Bony fixation in the era of spinal robotics: A systematic review and meta-analysis
•Limited literature exists on robotic placement of non-pedicle screw trajectories.•Nine screw trajectories were identified in the literature.•S2-alar-iliac, sacroiliac, and cortical bone trajectory were most common.•Robotic screw placement was more accurate than conventional.•Eight robotic platforms...
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| Veröffentlicht in: | Journal of clinical neuroscience 2022-03, Vol.97, p.62-74 |
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| creator | Himstead, Alexander S. Shahrestani, Shane Brown, Nolan J. Produturi, Gautam Shlobin, Nathan A. Al Jammal, Omar Choi, Elliot H. Ransom, Seth C. Daniel Diaz-Aguilar, Luis Sahyouni, Ronald Abraham, Mickey Pham, Martin H. |
| description | •Limited literature exists on robotic placement of non-pedicle screw trajectories.•Nine screw trajectories were identified in the literature.•S2-alar-iliac, sacroiliac, and cortical bone trajectory were most common.•Robotic screw placement was more accurate than conventional.•Eight robotic platforms were identified with accuracy rates greater than 93%
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. |
| doi_str_mv | 10.1016/j.jocn.2022.01.005 |
| format | Article |
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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.</description><identifier>ISSN: 0967-5868</identifier><identifier>EISSN: 1532-2653</identifier><identifier>DOI: 10.1016/j.jocn.2022.01.005</identifier><identifier>PMID: 35065405</identifier><language>eng</language><publisher>Scotland: Elsevier Ltd</publisher><subject>Accuracy ; Humans ; Meta-analysis ; Pedicle Screws ; Robotic surgery ; Robotic Surgical Procedures ; Robotics ; Screw ; Spinal fixation ; Spinal Fusion ; Spine - surgery ; Systematic review</subject><ispartof>Journal of clinical neuroscience, 2022-03, Vol.97, p.62-74</ispartof><rights>2022 Elsevier Ltd</rights><rights>Copyright © 2022 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-35ae03299c4d0b9b91e3be40ecdff4bc06438fabdf31989bd724646e1fed788e3</citedby><cites>FETCH-LOGICAL-c356t-35ae03299c4d0b9b91e3be40ecdff4bc06438fabdf31989bd724646e1fed788e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0967586822000054$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35065405$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Himstead, Alexander S.</creatorcontrib><creatorcontrib>Shahrestani, Shane</creatorcontrib><creatorcontrib>Brown, Nolan J.</creatorcontrib><creatorcontrib>Produturi, Gautam</creatorcontrib><creatorcontrib>Shlobin, Nathan A.</creatorcontrib><creatorcontrib>Al Jammal, Omar</creatorcontrib><creatorcontrib>Choi, Elliot H.</creatorcontrib><creatorcontrib>Ransom, Seth C.</creatorcontrib><creatorcontrib>Daniel Diaz-Aguilar, Luis</creatorcontrib><creatorcontrib>Sahyouni, Ronald</creatorcontrib><creatorcontrib>Abraham, Mickey</creatorcontrib><creatorcontrib>Pham, Martin H.</creatorcontrib><title>Bony fixation in the era of spinal robotics: A systematic review and meta-analysis</title><title>Journal of clinical neuroscience</title><addtitle>J Clin Neurosci</addtitle><description>•Limited literature exists on robotic placement of non-pedicle screw trajectories.•Nine screw trajectories were identified in the literature.•S2-alar-iliac, sacroiliac, and cortical bone trajectory were most common.•Robotic screw placement was more accurate than conventional.•Eight robotic platforms were identified with accuracy rates greater than 93%
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.</description><subject>Accuracy</subject><subject>Humans</subject><subject>Meta-analysis</subject><subject>Pedicle Screws</subject><subject>Robotic surgery</subject><subject>Robotic Surgical Procedures</subject><subject>Robotics</subject><subject>Screw</subject><subject>Spinal fixation</subject><subject>Spinal Fusion</subject><subject>Spine - surgery</subject><subject>Systematic review</subject><issn>0967-5868</issn><issn>1532-2653</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtrGzEURkVpaJy0fyCLoGU3M7l6elSySUNeEAiEdi000hWV8YxcaZzU_75jnHTZ1d2c78A9hJwxaBkwfbFqV9mPLQfOW2AtgPpAFkwJ3nCtxEeyAKOXjep0d0xOal0BgJECPpFjoUArCWpBnr_ncUdj-uOmlEeaRjr9QorF0Rxp3aTRrWnJfZ6Sr9_oFa27OuEww54WfEn4St0Y6ICTa9zM7mqqn8lRdOuKX97uKfl5e_Pj-r55fLp7uL56bLxQemqEcgiCG-NlgN70hqHoUQL6EKPsPWgpuuj6EAUznenDkkstNbKIYdl1KE7J14N3U_LvLdbJDql6XK_diHlbLdec844xaWaUH1Bfcq0Fo92UNLiyswzsvqVd2X1Lu29pgdm55Tw6f_Nv-wHDv8l7vBm4PAA4fzm3KLb6hKPHkAr6yYac_uf_C8gDhbM</recordid><startdate>202203</startdate><enddate>202203</enddate><creator>Himstead, Alexander S.