• TiRobot-assisted navigation significantly improves pedicle screw placement accuracy (95.4% vs. 86.0%) and reduces facet joint violation rate (2.8% vs. 10.5%) compared to conventional C-arm fluoroscopy.
• Intraoperative fluoroscopy time is significantly reduced with TiRobot navigation, lowering radiation exposure for patients and surgical staff.
• No significant differences were observed in operation time, blood loss, hospital stay, or clinical outcomes (VAS, ODI, radiological parameters) between the two techniques.
• TiRobot navigation provides equivalent early clinical efficacy while offering superior precision and structural protection, supporting its use in minimally invasive thoracolumbar fracture surgery.