Robotic-Assisted Kyphoplasty Demonstrates Superior Efficacy, Safety, and Procedural Efficiency Compared to Fluoroscopy-Guided Techniques: A Retrospective Analysis of 240 Patients

Background Osteoporotic vertebral compression fractures (OVCFs) are a significant health burden with increasing prevalence in the aging population. This study compares robotic-assisted kyphoplasty (RK) with conventional fluoroscopy-guided kyphoplasty (FK) for the treatment of OVCFs. Methods A single-center retrospective study analysed 240 patients (120 in each group) who underwent kyphoplasty for OVCFs between January 2020 and December 2022. Clinical outcomes were assessed using Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). Radiological outcomes included vertebral height restoration and kyphotic angle correction. Procedural parameters including radiation exposure, procedural time, and complications were also analysed. Results Both groups demonstrated significant clinical and radiological improvements. The RK group showed better vertebral height restoration (68.00% vs. 64.38%, p = 0.004) and significantly lower cement leakage rates (5.8% vs. 19.2%, p = 0.002) compared to the FK group. Radiation exposure was significantly lower in the RK group (18.76 mGy vs. 22.69 mGy, p < 0.00001). Total procedure time was longer in the RK group (86.40 min vs. 50.91 min, p < 0.00001), primarily due to longer scan and planning time, while pure surgical time remained comparable between groups. Conclusion Robotic-assisted kyphoplasty provides improved safety profiles with reduced cement leakage and radiation exposure, as well as better vertebral height restoration compared to traditional fluoroscopy-guided techniques. These advantages should be weighed against longer total procedure times when selecting appropriate treatment for patients with OVCFs.