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.

IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY
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
{"title":"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.","authors":"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","doi":"10.1007/s10143-025-03333-3","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"257"},"PeriodicalIF":2.5000,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurosurgical Review","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10143-025-03333-3","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
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.

青少年特发性脊柱侧凸(AIS)是一种常见的脊柱畸形,通常需要手术干预。后椎弓根脊柱器械植入术是矫正AIS的常见手术,可采用徒手透视(FHF)、导航辅助(NVA)或机器人辅助(RBA)技术进行椎弓根螺钉植入。本研究旨在通过贝叶斯网络荟萃分析(BNMA)评估这些技术的准确性和临床疗效,分析对象包括 12 项研究中的 764 名患者和 8,144 枚螺钉。我们的研究结果表明,与 FHF 和 NVA 相比,RBA 在椎弓根螺钉置入方面具有更高的准确性。但是,RBA 需要更长的手术时间。相比之下,NVA则提供了一种平衡的方法,在提供良好准确性的同时,手术时间也相对较短。两种技术在失血量、Cobb 角校正或住院时间方面没有明显差异。此外,在手术时间或失血量方面,RBA 和 NVA 之间也没有统计学意义上的显著差异。这些结果具有重要的临床意义,表明 RBA 可能是实现高精度的首选,尤其是在复杂病例中,而 NVA 仍是快速手术的可行替代方案。还需要进一步的研究来评估这些技术在临床实践中的长期效果、辐射暴露和成本效益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Neurosurgical Review
Neurosurgical Review 医学-临床神经学
CiteScore
5.60
自引率
7.10%
发文量
191
审稿时长
6-12 weeks
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.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信