Robotic Spine Surgery: Systematic Review of Common Error Types and Best Practices

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.