HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery最新文献

{"title":"Revision Arthroscopic Bankart Repair for Anterior Shoulder Instability After a Failed Arthroscopic Soft-Tissue Repair Yields Comparable Failure Rates to Primary Bankart Repair: A Systematic Review.","authors":"Ajaykumar Shanmugaraj,&nbsp;Seaher Sakha,&nbsp;Tushar Tejpal,&nbsp;Timothy Leroux,&nbsp;Jacob M Kirsch,&nbsp;Moin Khan","doi":"10.1177/15563316211030606","DOIUrl":"https://doi.org/10.1177/15563316211030606","url":null,"abstract":"<p><strong>Background: </strong>The management of recurrent instability after arthroscopic Bankart repair remains challenging. Of the various treatment options, arthroscopic revision repairs are of increasing interest due to improved visualization of pathology and advancements in arthroscopic techniques and instrumentation.</p><p><strong>Purpose: </strong>We sought to assess the indications, techniques, outcomes, and complications for patients undergoing revision arthroscopic Bankart repair after a failed index arthroscopic soft-tissue stabilization for anterior shoulder instability.</p><p><strong>Methods: </strong>We performed a systematic review of studies identified by a search of Medline, Embase, and PubMed. Our search range was from data inception to April 29, 2020. Outcomes include clinical outcomes and rates of complication and revision. The Methodological Index for Non-randomized Studies (MINORS) was used to assess study quality. Data are presented descriptively.</p><p><strong>Results: </strong>Twelve studies were identified, comprising 279 patients (281 shoulders) with a mean age of 26.1 ± 3.8 years and a mean follow-up of 55.7 ± 24.3 months. Patients had improvements in postoperative outcomes (eg, pain and function). The overall complication rate was 29.5%, the most common being recurrent instability (19.9%).</p><p><strong>Conclusion: </strong>With significant improvements postoperatively and comparable recurrent instability rates, there exists a potential role in the use of revision arthroscopic Bankart repair where the glenoid bone loss is less than 20%. Clinicians should consider patient history and imaging findings to determine whether a more rigorous stabilization procedure is warranted. Large prospective cohorts with long-term follow-up and improved documentation are required to determine more accurate failure rates.</p>","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":" ","pages":"145-155"},"PeriodicalIF":2.5,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/15563316211030606","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39862065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of COVID-19 on Orthopedic Surgery Fellowship Training: A Survey of Fellowship Program Directors.","authors":"Braiden M Heaps,&nbsp;Jeffrey R Dugas,&nbsp;Orr Limpisvasti","doi":"10.1177/15563316211012006","DOIUrl":"https://doi.org/10.1177/15563316211012006","url":null,"abstract":"<p><p><i>Background</i>: The COVID-19 pandemic has had a wide-reaching impact. Graduate medical education of orthopedic surgeons was not spared from the jarring changes. <i>Purpose</i>: We sought to survey fellowship program directors in the field of orthopedic surgery about how the COVID-19 pandemic affected the education of the 2019 to 2020 and 2020 to 2021 fellowship classes and the future of their programs. <i>Methods</i>: In October 2020, an 18-item survey was distributed by an official of the American Academy of Orthopedic Surgeons (AAOS) to the specialty societies that govern fellowship training. Each specialty society then distributed the survey to its respective program directors. A reminder email was sent during the enrollment period. Each respondent was able to complete the survey once. Survey questions were grouped into 3 sections: general information about the fellowship training programs, the impact of COVID-19 on the 2019 to 2020 fellowship class, and the future impact of COVID-19 on the fellowship training programs. <i>Results</i>: Of the 564 accredited orthopedic surgery fellowship programs in the United States, 190 directors responded. Of these, 73.59% reported COVID-19 had a negative impact on the 2019 to 2020 fellowship class. A normal distribution of responses was found regarding didactic and academic learning, research, and mentorship opportunities. A majority of respondents said they believe that there will be no negative impact on patient care the fellows provide in the years to come. <i>Conclusion</i>: Orthopedic surgery fellowship program directors acknowledged that while there were negative effects to training in the pandemic, they did not think these would negatively affect patient care provided by 2019 to 2020 fellows in the short and medium term. They also reported positive outcomes from the experience of the pandemic, including new ways to educate fellows.