Meta-analysis of the effect of robot-assisted and free-handed pedicle screw placement in spinal diseases

doi:10.3969/j.issn.1004-583X.2023.03.002

Abstract

Abstract:

Objective To compare the clinical effects of robot-assisted versus free-handed pedicle screw placement in spinal surgery, and to provide a theoretical reference for the future development of spinal surgery. Methods We searched related case-control studies published from February 2011 to February 2021, in six databases including Pubmed, Cochrane Library, CNKI, Embase, WF and VIP. According to Chinese and English retrieval strategies, retrieved eligible 418 documents, further screened and finally included 13 documents. In this paper, we extracted and analyzed the data by Review manager 5.3 software. Results When pedicle screws were used to placed, the accuracy of robot-assisted placement was higher than that of free-hand fluoroscopy-guided (95% $C I$ =2.19-3.61, $P$ <0.01). The time required for robot-assisted and fluoroscopy-guided was similar (95% $C I$ =-0.18-33.96, $P$ =0.05), but the other indicators were comparable between groups. Conclusion Robot-assisted screw placement is more accurate than traditional freehand screw placement, which is a more accurate and safe choice for the treatment of spinal diseases. Moreover, the operation time, radiation dose and time of robot-assisted tend to decline, which will play an important role in spinal surgery in the future.

Key words: robotic surgical procedures, fluoroscopy-guided, pedicle screw, screw placement accuracy, operative time

CLC Number:

Li Yang, Du Yibin. Meta-analysis of the effect of robot-assisted and free-handed pedicle screw placement in spinal diseases[J]. Clinical Focus, 2023, 38(3): 208-215.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.03.002

https://huicui.hebmu.edu.cn/EN/Y2023/V38/I3/208

Figures/Tables 10

References 28

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纳入研究	类型	国家	年份	组别	例数	年龄 (岁)	性别 (男/女)	结局指标	改良Jadad 质量评价(分)
Ringel^[5]	随机对照	德国	2012	机器人辅助	30	68	14/16	①②④⑥⑦	7
				透视引导	30	67	12/18
Feng^[6]	随机对照	中国	2019	机器人辅助	40	67.6±6.5	12/28	①③⑥⑦	5
				透视引导	40	67.9±7.3	13/27
Keric^[7]	回顾性	德国	2017	机器人辅助	52	72.3±11.1	36/30	①②④⑤⑥⑦	6
				透视引导	70	68.0±11.2	13/11
Hyun^[8]	随机对照	韩国	2017	机器人辅助	30	66.5	9/21	①③④⑤⑥⑦	7
				透视引导	30	66.8	8/22
Kim^[9]	随机对照	韩国	2015	机器人辅助	20	64.4±11.9	11/9	①⑥	6
				透视引导	20	64.7±8.6	8/12
Lautado^[10]	回顾性	瑞士	2018	机器人辅助	11	65	-	①	5
				透视引导	48	60.7
Schizas^[11]	随机对照	瑞士	2012	机器人辅助	11	65	6/5	①③④	6
				透视引导	23	66	8/15
Kantelhardt^[12]	回顾性	德国	2011	机器人辅助	55	63.1	52/60	①②④⑥⑦	6
				透视引导	57
Lonjon^[13]	随机对照	法国	2016	机器人辅助	10	63.4±11.0	4/6	①②③④⑥⑦	7
				透视引导	10		4/6
Han^[14]	回顾性	中国	2019	机器人辅助	52	54.6±11.3	55/60	①③④⑥⑦	5
				透视引导	70	56.1±13.4	58/61
Schatlo^[15]	回顾性	德国	2014	机器人辅助	55	52(27-83)	29/26	①②⑥⑦	6
				透视引导	40	58(23-82)	28/12
Roser^[16]	回顾性	德国	2013	机器人辅助	18	-	-	①③④	5
				透视引导	10
田伟^[17]	随机对照	中国	2016	机器人辅助	23	54.9±11.9	17/23	①⑥	5
				透视引导	17

纳入研究	类型	国家	年份	组别	例数	年龄 (岁)	性别 (男/女)	结局指标	改良Jadad 质量评价(分)
Ringel^[5]	随机对照	德国	2012	机器人辅助	30	68	14/16	①②④⑥⑦	7
				透视引导	30	67	12/18
Feng^[6]	随机对照	中国	2019	机器人辅助	40	67.6±6.5	12/28	①③⑥⑦	5
				透视引导	40	67.9±7.3	13/27
Keric^[7]	回顾性	德国	2017	机器人辅助	52	72.3±11.1	36/30	①②④⑤⑥⑦	6
				透视引导	70	68.0±11.2	13/11
Hyun^[8]	随机对照	韩国	2017	机器人辅助	30	66.5	9/21	①③④⑤⑥⑦	7
				透视引导	30	66.8	8/22
Kim^[9]	随机对照	韩国	2015	机器人辅助	20	64.4±11.9	11/9	①⑥	6
				透视引导	20	64.7±8.6	8/12
Lautado^[10]	回顾性	瑞士	2018	机器人辅助	11	65	-	①	5
				透视引导	48	60.7
Schizas^[11]	随机对照	瑞士	2012	机器人辅助	11	65	6/5	①③④	6
				透视引导	23	66	8/15
Kantelhardt^[12]	回顾性	德国	2011	机器人辅助	55	63.1	52/60	①②④⑥⑦	6
				透视引导	57
Lonjon^[13]	随机对照	法国	2016	机器人辅助	10	63.4±11.0	4/6	①②③④⑥⑦	7
				透视引导	10		4/6
Han^[14]	回顾性	中国	2019	机器人辅助	52	54.6±11.3	55/60	①③④⑥⑦	5
				透视引导	70	56.1±13.4	58/61
Schatlo^[15]	回顾性	德国	2014	机器人辅助	55	52(27-83)	29/26	①②⑥⑦	6
				透视引导	40	58(23-82)	28/12
Roser^[16]	回顾性	德国	2013	机器人辅助	18	-	-	①③④	5
				透视引导	10
田伟^[17]	随机对照	中国	2016	机器人辅助	23	54.9±11.9	17/23	①⑥	5
				透视引导	17