Comparison of accuracy of pedicle screw placement for adolescent idiopathic scoliosis using freehand fluoroscopic, navigation, and robotic-assisted techniques - a systematic review and bayesian network meta-analysis.
Paweł Łajczak, Ayesha Ayesha, Rabbia Jabbar, Yasmin Picanço Silva, Eshita Sharma, Oguz Kagan Sahin, Kaike Eduardo da Silva Lobo, Iago Nathan Simon Petry, Aisha Rizwan Ahmed, Fabio Victor Vieira Rocha, Walter Fagundes, Yan G M D Silva
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引用次数: 0
Abstract
Adolescent idiopathic scoliosis (AIS) is a prevalent spinal deformity, often requiring surgical intervention. Posterior pedicle spine instrumentation, a common procedure for correcting AIS, can be performed using freehand fluoroscopic (FHF), navigation-assisted (NVA), or robotic-assisted (RBA) techniques for pedicle screw insertion. This study aimed to evaluate the accuracy and clinical outcomes of these techniques through a Bayesian network meta-analysis (BNMA) of 764 patients and 8,144 screws from twelve studies. Our findings suggest that RBA offers superior accuracy in pedicle screw placement compared to both FHF and NVA. However, RBA is associated with longer operative times. NVA, in contrast, provides a balanced approach by offering good accuracy with relatively shorter surgery times. No significant differences were observed in blood loss, Cobb angle correction, or hospital stay between the techniques. Additionally, no statistically significant differences were found between RBA and NVA in terms of operative duration or blood loss. These results have important clinical implications, indicating that RBA may be the preferred option for achieving high precision, particularly in complex cases, while NVA remains a viable alternative for quicker procedures. Further research is needed to assess the long-term outcomes, radiation exposure, and cost-effectiveness of these techniques in clinical practice.
期刊介绍:
The goal of Neurosurgical Review is to provide a forum for comprehensive reviews on current issues in neurosurgery. Each issue contains up to three reviews, reflecting all important aspects of one topic (a disease or a surgical approach). Comments by a panel of experts within the same issue complete the topic. By providing comprehensive coverage of one topic per issue, Neurosurgical Review combines the topicality of professional journals with the indepth treatment of a monograph. Original papers of high quality are also welcome.