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

“We observed a consistent reduction in opioid utilization among patients who underwent robotic-assisted surgery, including lower overall opioid consumption and substantially less need for intravenous patient-controlled analgesia,” said Kyle W. Morse, MD, spine surgeon at HSS and co-author of the study. “Importantly, these reductions occurred while maintaining similar safety outcomes. These findings suggest robotic guidance may offer meaningful benefits for patients recovering from lumbar fusion surgery and could play an important role in future opioid-sparing perioperative care pathways.”

The findings add to a growing body of evidence that robotic-assisted spine surgery may provide benefits beyond surgical precision, potentially helping reduce opioid exposure during recovery while maintaining comparable safety outcomes.

About HSS

HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the 17th consecutive year), No. 3 in rheumatology by U.S. News & World Report (2026-2027), and the best pediatric orthopedic hospital in NY, NJ and CT by U.S. News & World Report “Best Children’s Hospitals” list (2026-2027). HSS is the worlds most awarded hospital in orthopedics by Newsweek each year since the “World’s Best Specialized Hospitals” survey was introduced in 2020. Founded in 1863, the Hospital has the lowest readmission rate in the nation, and among the lowest infection and complication rates. HSS was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center six consecutive times. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State, as well as in Florida. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. In addition, more than 200 HSS clinical investigators are working to improve patient outcomes through better ways to prevent, diagnose, and treat orthopedic, rheumatic and musculoskeletal diseases. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research for physicians, nurses, allied health professionals, academic trainees, and consumers in more than 165 countries. The institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally. www.hss.edu.

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