Meta-analysis of clinical efficacy of robot-assisted pedicle screw placement for the treatment of thoracolumbar vertebral fractures
10.3969/j.issn.1672-8270.2024.02.029
- VernacularTitle:机器人辅助椎弓根螺钉置入治疗胸腰椎骨折的临床疗效Meta分析
- Author:
Lili WANG
1
;
Lanting LYU
;
Xinying LIU
;
Binbin CHEN
Author Information
1. 北京大学医学部卫生政策与技术评估中心 北京 100191
- Keywords:
Surgical robot;
Pedicle screw placement;
Thoracolumbar fracture;
Meta-analysis
- From:
China Medical Equipment
2024;21(2):149-156
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze and compare the clinical efficacy of robot-assisted and conventional navigation-assisted percutaneous minimally invasive pedicle screw placement in the treatment of thoracolumbar fractures and to provide reference for clinical treatment decisions.Methods:A literature search was performed in China National Knowledge Infrastructure(CNKI),VIP,Wanfang and English databases PubMed and Web of science by using the keywords"vertebral pedicle screws,"and"robot"in Chinese and"robot"and"pedicle screws"in English.The search time in both Chinese and English was from the establishment of the database to December 2022.The relevant clinical studies on robot-assisted and traditional navigation-assisted percutaneous minimally invasive pedicle screw placement for the treatment of thoracolumbar cone fractures were collected.Cochrane Scale and Newcastle-Ottawa Scale(NOS)were used to evaluate the quality of literatures and meta-analysis was carried out.The clinical effects of robot-assisted and traditional navigation-assisted surgery was compared.Results:A total of 15 articles were included in the study.Compared with traditional navigation-assisted percutaneous minimally invasive pedicle screw placement,robotic-assisted surgery resulted in shorter operative time[WMD=-11.45,95% CI(-18.94～-3.95),P＜0.05],less intraoperative bleeding[WMD=-19.11,95% CI(-27.51～-10.70),P<0.001],higher screw placement accuracy[number of grade A nails:RR=1.20,95% CI(1.16～1.25),P<0.001;number of grade A+B nails:RR=1.09,95% CI(1.07～1.11),P<0.001],and fewer complications[RR=0.35,95% CI(0.13～0.93),P＜0.05].The difference in hospitalization time was not statistically significant(P>0.05).Conclusion:In percutaneous minimally invasive pedicle screw placement for the treatment of thoracolumbar fractures,robot-assisted surgery has advantages over navigation-assisted surgery in terms of operative time,intraoperative bleeding,placement accuracy and complications.
