Comparison of accuracy and safety between robot-assisted and conventional fluoroscope assisted placement of pedicle screws in thoracolumbar spine: A meta-analysis.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2021;9(21):14 Medicine (Baltimore). 2021 Sep 24;100(38): e27282.What this means for my practice?
The results of this study found robot-assisted pedicle screw placement to result in significantly greater accuracy, lower facet joint revision rate and lower revision rate compared to fluoroscopy-guided placement. This study was limited by the lack of assessment of the impact of minimally invasive or open surgery on placement, the variation in surgical techniques used, and small number of studies available for fluoroscopy time and facet joint revision rate. Future randomized trials are of interest to further expand the evidence available of the topic.
Study Summary
Thirteen randomized controlled trials containing a total of 4727 patients undergoing thoracolumbar spine surgery were included in this meta-analysis comparing robot-assisted pedicle screw placement and fluoroscopy-guided pedicle screw placement. The pooled outcomes of interest included accuracy of screw placement, adverse events, facet joint invasion rate, revision, and fluoroscopy time. Results of the meta-analysis demonstrated significantly greater pooled screw placement accuracy, lower facet joint invasion rate, and lower revision rate in the robot-assisted group.
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