Effectiveness and safety of robot-assisted versus fluoroscopy-assisted cortical bone trajectory screw instrumentation in spinal surgery: a systematic review and meta-analysis.
Xu WangHao-Xuan LiQing-San ZhuQing-San ZhuPublished in: Journal of robotic surgery (2024)
Robot-assisted (RA) technology has been shown to be a safe aid in spine surgery, this meta-analysis aims to compare surgical parameters and clinical indexes between robot-assisted cortical bone trajectory (CBT) and fluoroscopy-assisted (FA) cortical bone trajectory in spinal surgery. We searched databases such as PubMed, Web of Science, the Cochrane Library, and the China National Knowledge Infrastructure. The study selection process was guided by the PICOS (Patient/Problem, Intervention, Comparison, Outcome, Study Design) strategy. The risk of bias in non-randomized comparative studies was assessed using the risk of bias in non-randomized studies of interventions (ROBINS-I) tool. We performed this meta-analysis using RevMan 5.3 software (Cochrane Collaboration, Copenhagen, Denmark), and the level of statistical significance was set at P < 0.05. Six articles involving 371 patients and 1535 screws were included in this meta-analysis. RA-CBT outperformed FA-CBT in terms of various parameters, such as accuracy of pedicle screw position (both Gertzbein-Robbins scale and Ding scale), avoidance of superior facet joint violation (FJV), and reduction of neurological injury. Our meta-analysis offered a thorough evaluation of the efficacy and safety of RA-CBT in spinal surgery. The findings revealed that RA-CBT produced statistically significant results in terms of pedicle screw position accuracy and superior facet joint violation prevention. In terms of surgical parameters and clinical indexes, future research and clinical practice should investigate the efficacy of RA-CBT further. The study was registered in the PROSPERO (CRD42023466280).
Keyphrases
- robot assisted
- minimally invasive
- systematic review
- rheumatoid arthritis
- case control
- meta analyses
- disease activity
- spinal cord
- coronary artery bypass
- bone mineral density
- ankylosing spondylitis
- end stage renal disease
- clinical practice
- randomized controlled trial
- open label
- healthcare
- double blind
- public health
- physical activity
- quality improvement
- soft tissue
- interstitial lung disease
- phase ii
- spinal cord injury
- surgical site infection
- placebo controlled
- clinical trial
- systemic lupus erythematosus
- peritoneal dialysis
- coronary artery disease
- brain injury
- data analysis
- idiopathic pulmonary fibrosis
- deep learning
- atrial fibrillation
- postmenopausal women
- subarachnoid hemorrhage
- artificial intelligence