</creator><creator>Shahrestani, Shane</creator><creator>Brown, Nolan J.</creator><creator>Produturi, Gautam</creator><creator>Shlobin, Nathan A.</creator><creator>Al Jammal, Omar</creator><creator>Choi, Elliot H.</creator><creator>Ransom, Seth C.</creator><creator>Daniel Diaz-Aguilar, Luis</creator><creator>Sahyouni, Ronald</creator><creator>Abraham, Mickey</creator><creator>Pham, Martin H.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202203</creationdate><title>Bony fixation in the era of spinal robotics: A systematic review and meta-analysis</title><author>Himstead, Alexander S. ; Shahrestani, Shane ; Brown, Nolan J. ; Produturi, Gautam ; Shlobin, Nathan A. ; Al Jammal, Omar ; Choi, Elliot H. ; Ransom, Seth C. ; Daniel Diaz-Aguilar, Luis ; Sahyouni, Ronald ; Abraham, Mickey ; Pham, Martin H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-35ae03299c4d0b9b91e3be40ecdff4bc06438fabdf31989bd724646e1fed788e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Accuracy</topic><topic>Humans</topic><topic>Meta-analysis</topic><topic>Pedicle Screws</topic><topic>Robotic surgery</topic><topic>Robotic Surgical Procedures</topic><topic>Robotics</topic><topic>Screw</topic><topic>Spinal fixation</topic><topic>Spinal Fusion</topic><topic>Spine - surgery</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Himstead, Alexander S.</creatorcontrib><creatorcontrib>Shahrestani, Shane</creatorcontrib><creatorcontrib>Brown, Nolan J.</creatorcontrib><creatorcontrib>Produturi, Gautam</creatorcontrib><creatorcontrib>Shlobin, Nathan A.</creatorcontrib><creatorcontrib>Al Jammal, Omar</creatorcontrib><creatorcontrib>Choi, Elliot H.</creatorcontrib><creatorcontrib>Ransom, Seth C.</creatorcontrib><creatorcontrib>Daniel Diaz-Aguilar, Luis</creatorcontrib><creatorcontrib>Sahyouni, Ronald</creatorcontrib><creatorcontrib>Abraham, Mickey</creatorcontrib><creatorcontrib>Pham, Martin H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical neuroscience</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Himstead, Alexander S.</au><au>Shahrestani, Shane</au><au>Brown, Nolan J.</au><au>Produturi, Gautam</au><au>Shlobin, Nathan A.</au><au>Al Jammal, Omar</au><au>Choi, Elliot H.</au><au>Ransom, Seth C.</au><au>Daniel Diaz-Aguilar, Luis</au><au>Sahyouni, Ronald</au><au>Abraham, Mickey</au><au>Pham, Martin H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bony fixation in the era of spinal robotics: A systematic review and meta-analysis</atitle><jtitle>Journal of clinical neuroscience</jtitle><addtitle>J Clin Neurosci</addtitle><date>2022-03</date><risdate>2022</risdate><volume>97</volume><spage>62</spage><epage>74</epage><pages>62-74</pages><issn>0967-5868</issn><eissn>1532-2653</eissn><abstract>•Limited literature exists on robotic placement of non-pedicle screw trajectories.•Nine screw trajectories were identified in the literature.•S2-alar-iliac, sacroiliac, and cortical bone trajectory were most common.•Robotic screw placement was more accurate than conventional.•Eight robotic platforms were identified with accuracy rates greater than 93%
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.</abstract><cop>Scotland</cop><pub>Elsevier Ltd</pub><pmid>35065405</pmid><doi>10.1016/j.jocn.2022.01.005</doi><tpages>13</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Journal of clinical neuroscience, 2022-03, Vol.97, p.62-74 |
| issn | 0967-5868 1532-2653 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Accuracy Humans Meta-analysis Pedicle Screws Robotic surgery Robotic Surgical Procedures Robotics Screw Spinal fixation Spinal Fusion Spine - surgery Systematic review |
| title | Bony fixation in the era of spinal robotics: A systematic review and meta-analysis |
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