Robotic versus intraoperative image-based navigated thoraco-lumbar pedicle screw fixation: a systematic review and meta-analysis.

Q1 Medicine

MUSCULOSKELETAL SURGERY Pub Date : 2026-07-21 DOI:10.1007/s12306-026-00965-6

G F Papalia, N Nardi, G Maltese, G Marcello, N Fazzi, F Russo, G Vadalà, R Papalia, V Denaro

{"title":"Robotic versus intraoperative image-based navigated thoraco-lumbar pedicle screw fixation: a systematic review and meta-analysis.","authors":"G F Papalia, N Nardi, G Maltese, G Marcello, N Fazzi, F Russo, G Vadalà, R Papalia, V Denaro","doi":"10.1007/s12306-026-00965-6","DOIUrl":null,"url":null,"abstract":"Purpose: Spondylodesis is performed to stabilize and immobilize spinal regions impacted by conditions such as degenerative disorders, deformities, trauma, tumors, or infections. To improve the accuracy of pedicle screw placement, computer-assisted navigation systems were introduced in spine surgery. The objective of this study was to compare the accuracy of pedicle screw placement and the patient outcomes in robotic-guided versus intraoperative 3D navigation techniques for thoraco-lumbar spine surgery.Methods: The search was conducted on 30 September 2025 on Scopus, Cochrane Central Library and PubMed. Prospective and retrospective studies that compared pedicle screw placement, clinical outcomes and complications using robotic versus intraoperative 3D navigation technique in the thoracolumbar segment were included. Hospital stay, operative time and blood loss were evaluated as continuous outcomes with mean difference. Screw accuracy, FJV, intraoperative and postoperative screw revisions, complications and complications were evaluated as dichotomous outcomes with odds ratio. Statistical significance was set at p < 0.05.Results: Among the 14 studies included in the meta-analysis, statistically significant results in favor of robotic group were described for hospital stay (p = 0.003) and pedicle screw accuracy (p < 0.00001). However, no significant differences were observed in terms of intraoperative or postoperative screw revisions, facet joint violations, operative time and blood loss.Conclusion: Robotic-guided pedicle screw fixation represents a safe and highly effective technique, showing statistically significant superiority in screw placement accuracy compared to CT-guided navigation.","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"MUSCULOSKELETAL SURGERY","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12306-026-00965-6","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: Spondylodesis is performed to stabilize and immobilize spinal regions impacted by conditions such as degenerative disorders, deformities, trauma, tumors, or infections. To improve the accuracy of pedicle screw placement, computer-assisted navigation systems were introduced in spine surgery. The objective of this study was to compare the accuracy of pedicle screw placement and the patient outcomes in robotic-guided versus intraoperative 3D navigation techniques for thoraco-lumbar spine surgery.

Methods: The search was conducted on 30 September 2025 on Scopus, Cochrane Central Library and PubMed. Prospective and retrospective studies that compared pedicle screw placement, clinical outcomes and complications using robotic versus intraoperative 3D navigation technique in the thoracolumbar segment were included. Hospital stay, operative time and blood loss were evaluated as continuous outcomes with mean difference. Screw accuracy, FJV, intraoperative and postoperative screw revisions, complications and complications were evaluated as dichotomous outcomes with odds ratio. Statistical significance was set at p < 0.05.

Results: Among the 14 studies included in the meta-analysis, statistically significant results in favor of robotic group were described for hospital stay (p = 0.003) and pedicle screw accuracy (p < 0.00001). However, no significant differences were observed in terms of intraoperative or postoperative screw revisions, facet joint violations, operative time and blood loss.

Conclusion: Robotic-guided pedicle screw fixation represents a safe and highly effective technique, showing statistically significant superiority in screw placement accuracy compared to CT-guided navigation.

查看原文本刊更多论文

机器人与术中基于图像的导航胸腰椎椎弓根螺钉固定：一项系统综述和荟萃分析。

目的：椎体融合术用于稳定和固定受退行性疾病、畸形、创伤、肿瘤或感染等影响的脊柱区域。为了提高椎弓根螺钉放置的准确性，计算机辅助导航系统被引入脊柱外科。本研究的目的是比较机器人引导与术中3D导航技术在胸腰椎手术中椎弓根螺钉放置的准确性和患者的预后。方法：于2025年9月30日在Scopus、Cochrane Central Library和PubMed上进行检索。前瞻性和回顾性研究比较了机器人与术中3D导航技术在胸腰椎段的椎弓根螺钉放置、临床结果和并发症。住院时间、手术时间和出血量以平均差异评价连续结局。螺钉准确性、FJV、术中术后螺钉复位、并发症及并发症以比值比作为二分类结果进行评估。结果：在纳入meta分析的14项研究中，机器人组在住院时间（p = 0.003）和椎弓根螺钉精度(p)方面的结果具有统计学意义。结论：机器人引导椎弓根螺钉固定是一种安全高效的技术，与ct引导导航相比，在螺钉放置精度方面具有统计学意义的优势。

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

MUSCULOSKELETAL SURGERY Medicine-Surgery

CiteScore

4.50

自引率

0.00%

发文量

期刊介绍： Musculoskeletal Surgery – Formerly La Chirurgia degli Organi di Movimento, founded in 1917 at the Istituto Ortopedico Rizzoli, is a peer-reviewed journal published three times a year. The journal provides up-to-date information to clinicians and scientists through the publication of original papers, reviews, case reports, and brief communications dealing with the pathogenesis and treatment of orthopaedic conditions.An electronic version is also available at http://www.springerlink.com.The journal is open for publication of supplements and for publishing abstracts of scientific meetings; conditions can be obtained from the Editors-in-Chief or the Publisher.