</p>","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":" ","pages":"105-109"},"PeriodicalIF":2.5,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/15563316211012006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39861634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Workflow and Efficiency of Robotic-Assisted Navigation in Spine Surgery.","authors":"Fedan Avrumova,&nbsp;Ahilan Sivaganesan,&nbsp;Ram Kiran Alluri,&nbsp;Avani Vaishnav,&nbsp;Sheeraz Qureshi,&nbsp;Darren R Lebl","doi":"10.1177/15563316211026658","DOIUrl":"https://doi.org/10.1177/15563316211026658","url":null,"abstract":"The increasing interest in improving intraoperative workflow and efficiency is evident from the growing body of literature on spinal robotics. The first robotic-assisted system for adult spine surgery received US Food and Drug Administration (FDA) clearance in 2004 [4]. Newer robotic systems with integrated surgical navigation have shown the potential for improved accuracy, shorter time-per-screw placement, less fluoroscopy/radiation time, and shorter hospital stays over freehand techniques [8,9]. One early iteration, the Mazor SpineAssist system, provided 6° of freedom of mobility for surgical instrumentation in addition to close to optimal screw positioning and placement [5]. Mazor Robotics released the second generation (Renaissance Guidance System) in 2011, which was followed by the third generation (Mazor X) in 2016. (Mazor Robotics was purchased by Medtronic in 2018.) The most recent version is the Mazor X Stealth Edition; first used in 2019, it combines navigation and robotics in a single platform [5]. Recent competitors include ExcelsiusGPS (Globus Medical, Inc., Audubon, PA, USA), ROSA Spine (Zimmer Biomet Robotics, formerly Medtech SA, Montpellier, France), and Cirq (BrainLab, Munich, Germany) [12]. While multiple studies have examined the operative metrics of robotic-assisted surgery, few have offered a practical understanding of the types of surgeries that can be performed using various systems and the intraoperative workflows required. Here we review these issues, with the aim of providing a foundation for surgeons seeking to incorporate robotics into their practice in an efficient manner. We focus on the Mazor X Robotic Guidance System and the ExcelsiusGPS Robotic Navigation Platform; each has a different physical relationship to the operating room table. The Mazor X is a table-mounted system while the ExcelsiusGPS is a freestanding system with optical arrays. The Mazor X has an inherent stability due to its physical connection to the patient but, due to the weight of the bedmounted arm, it cannot maintain that stability if the patient’s position changes. In addition, a 2 to 3 mm incision must be made on the patient’s right side for posterior superior iliac spine (PSIS) pin placement. In contrast, the ExcelsiusGPS is a freestanding system that does not attach to either the bed or the patient. This allows the patient to change positions without interfering with robotic arm stability. The ROSA Spine received FDA clearance in 2016, and BrainLab’s Cirq received FDA clearance in 2019. Similar to the ExcelsiusGPS, ROSA is a freestanding system that uses a robotic arm and navigation camera, each mounted to mobile bases. BrainLab Cirq is similar to the Mazor X, as it is table-mounted.","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"17 3","pages":"302-307"},"PeriodicalIF":2.5,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/15563316211026658","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39429118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Robotics Coupled With Navigation for Pediatric Congenital Spine Deformity.","authors":"Andrew N Sawires,&nbsp;Craig M Birch,&nbsp;Daniel Hedequist","doi":"10.1177/15563316211027166","DOIUrl":"https://doi.org/10.1177/15563316211027166","url":null,"abstract":"<p><p><i>Background</i>: Spinal instrumentation in children with congenital spine deformity poses challenges to the surgeon, given the small patient size and the anomalous anatomy often encountered. <i>Purpose</i>: We aimed to investigate the accuracy of