Background: Surgical robotics can minimize the discrepancy between surgical preoperative plan and postoperative execution. This work explores the performance of a supervisory-control architecture robot (8i Robotics) for autonomous pedicle instrumentation in both an open and MIS workflow in a poricne model, as well as guidance accuracy in humans. Methods: 11 porcine subjects (7 open, 4 minimally invasive) had clinical grading assessment of pedicle screw placement. 3 of the open cohort had detailed precision analysis. Post-operative CT assessed screw location. Euclidean error was calculated at screw head and screw tip and confidence ellipses generated. In two human patients, guidance accuracy was compared to existing neuro-navigation. Results: All screws where GRS A. There was no clinical difference between clinical assessment of MIS vs Open workflow. Mean tip and head Euclidean error where 2.47+/-1.25mm and 2.25+/-1.25mm respectively. Guidance was successfully obtained in both human cases. Conclusions: 100% of screws obtained satisfactory clinical grading. This demonstrates the capability of a supervisory controlled robotic pedicle screw insertion robot in both open and minimally invasive workflow. Furthermore, initial guidance was feasible in living human patients with comparable agreement to current navigation. This work demonstrates exciting promise for the future of autonomous surgical robotics.