Operative Neurosurgery 28:295–302, 2025
• Robotic systems enhance accuracy in pedicle screw placement, reducing complications and hospital stays.
• Common errors in robotic spine surgery include registration, skiving, and interference errors.
• Registration errors occur due to imaging discrepancies or unexpected intraoperative movements.
• Skiving errors result from sliding of drilling instruments, often due to poor entry points.
• Interference errors arise from unintended interactions with soft tissue or robotic system malfunctions.
• Best practices include meticulous preoperative planning and careful patient positioning to minimize errors.
• High BMI and female sex are risk factors for screw deviation due to bone quality issues.
• Modern systems use sharp burrs to reduce skiving by ensuring smooth entry points.
• Soft tissue management is crucial to prevent interference errors during surgery.
• Intraoperative imaging helps confirm accurate screw placement, reducing registration errors.
• Screw failure rates: Registration errors (60%), skiving errors (26.8%), interference errors (19.5%).
• Newer robotic systems show improved accuracy but still face challenges with registration errors.
• Study limitations include varied resources, surgeon experience, and subjective error reporting.
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