screw placement when robotics coupled with real-time navigation was used for surgical treatment of pediatric congenital spine deformity at 1 institution. <i>Methods</i>: We conducted a retrospective search of our institution's database for all patients younger than 18 years of age with congenital spine deformity who were treated with the robotics surgical platform coupled with navigation between June 2019 and December 2020. We recorded data on demographics, location and type of anomaly, procedure performed, and intraoperative variables related to robotics and navigation. We reviewed the images of patients who had intraoperative 3-dimensional imaging or postoperative computed tomographic scans to determine the accuracy of screw placement using the Gertzbein-Robbins scale. <i>Results</i>: In 14 patients identified, a total of 95 screws were attempted, with 94 successfully placed using robotics coupled with navigation. There were no noted screw-related complications (neurologic or visceral) and no return to the operating room for screw malposition. <i>Conclusion</i>: Patients with congenital spine deformity present potentially unique challenges due to variant anatomy. This retrospective series suggests that robotics coupled with navigation for congenital spine deformity correction in the pediatric population may aid in accurate screw placement and reduce complication rates. More rigorous study is warranted.</p>","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"17 3","pages":"289-293"},"PeriodicalIF":2.5,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/15563316211027166","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39429681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT-Based Image-Guided Navigation and the DaVinci Robot in Spine Oncology: Changing Surgical Paradigms.","authors":"Anubhav G Amin,&nbsp;Ori Barzilai,&nbsp;Mark H Bilsky","doi":"10.1177/15563316211032009","DOIUrl":"https://doi.org/10.1177/15563316211032009","url":null,"abstract":"The benefits of image-guided navigation and robotics in spine surgery include improving accuracy of pedicle screw placement compared with freehand techniques, serving as a critical adjunct to minimal access surgery (MAS), and reducing radiation exposure for operating room personnel. Whereas these modalities have been beneficial for degenerative conditions, deformity, and trauma, they are becoming transformational in the treatment of primary malignant, metastatic, and benign spine tumors. Integration of these techniques has been a critical development in reducing morbidity for an often medically frail cancer population and improving targeted tumor resection. Navigation has aided the transition from long-segment to short-segment polymethyl methacrylate (PMMA)-augmented pedicle screw fixation used both for percutaneous reconstruction of unstable spines and more recently in open separation surgery for spinal cord decompression. Navigated instruments are becoming important adjuncts in the development of MAS for separation surgery, creating osteotomy trajectories to achieve wide or marginal en bloc excisions for primary malignant tumors and targeting intraosseous benign tumors. In tumor surgery, robotic integration with navigation may offer additional benefits to accurate placement of pedicle screws, but interest in this domain is focused on the da Vinci surgical system (Intuitive, Sunnyvale, CA) for roboticassisted resection of benign paraspinal nerve sheath tumors, principally schwannomas and ganglioneuromas.","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"17 3","pages":"294-301"},"PeriodicalIF":2.5,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/15563316211032009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39429682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to: Patient Perceptions of COVID-19-Related Surgical Delay: An Analysis of Patients Awaiting Total Hip and Knee Arthroplasty.","authors":"","doi":"10.1177/15563316211021735","DOIUrl":"https://doi.org/10.1177/15563316211021735","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1007/s11420-020-09799-9.].