{"title":"Turning the screw: assessing the impact of full power-assisted versus manual pedicle screw insertion in paediatric spine surgery.","authors":"Weronika Nocun, Neel Badhe, Vasanth Bharathidasan, Gayathri Vimal, Kalyani Parvathi Nair, Elie Najjar","doi":"10.1007/s43390-025-01138-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Long-level pedicle screw placement involves repetitive, forceful rotational movements that increase the risk of musculoskeletal pain and disorders in spine surgeons. Full power-assisted pedicle screw insertion may mitigate these risks, but its efficacy and safety compared to manual techniques remain underexplored. Understanding these differences is crucial for optimizing surgical practices and improving outcomes.</p><p><strong>Objective: </strong>To systematically evaluate the outcomes of full power-assisted versus manual pedicle screw insertion in paediatric spine surgery, focusing on operative time and complications.</p><p><strong>Methods: </strong>A systematic review of English-language literature published up to September 2024 was conducted using the search criteria (\"Pedicle Screws\"[Mesh]) and (power), adhering to PRISMA guidelines. Studies comparing full power-assisted and manual pedicle screw insertion were included.</p><p><strong>Results: </strong>Of 2,559 patients, 1,715 underwent full power-assisted insertion (65.7% female, mean age 14.3 years, mean follow-up 20.8 months), and 844 underwent manual insertion (67.9% female, mean age 14.5 years, mean follow-up 26.9 months). Operative times were comparable (248 vs. 251.4 min, p = 0.69), as were screw breach rates (0.49% vs. 1.42%, p = 0.23). However, manual insertion was associated with a significantly higher rate of other complications compared to full power-assisted techniques (0.077% vs. 0.022%, p = 0.03).</p><p><strong>Conclusion: </strong>Full power-assisted pedicle screw insertion is as efficient and accurate as manual techniques, with fewer complications in pedicle screw placement surgery. These findings support the use of power assistance to enhance surgical safety. Further research should validate these results in diverse patient populations and long-term follow-up.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine deformity","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s43390-025-01138-4","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Long-level pedicle screw placement involves repetitive, forceful rotational movements that increase the risk of musculoskeletal pain and disorders in spine surgeons. Full power-assisted pedicle screw insertion may mitigate these risks, but its efficacy and safety compared to manual techniques remain underexplored. Understanding these differences is crucial for optimizing surgical practices and improving outcomes.
Objective: To systematically evaluate the outcomes of full power-assisted versus manual pedicle screw insertion in paediatric spine surgery, focusing on operative time and complications.
Methods: A systematic review of English-language literature published up to September 2024 was conducted using the search criteria ("Pedicle Screws"[Mesh]) and (power), adhering to PRISMA guidelines. Studies comparing full power-assisted and manual pedicle screw insertion were included.
Results: Of 2,559 patients, 1,715 underwent full power-assisted insertion (65.7% female, mean age 14.3 years, mean follow-up 20.8 months), and 844 underwent manual insertion (67.9% female, mean age 14.5 years, mean follow-up 26.9 months). Operative times were comparable (248 vs. 251.4 min, p = 0.69), as were screw breach rates (0.49% vs. 1.42%, p = 0.23). However, manual insertion was associated with a significantly higher rate of other complications compared to full power-assisted techniques (0.077% vs. 0.022%, p = 0.03).
Conclusion: Full power-assisted pedicle screw insertion is as efficient and accurate as manual techniques, with fewer complications in pedicle screw placement surgery. These findings support the use of power assistance to enhance surgical safety. Further research should validate these results in diverse patient populations and long-term follow-up.
背景:在脊柱外科医生中,长水平椎弓根螺钉置入涉及重复性的、有力的旋转运动,这增加了肌肉骨骼疼痛和疾病的风险。全动力辅助椎弓根螺钉置入可以减轻这些风险,但与手工技术相比,其有效性和安全性仍有待进一步研究。了解这些差异对于优化手术实践和改善结果至关重要。目的:系统评价全助力与手动椎弓根螺钉置入在小儿脊柱手术中的效果,重点分析手术时间和并发症。方法:根据PRISMA指南,使用检索标准(“椎弓根螺钉”[Mesh])和(power)对截至2024年9月发表的英语文献进行系统综述。包括了比较全动力辅助和手动椎弓根螺钉置入的研究。结果:2559例患者中,1715例患者采用全助力插入(65.7%为女性,平均年龄14.3岁,平均随访20.8个月),844例患者采用手动插入(67.9%为女性,平均年龄14.5岁,平均随访26.9个月)。手术时间比较(248 vs. 251.4 min, p = 0.69),螺钉断裂率比较(0.49% vs. 1.42%, p = 0.23)。然而,与全助力技术相比,手动插入与其他并发症的发生率明显更高(0.077%对0.022%,p = 0.03)。结论:全助力椎弓根螺钉置入术与手工置入术一样高效、准确,并发症少。这些发现支持使用动力辅助来提高手术安全性。进一步的研究应该在不同的患者群体和长期随访中验证这些结果。
期刊介绍:
Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.