P17. What clinical advantage does the Mazor X have over the renaissance in robot assisted spine surgery: A multicenter propensity matched analysis of 2,671 screws and 400 patients with a 1 year minimum follow-up

BACKGROUND CONTEXT As new robot technology continues to be introduced into practice, it is important for the surgeon to know how these new advances are influencing screw accuracy and outcomes. This is the first and largest multicenter study comparing two robot systems (Renaissance and Mazor X). PURPOSE To compare the screw accuracy, robot reliability and efficiency, and 1-year clinical outcomes between two robot platforms. STUDY DESIGN/SETTING Multicenter cohort. PATIENT SAMPLE Adult patients (≥18 years old) who underwent robot-assisted spine surgery with either the Renaissance or Mazor X robot system at four geographically different institutions. OUTCOME MEASURES Screw accuracy, robot time per screw, robot abandonment, and 1-year clinical outcomes between two robot systems. METHODS In this multicenter study, we performed a propensity-score matching algorithm based on perioperative factors (eg, demographics, comorbidities, indications for surgery, prior spine surgery, pelvic fixation, instrumented levels, planned robot screws) to control for the potential selection bias between the two robotic systems. Chi-square/fisher exact test and t-test/ANOVA were used for categorical and continuous variables, respectively. RESULTS A total of 400 adult patients were included in this study (200 Renaissance, 200 X). The most common preoperative diagnoses included high grade spondylolisthesis (47.5%), degenerative scoliosis (20.3%), and degenerative disc disease (15.8%). The mean number of instrumented levels was 4.0. The mean number of planned robot screws was 7.4. The screw accuracy for both robots were excellent (X: 99.0% vs Renaissance: 98.1%, p=0.078). The Mazor X achieved a significantly shorter robot time per screw (X: 5.8 minutes vs Renaissance: 7.2 minutes, p=0.016). Furthermore, the robot abandonment rate due to registration issues was significantly higher for the Renaissance (4.5%) than the X (0.5%, p=0.010). Non-robot related complications such as dura tear, motor/sensory deficits, blood transfusion, and return to the OR during same admission was similar between robots (p>0.05). Interestingly the LOS was nearly a day shorter for the X (4.7 days) than the Renaissance (5.5 days, p CONCLUSIONS Our multicenter study demonstrates that the Mazor X achieves a significantly lower robot time spent per screw, higher robot reliability, and potentially lower overall costs given the nearly 1-day reduction in hospital length of stay. These findings are likely the result of the recent advancements in Mazor X technology, particularly the cutting edge preoperative planning software. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.