</p>","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"17 3","pages":"359"},"PeriodicalIF":2.5,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/15563316211021735","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39429125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the Efficacy of Radiation Free Machine-Vision Image-Guided Surgery With Traditional 2-Dimensional Fluoroscopy: A Randomized, Single-Center Study.","authors":"Jessica Dorilio,&nbsp;Nicole Utah,&nbsp;Christina Dowe,&nbsp;Fedan Avrumova,&nbsp;Daniel Alicea,&nbsp;Antonio Brecevich,&nbsp;Tucker Callanan,&nbsp;Andrew Sama,&nbsp;Darren R Lebl,&nbsp;Celeste Abjornson,&nbsp;Frank P Cammisa","doi":"10.1177/15563316211029837","DOIUrl":"https://doi.org/10.1177/15563316211029837","url":null,"abstract":"<p><p><i>Background:</i> Three-dimensional (3D) computer-assisted navigation (CAN) has emerged as a potential alternative to 2-dimensional (2D) fluoroscopy in the surgical placement of spinal instrumentation. Recently, 3D-CAN systems have improved significantly in their ability to provide real-time anatomical referencing while shortening the registration and set-up time. A novel system in navigation, Machine-Vision Image-Guided Surgery (MvIGS; 7D Surgical, Toronto, Canada) was cleared by the US Food and Drug Administration, but its potential benefits in reducing intra-operative radiation exposure to patients and enhancing surgical accuracy of pedicle screw placement are not fully known. <i>Purpose</i>: We sought to conduct a prospective, randomized, clinical study comparing the 3D-MvIGS spinal navigation system and 2D-fluoroscopy for pedicle screw insertion up to 3 levels (T10-S1) and for various measures of surgical efficacy. <i>Methods</i>: Sixty-two eligible patients were randomized to receive spine surgery using either the 3D-MvIGS group or the conventional 2D-fluoroscopy for pedicle screw fixation for the treatment of spinal stenosis and degenerative spondylolisthesis. Intra-operative parameters and procedure-related unintended protocol violations were recorded. <i>Results</i>: Operative time and estimated blood loss were not significantly different between groups. Radiation time and exposure to patients were significantly reduced in the 3D-MvIGS group. There was no difference between groups in pedicle screw placement accuracy (2D-fluoroscopy group, 96.6%; 3D-MvIGS group, 94.2%). There were no major complications or cases that required revision surgery. <i>Conclusion</i>: The 3D-MvIGS navigation system performed comparably with 2D-fluoroscopy in terms of pedicle screw placement accuracy and operative time. The 3D-MvIGS showed a significant reduction in radiation exposure to patients. In more complex cases or larger cohorts, the true value of greater anatomical visualization can be elucidated.</p>","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"17 3","pages":"274-280"},"PeriodicalIF":2.5,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/15563316211029837","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39429679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facet Violation With Percutaneous Pedicle Screw Placement: Impact of 3D Navigation and Facet Orientation.","authors":"Ting Cong,&nbsp;Ahilan Sivaganesan,&nbsp;Christopher M Mikhail,&nbsp;Avani S Vaishnav,&nbsp;James Dowdell,&nbsp;Joseph Barbera,&nbsp;Hiroshi Kumagai,&nbsp;Jonathan Markowitz,&nbsp;Evan Sheha,&nbsp;Sheeraz A Qureshi","doi":"10.1177/15563316211026324","DOIUrl":"https://doi.org/10.1177/15563316211026324","url":null,"abstract":"<p><p><i>Background:</i> The gold standard for percutaneous pedicle screw placement is 2-dimensional (2D) fluoroscopy. Data are sparse on the accuracy of 3-dimensional (3D) navigation percutaneous screw placement in minimally invasive spine procedures. <i>Objective</i>: We sought to compare a single surgeon's percutaneous pedicle screw placement accuracy using 2D fluoroscopy versus 3D navigation, as well as to investigate the effect of facet orientation on facet violation when using 2D fluoroscopy. <i>Methods</i>: We conducted a retrospective radiographic study of consecutive cohort of patients who underwent percutaneous lumbar instrumentation using either 2D fluoroscopy or 3D navigation. All procedures were performed by a single surgeon at 2 academic institutions between 2011 and 2018. Radiographic measurement of screw accuracy was assessed using a postoperative computed tomographic scan. The primary outcome was facet violation, and secondary outcomes were endplate/tip breaches, the Gertzbein-Robbins classification for cortical breaches, and the Simplified Screw Accuracy grade. Statistical comparisons were made between screws placed using 2D fluoroscopy versus 3D navigation. Axial facet angles were also measured to correlate with facet violation rates. <i>Results</i>: In the 138 patients included, 376 screws were placed with fluoroscopy and 193 with navigation. Superior (unfused) level facet violation was higher with 2D fluoroscopy than with 3D navigation (9% vs 0.5%), which comprises the main cause for poor screw placement. Axial facet angles exceeding 45° at L4 and 60° at L5 were correlated with facet violations. <i>Conclusion</i>: This retrospective study found that 3D navigation is associated with lower facet violation rates in percutaneous lumbar pedicle screw placement when compared with 2D fluoroscopy. These findings suggest that 3D navigation may be of particular value when facet joints are coronally oriented.