Bony fixation in the era of spinal robotics: A systematic review and meta-analysis.

Humans Pedicle Screws Robotic Surgical Procedures Robotics Spinal Fusion Spine / surgery
Accuracy Meta-analysis Robotic surgery Robotics Screw Spinal fixation Spinal fusion Systematic review

Journal

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
ISSN: 1532-2653
Titre abrégé: J Clin Neurosci
Pays: Scotland
ID NLM: 9433352

Informations de publication

Date de publication:
Mar 2022
Historique:
received: 02 10 2021
revised: 01 01 2022
accepted: 08 01 2022
pubmed: 23 1 2022
medline: 3 3 2022
entrez: 22 1 2022
Statut: ppublish

Résumé

Accurate spinal screw placement in spinal instrumentation is of utmost importance to avoid injury to surrounding neurovascular structures. This study was performed to investigate differences in accuracy, operating room time, length of stay, and operative blood loss across studies involving all types of spinal fixation. PubMed, EMBASE, and Scopus were systematically queried to identify articles that fit the inclusion and exclusion criteria. Meta-analysis was performed using R software, and odds ratios and 95% CIs were calculated. Sixty-nine articles were included in qualitative synthesis, and 35 studies in the meta-analysis, for a total of 8,174 robotically placed screws in 1,492 patients compared to 9,791 conventionally placed screws in 1,638 patients. A total of 9 screw trajectories were studied in the literature, although only 4 had enough evidence to be included in the meta-analysis. Robotic screw placement was more accurate than conventional screw placement (OR 2.24; 95% CI, 1.71-2.94). Robotic placement was not associated with significantly different postoperative length of stay (SMD -0.32; 95% CI, -1.20, 0.51), operative blood loss (SMD -0.25; 95% CI, -0.79, 0.19), or operative duration (SMD 0.08; 95% CI -1.00, 1.39). A total of 8 robotic platforms were found in the literature with accuracy rates above 93%. Robotic spinal fixation is associated with increased screw placement accuracy and similar operative blood loss, length of stay, and operative duration. These findings support the safety and cost-effectiveness of robotic spinal surgery across the spectrum of robotic systems and screw types.

Sections du résumé

BACKGROUND BACKGROUND
Accurate spinal screw placement in spinal instrumentation is of utmost importance to avoid injury to surrounding neurovascular structures. This study was performed to investigate differences in accuracy, operating room time, length of stay, and operative blood loss across studies involving all types of spinal fixation.
METHODS METHODS
PubMed, EMBASE, and Scopus were systematically queried to identify articles that fit the inclusion and exclusion criteria. Meta-analysis was performed using R software, and odds ratios and 95% CIs were calculated.
RESULTS RESULTS
Sixty-nine articles were included in qualitative synthesis, and 35 studies in the meta-analysis, for a total of 8,174 robotically placed screws in 1,492 patients compared to 9,791 conventionally placed screws in 1,638 patients. A total of 9 screw trajectories were studied in the literature, although only 4 had enough evidence to be included in the meta-analysis. Robotic screw placement was more accurate than conventional screw placement (OR 2.24; 95% CI, 1.71-2.94). Robotic placement was not associated with significantly different postoperative length of stay (SMD -0.32; 95% CI, -1.20, 0.51), operative blood loss (SMD -0.25; 95% CI, -0.79, 0.19), or operative duration (SMD 0.08; 95% CI -1.00, 1.39). A total of 8 robotic platforms were found in the literature with accuracy rates above 93%.
CONCLUSION CONCLUSIONS
Robotic spinal fixation is associated with increased screw placement accuracy and similar operative blood loss, length of stay, and operative duration. These findings support the safety and cost-effectiveness of robotic spinal surgery across the spectrum of robotic systems and screw types.

Identifiants

DOI: 10.1016/j.jocn.2022.01.005 PMID: 35065405
pubmed: 35065405
pii: S0967-5868(22)00005-4
doi: 10.1016/j.jocn.2022.01.005
pii:
doi:

Types de publication

Journal Article Meta-Analysis Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

62-74

Informations de copyright

Copyright © 2022 Elsevier Ltd. All rights reserved.

Auteurs

Alexander S Himstead (AS)

School of Medicine, University of California, Irvine, Irvine, CA. Electronic address: ahimstea@hs.uci.edu.

Shane Shahrestani (S)

Keck School of Medicine of USC, Los Angeles, California; Medical Scientist Training Program, California Institute of Technology, Pasadena, CA.

Nolan J Brown (NJ)

School of Medicine, University of California, Irvine, Irvine, CA.

Gautam Produturi (G)

Department of Neurosurgery, University of California San Diego School of Medicine, San Diego, California.

Nathan A Shlobin (NA)

Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL.

Omar Al Jammal (O)

Department of Neurosurgery, University of California San Diego School of Medicine, San Diego, California.

Elliot H Choi (EH)

Medical Scientist Training Program, School of Medicine, Case Western Reserve University, Cleveland, OH.

Seth C Ransom (SC)

Department of Neurological Surgery, University of Arkansas for Medical Sciences, Little Rock, AR.

Luis Daniel Diaz-Aguilar (L)

Department of Neurosurgery, University of California San Diego School of Medicine, San Diego, California.

Ronald Sahyouni (R)

Department of Neurosurgery, University of California San Diego School of Medicine, San Diego, California.

Mickey Abraham (M)

Department of Neurosurgery, University of California San Diego School of Medicine, San Diego, California.

Martin H Pham (MH)

Department of Neurosurgery, University of California San Diego School of Medicine, San Diego, California. Electronic address: mhpham@health.ucsd.edu.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Bony fixation in the era of spinal robotics: A...
questionsmedicales.fr › Équipement et fournitures › Équipement chirurgical › Matériels de fixation chirurgicale › Appareils de fixation orthopédique › Fixateurs internes › Vis orthopédiques › Vis pédiculaires › Bony fixation in the era of spinal robotics: A...
questionsmedicales.fr › Technologie, industrie et agriculture › Technologie › Automatisation › Interventions chirurgicales robotisées › Bony fixation in the era of spinal robotics: A...
questionsmedicales.fr › Sciences de l'information › Méthodologies informatiques › Algorithmes › Intelligence artificielle › Robotique › Bony fixation in the era of spinal robotics: A...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures orthopédiques › Arthrodèse › Arthrodèse vertébrale › Bony fixation in the era of spinal robotics: A...
questionsmedicales.fr › Appareil locomoteur › Squelette › Rachis › Bony fixation in the era of spinal robotics: A...