颈椎手术中机器人或计算机辅助导航与透视徒手技术在颈椎后螺钉置入准确性方面的比较:一项荟萃分析。

IF 2.9 2区 医学 Q2 CLINICAL NEUROLOGY
Journal of neurosurgery. Spine Pub Date : 2024-09-06 Print Date: 2024-12-01 DOI:10.3171/2024.5.SPINE24207
Lu-Ping Zhou, Ren-Jie Zhang, Yi Shang, Chen-Hao Zhao, Liang Kang, Chong-Yu Jia, Jia-Qi Wang, Hua-Qing Zhang, Cai-Liang Shen
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引用次数: 0

摘要

目的:在颈椎手术中,机器人引导(RG)和计算机辅助导航(CAN)越来越多地被用于颈椎后路螺钉置入,而颈椎螺钉置入不当可能导致灾难性并发症。然而,与传统的徒手(FH)技术相比,使用RG或CAN导航的优越性仍存在争议,目前还没有在颈椎手术中对这两种方法进行比较的荟萃分析:方法: 在 PubMed、Embase、Web of Science、Cochrane、中国国家知识基础设施和万方数据库中检索符合条件的文献。方法:检索了PubM、Embed、Web Science、Cochrane、中国国家知识基础设施和万方数据库中符合条件的文献,并纳入了报告使用RG或CAN与FH技术相比颈椎螺钉置入准确性的主要结果的研究。偏倚采用 Cochrane 偏倚风险标准和纽卡斯尔-渥太华量表进行评估。结果以几率比例或标准化平均差异以及相应的 95% 置信区间进行评估:本荟萃分析纳入了 2012 年至 2023 年间发表的 1 项随机对照试验和 18 项比较队列研究,包括 946 名患者和 4163 枚颈椎螺钉。与FH技术相比,RG和CAN技术的颈椎螺钉精确度达到最佳且临床可接受的比率要高得多。此外,与 FH 组相比,导航组的术后不良事件更少、失血更少、住院时间更短、术后颈部残疾指数评分更低。然而,导航组和 FH 组的术中时间以及术后视觉模拟量表和日本骨科协会评分在最终随访时相当:结论:就颈椎螺钉置入的准确性而言,RG 和 CAN 均优于 FH 技术。包括 RG 和 CAN 方法在内的导航技术在颈椎手术中是准确、安全和可行的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of robotic or computer-assisted navigation versus fluoroscopic freehand techniques in the accuracy of posterior cervical screw placement during cervical spine surgery: a meta-analysis.

Objective: Robot guidance (RG) and computer-assisted navigation (CAN) have been increasingly utilized for posterior cervical screw placement in cervical spine surgery, and cervical screw malposition may contribute to catastrophic complications. However, the superiority of the navigation using RG or CAN compared with conventional freehand (FH) techniques remains controversial, and no meta-analysis comparing the two methods in cervical spine surgery has been performed.

Methods: The PubMed, Embase, Web of Science, Cochrane, China National Knowledge Infrastructure, and Wanfang databases were searched for eligible literature. Studies reporting the primary outcomes of the accuracy of cervical screw placement using RG or CAN compared with FH techniques were included. Bias was evaluated using the Cochrane risk of bias criteria and the Newcastle-Ottawa Scale. The outcomes were evaluated in terms of odds ratio or standardized mean difference and corresponding 95% confidence interval.

Results: One randomized controlled trial and 18 comparative cohort studies published between 2012 and 2023 consisting of 946 patients and 4163 cervical screws were included in this meta-analysis. The RG and CAN techniques were associated with a substantially higher rate of optimal and clinically acceptable cervical screw accuracy than FH techniques. Furthermore, compared with the FH group, the navigation group showed fewer postoperative adverse events, less blood loss, shorter hospital lengths of stay, and lower postoperative Neck Disability Index scores. However, the navigation and FH groups had equivalent intraoperative times and postoperative visual analog scale and Japanese Orthopaedic Association scores at the final follow-up.

Conclusions: Both RG and CAN are superior to FH techniques in terms of the accuracy of cervical screw placement. Navigation techniques, including RG and CAN methods, are accurate, safe, and feasible in cervical spine surgery.

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来源期刊
Journal of neurosurgery. Spine
Journal of neurosurgery. Spine 医学-临床神经学
CiteScore
5.10
自引率
10.70%
发文量
396
审稿时长
6 months
期刊介绍: Primarily publish original works in neurosurgery but also include studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology.
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