  • Armando Bunjaj

  • Jeffrey P. Turnbull

  • Joshua Caskey

  • Shivum Desai

  • Heather Heitkotter

  • Daniel A. Carr

  • June 30, 2026

  • 0 min

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Clinical Report: Comparative Analysis of Robotic-Assisted and Fluoroscopy-Assisted MIS-TLIF

Overview

This study compares robotic-assisted (RA) and fluoroscopy-assisted (FA) techniques in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). The RA approach showed improved screw placement accuracy and reduced early opioid consumption.

Background

Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is a common surgical intervention for degenerative lumbar disease. The adoption of robotic-assisted techniques aims to enhance surgical precision and reduce opioid consumption.

Data Highlights

OutcomeRA GroupFA GroupP-value
Screw Accuracy (Grade A)91%57%<0.001
Inpatient MME (Postoperative Days 0-1)LowerHigher0.002
Total LOS MMELowerHigher0.0015
Long-term Opioid Use (3, 6, 12 months)SimilarSimilarp > 0.05

Key Findings

  • The RA group had a significantly higher proportion of grade A screws compared to the FA group (91% vs. 57%, p < 0.001).
  • Inpatient opioid consumption was significantly lower in the RA group on postoperative days 0-1 (p = 0.002).
  • Total opioid consumption during length of stay was also lower in the RA group (p = 0.0015).
  • Long-term opioid use at 3, 6, and 12 months showed no significant differences between the two groups (p > 0.05).

Clinical Implications

The findings suggest that while robotic-assisted techniques improve screw placement accuracy and reduce early postoperative opioid consumption, they do not lead to differences in long-term opioid use or patient-reported outcomes. This information may guide surgical decision-making and opioid management strategies.

Conclusion

Robotic-assisted MIS-TLIF offers advantages in screw accuracy and early opioid consumption.

Related Resources & Content

  1. Author(s)/Org, Source, Year -- Title
  2. Author(s)/Org, Source, Year -- Title
  3. Author(s)/Org, Source, Year -- Title
  4. Author(s)/Org, Source, Year -- Title
  5. Consensus statement for perioperative care in lumbar spinal fusion: Enhanced Recovery After Surgery (ERAS®) Society recommendations - ScienceDirect
  6. Robot-assisted vs conventional lumbar interbody fusion: A systematic review and meta-analysis of perioperative, radiographic, and clinical outcomes - PubMed
  7. Consensus statement for perioperative care in lumbar spinal fusion: Enhanced Recovery After Surgery (ERAS®) Society recommendations - ScienceDirect
  8. Robot-assisted vs conventional lumbar interbody fusion: A systematic review and meta-analysis of perioperative, radiographic, and clinical outcomes - PubMed

Original Source(s)

Robotic-assisted vs. fluoroscopy-assisted MIS-TLIF: improved screw accuracy and reduced early opioid use with comparable long-term outcomes

  • by Daniel W. Griepp, Bryce Sarcar, Hepzibha Alexander, Rabia Ahmed, Andrew Beggs, Armando Bunjaj, Jeffrey P. Turnbull, Joshua Caskey, Shivum Desai, Heather Heitkotter, Daniel A. Carr

  • June 30, 2026

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