</p>","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"17 3","pages":"281-288"},"PeriodicalIF":2.5,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/15563316211026324","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39429680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overview of Robotic Technology in Spine Surgery.","authors":"Ram K Alluri,&nbsp;Fedan Avrumova,&nbsp;Ahilan Sivaganesan,&nbsp;Avani S Vaishnav,&nbsp;Darren R Lebl,&nbsp;Sheeraz A Qureshi","doi":"10.1177/15563316211026647","DOIUrl":"https://doi.org/10.1177/15563316211026647","url":null,"abstract":"<p><p>As robotics in spine surgery has progressed over the past 2 decades, studies have shown mixed results on its clinical outcomes and economic impact. In this review, we highlight the evolution of robotic technology over the past 30 years, discussing early limitations and failures. We provide an overview of the history and evolution of currently available spinal robotic platforms and compare and contrast the available features of each. We conclude by summarizing the literature on robotic instrumentation accuracy in pedicle screw placement and clinical outcomes such as complication rates and briefly discuss the future of robotic spine surgery.</p>","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"17 3","pages":"308-316"},"PeriodicalIF":2.5,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/15563316211026647","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39429119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Less Invasive Pediatric Spinal Deformity Surgery: The Case for Robotic-Assisted Placement of Pedicle Screws.","authors":"Kyle W Morse,&nbsp;Hila Otremski,&nbsp;Kira Page,&nbsp;Roger F Widmann","doi":"10.1177/15563316211027828","DOIUrl":"https://doi.org/10.1177/15563316211027828","url":null,"abstract":"<p><p><i>Introduction:</i> Pediatric spinal deformity involves a complex 3-dimensional (3D) deformity that increases the risk of pedicle screw placement due to the close proximity of neurovascular structures. To increase screw accuracy, improve patient safety, and minimize surgical complications, the placement of pedicle screws is evolving from freehand techniques to computer-assisted navigation and to the introduction of robotic-assisted placement. <i>Purpose</i>: The aim of this review was to review the current literature on the use of robotic navigation in pediatric spinal deformity surgery to provide both an error analysis of these techniques and to provide recommendations to ensure its safe application. <i>Methods</i>: A narrative review was conducted in April 2021 using the MEDLINE (PubMed) database. Studies were included if they were peer-reviewed retrospective or prospective studies, included pediatric patients, included a primary diagnosis of pediatric spine deformity, utilized robotic-assisted spinal surgery techniques, and reported thoracic or lumbar pedicle screw breach rates or pedicle screw malpositioning. <i>Results</i>: In the few studies published on the use of robotic techniques in pediatric spinal deformity surgery, several found associations between the technology and increased rates of screw placement accuracy, reduced rates of breach, and minimal complications. All were retrospective studies. <i>Conclusions</i>: Current literature is of a low level of evidence; nonetheless, the findings suggest the accuracy and safety of robotic-assisted spinal surgery in pediatric pedicle screw placement. The introduction of robotics may drive further advances in less invasive pediatric spinal deformity surgery. Further study is warranted.</p>","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"17 3","pages":"317-325"},"PeriodicalIF":2.5,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/15563316211027828","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39429120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}