Department of Orthopedics and Spine Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Spine (Phila Pa 1976). 2020 Jan 15;45(2):E111-E119. doi: 10.1097/BRS.0000000000003193.
A meta-analysis.
To investigate whether robot-assisted techniques are superior to conventional techniques in terms of the accuracy of pedicle screw placement and clinical indexes.
Robot-assisted techniques are increasingly applied to spine surgery to reduce the rate of screw misplacement. However, controversy about the superiority of robot-assisted techniques over conventional freehand techniques remains.
We conducted a comprehensive search of PubMed, EMBASE, and Cochrane Library for potentially eligible articles. The outcomes were evaluated in terms of risk ratio (RR) or standardized mean difference and the associated 95% confidence intervals (CIs). Meta-analysis was performed using the RevMan 5.3 software and subgroup analyses were performed based on the robot type for the accuracy of pedicle screw placement.
Nine randomized controlled trials with 696 patients were included in this meta-analysis. The results demonstrated that the robot-assisted technique was more accurate in pedicle screw placement than the freehand technique. Subgroup analyses showed that the TINAVI robot-assisted technique was more accurate in screw positions Grade A (RR, 1.10; 95% CI, 1.06-1.14), Grade B (RR, 0.46; 95% CI, 0.28-0.75), and Grades C + D + E (RR, 0.21; 95% CI, 0.09-0.45) than the freehand technique, whereas the Renaissance robot-assisted technique showed the same accuracy as the freehand technique in screw positions Grade A, Grade B, and Grades C + D + E. Furthermore, the robot-assisted techniques showed equivalent postoperative stay, visual analogue scale scores, and Oswestry disability index scores to those of the freehand technique and shorter intraoperative radiation exposure time, fewer radiation dose and proximal facet violations but longer surgical time than the freehand technique.
The robot-assisted technique is more accurate in pedicle screw placement than the freehand technique. And TINAVI robot-assisted pedicle screw placement is a more accurate alternative to conventional techniques and the Renaissance robot-assisted procedure.
荟萃分析。
研究机器人辅助技术在椎弓根螺钉置钉准确性和临床指标方面是否优于传统技术。
机器人辅助技术越来越多地应用于脊柱外科，以降低螺钉错位率。然而，关于机器人辅助技术是否优于传统徒手技术仍存在争议。
我们对 PubMed、EMBASE 和 Cochrane Library 进行了全面检索，以确定可能符合条件的文章。使用风险比（RR）或标准化均数差及其相关 95%置信区间（CI）评估结果。使用 RevMan 5.3 软件进行荟萃分析，并根据椎弓根螺钉置钉准确性对机器人类型进行亚组分析。
本荟萃分析纳入了 9 项随机对照试验，共 696 例患者。结果表明，机器人辅助技术在椎弓根螺钉置钉方面比徒手技术更准确。亚组分析显示，TINAVI 机器人辅助技术在螺钉位置 Grade A（RR，1.10；95%CI，1.06-1.14）、Grade B（RR，0.46；95%CI，0.28-0.75）和 Grades C+D+E（RR，0.21；95%CI，0.09-0.45）方面比徒手技术更准确，而 Renaissance 机器人辅助技术在螺钉位置 Grade A、Grade B 和 Grades C+D+E 方面与徒手技术具有相同的准确性。此外，机器人辅助技术在术后住院时间、视觉模拟评分和 Oswestry 残疾指数评分方面与徒手技术相当，而在术中辐射暴露时间、辐射剂量和近端关节突侵犯方面更少，但手术时间更长。
机器人辅助技术在椎弓根螺钉置钉方面比徒手技术更准确。TINAVI 机器人辅助椎弓根螺钉置钉是一种比传统技术更准确的替代方法，而 Renaissance 机器人辅助手术也是如此。
1 级。
