Comparison of robot-assisted and freehand pedicle screw placement for lumbar revision surgery

Association of robot-assisted techniques with the accuracy rates of pedicle screw placement: A network pooling analysis

“…The flow diagram in Figure 1 shows the patient selection process, with inclusion and exclusion criteria. 2046 participants (male: 46.22%; female: 53.78%) were included from 26 trials, 3 , 5 , 11 , 12 , 13 , 14 , 16 , 17 , 18 , 19 , 21 , 22 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 conducted in China ( n = 9), 3 , 11 , 16 , 19 , 36 , 38 , 39 , 40 , 41 Germany ( n = 7), 12 , 17 , 18 , 22 , 30 , 32 , 37 the United States of America ( n = 3), 28 , 31 , 33 Switzerland ( n = 3), 5 , 29 , 35 South Korea ( n = 3) 13 , 21 , 34 and France ( n = 1). 14 The robotic systems used for pedicle screw placement included SpineAssist ( n = 10), 5 , 12 , 18 , 22 , 28 …”

“…23 studies (1949 participants, 9319 pedicle screws) compared the differences in perfect pedicle screw insertion ( Figure 2 A). 3 , 5 , 8 , 11 , 12 , 13 , 14 , 16 , 17 , 18 , 19 , 21 , 22 , 28 , 29 , 30 , 32 , 34 , 35 , 36 , 38 , 39 , 40 , 41 The pooled estimates ( Figure 2 B) showed that Renaissance (OR, 2.86; [95% CI, 1.79 to 4.57]) and TiRobot (OR, 3.10; [95% CI, 2.19 to 4.40]) were associated with higher rates of perfect pedicle screw insertion than conventional freehand technique in the consistency model. Moreover, Renaissance (OR, 2.38; [95% CI, 1.37 to 4.13]) and TiRobot (OR, 2.58; [95% CI, 1.64 to 4.07]) were associated with higher rates of perfect pedicle screw insertion than SpineAssist in the consistency model.…”

“…Seven studies (799 participants, 2574 pedicle screws) compared the differences in proximal facet joint violation. 3 , 16 , 21 , 34 , 37 , 38 , 40 The pooled analysis showed that robot-assisted techniques were associated with low proximal facet joint violation rates (OR, 0.18; [95% CI, 0.10 to 0.32]; Figure 5 A). Egger's test ( P = 0.3974) revealed no significant publication bias.…”

“… 2 It is widely acknowledged that in lumbar spine revision surgery, the normal anatomical structure is often disrupted due to previous operations, further increasing risks during surgery. 3 In such cases, complications related to pedicle screw placement are not uncommon. 4 , 5 Moreover, in recent years, a computer-aided system has been developed to significantly improve the accuracy of screw placement.…”

“…A growing body of research has demonstrated that the robotic-assisted technique has higher accuracy rates than the conventional freehand technique. 3 , 17 , 18 , 19 , 20 Two prospective, randomized controlled trials (RCTs) have shown that robotic-assisted pedicle fixation is as accurate as the freehand technique. 21 , 22 In contrast, Ringel et al.…”