HSS Study Finds Robotic-Assisted Lumbar Fusion Associated with Lower Opioid Use After Surgery
SAN ANTONIO, October 15, 2026--Patients who underwent robotic-assisted minimally invasive lumbar fusion surgery required significantly less opioid medication during their hospital stay, without increased complications or longer hospital stays, compared with patients treated using conventional navigation-guided techniques, according to research presented by Hospital for Special Surgery (HSS) at the North American Spine Society (NASS) Annual Meeting.
The study, Comparison of Opioid Utilization After Robotic Arm-Assisted and Navigation-Guided Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS-TLIF), evaluated 804 patients who underwent one- or two-level lumbar fusion procedures between 2017 and 2025. Researchers found that patients whose surgeries were performed with robotic arm guidance used 16% less opioid medication during their hospitalization and were significantly less likely to require intravenous patient-controlled analgesia (PCA), a stronger form of pain management.
The findings come at a time when spine surgeons continue seeking ways to reduce opioid exposure while maintaining effective postoperative pain control.
"Reducing patients' exposure to opioid medications after surgery remains an important goal in spine care," said Sheeraz A. Qureshi, MD, MBA, Co-Chief of HSS Spine and co-author of the study. "While robotic technology is often recognized for improving surgical precision, these results suggest its benefits may extend beyond the operating room."
Minimally invasive transforaminal lumbar interbody fusion commonly uses advanced imaging and navigation systems to guide the placement of spinal implants. Robotic arm-assisted platforms build upon those technologies by providing additional stability and precision during surgery. While previous studies have largely focused on implant placement accuracy and surgical efficiency, less has been known about whether robotic assistance influences postoperative pain management.
Using a prospectively maintained spine surgery registry, investigators compared outcomes among 203 patients who underwent navigation-guided surgery and 601 patients who underwent robotic-assisted procedures. After accounting for differences in patient characteristics, surgeons and other factors, the robotic-assisted group consistently demonstrated lower opioid utilization.
Key findings included:
16% reduction in total in-hospital opioid consumption among patients who underwent robotic-assisted surgery
21% reduction in opioid use during the first 24 hours after surgery
57% reduction in the likelihood of requiring PCA pain medication
No significant differences in complications or hospital length of stay