Stiffness is increased in vertebrae after kyphoplasty with bone cement is performed, which cause an increase in subsequent fractures in adjacent levels. This has led to increased interest in alternative filling materials such as bioactive calcium phosphate ceramics or silicon-based polymers. This study's objective is to compare the results between kyphoplasty with bone cement and with the VK100 silicone. This is a comparative, prospective study involving 64 patients 64 patients, 23 treated using VK100 and 41 with PMMA. Clinical, radiological and functional results (Oswestry) and quality of life and (EQ-5D).were analyzed and compared between both groups, focusing on differences in subsequent fractures in adjacent levels. There are no differences between the two treatments in terms of epidemiological factors (age and sex) or hospital management. A significant difference is observed in the gain of vertebral body height, with greater improvement in those treated with PMMA. There is also a higher fracture rate in the PMMA group, the difference is not significant. Finally, both treatments show similar outcomes in pain relief and quality of life. Both VK100 Elastoplasty and PMMA Kyphoplasty are effective treatments for vertebral fractures. VK100 has a lower rate of complications and adjacent fractures. However, long-term results in terms of pain relief and quality of life are similar, making both treatments equally valid.

Background/Objectives: Screw placement accuracy with robotic guidance shows better results than freehand techniques, yet there is scant data for region-specific outcomes, fusion rates, and complication profiles in different populations. The purpose of this study is to assess and describe screw-rod accuracy, fusion rates, and complications of robot-assisted pedicle screw placement in a Spanish cohort. Methods: Robotic-guided technique for thoracolumbar fusion in 115 patients (July 2020–January 2025) using ExcelsiusGPS^® platform (Globus Medical Inc., Audubon, PA, USA). Inclusion criteria: adults (≥18 years) with postoperative CT to assess accuracy. Primary outcomes were screw accuracy (assessed on the Gertzbein–Robbins scale), fusion rates, and complications (infection, osteolysis, and subsidence). Jamovi 2.6 was employed for statistical analysis. Results: Of a total of 726 screws implanted, 590 screws (95 patients) were studied: 584 (99%) Grade A, 5 (0.8%) Grade B, and 1 (0.2%) Grade C. Fusion was achieved in 85 out of 95 patients (89.5%). Complications included superficial infections (3/115 patients, 2.6%) and asymptomatic osteolysis (8/95 patients, 8.4%, mostly at S1). There was no screw subsidence or removal. Conclusions: Robotic-guided pedicle screw placement demonstrated exceptional accuracy (99% Grade A), high fusion success (89.5%), and minimal complications in this Spanish cohort, supporting its clinical utility for spinal instrumentation.