Kang Yifan, Wei Lindong, Liu Jianrong
Doctoral Candidate, The Fifth Clinical Medical College of Shanxi Medical University, Shanxi Provincial People's Hospital, Taiyuan, 030001, China.
Xiongan Xuanwu Hospital, Xiongan New Area, China.
BMC Musculoskelet Disord. 2024 Dec 5;25(1):1002. doi: 10.1186/s12891-024-08088-4.
To investigate the safety and accuracy of robot-assisted pedicle screw placement in adolescent idiopathic scoliosis (AIS) surgery.
PubMed, Medline, Embase, Cochrane Library, Web of Science, CNKI, and EMCC databases were searched for studies utilizing the clinical data of adolescent idiopathic scoliosis patients (robot-assisted and fluoroscopy-assisted group) who underwent posterior pedicle screw fixation to collect preoperative, postoperative and follow-up indexes and imaging parameters, including screw implantation accuracy, the number of intraoperative fluoroscopy times, amount of bleeding, operation time, postoperative VAS score and postoperative Cobb angle.
Six studies were included in this meta-analysis, including 154 patients in the intervention group and 171 patients in the control group. Our results showed that screw implantation accuracy (WMD 1.07, 95% CI (1.01,1.14), P = 0.03) was higher than that in the control group. The number of intraoperative fluoroscopy times (WMD -6.11, 95% CI (-9.60, -2.62), P = 0.0006) and operation time (WMD 31.52, 95% CI (5.70,57.35), P = 0.02) in the robot group were less, and the differences were statistically significant. Intraoperative blood (WMD -59.05, 95% CI (-212.81,94.70), P = 0.45), postoperative VAS score (WMD -0.07, 95% CI (-0.24,0.11), P = 0.46), preoperative Cobb angle (WMD 0.79, 95% CI (-1.12,2.69), P = 0.42) (Fig. 7), postoperative Cobb angle (WMD -0.25, 95% CI (-1.12,0.62), P = 0.57) (Fig. 8) had no statistical significance in the robot group compared with control group.
The robot navigation system can improve screw implantation accuracy and reduce the operation time and radiation exposure during the operation.
探讨机器人辅助椎弓根螺钉置入在青少年特发性脊柱侧凸（AIS）手术中的安全性和准确性。
检索PubMed、Medline、Embase、Cochrane图书馆、Web of Science、中国知网和EMCC数据库，查找利用接受后路椎弓根螺钉固定的青少年特发性脊柱侧凸患者（机器人辅助组和透视辅助组）的临床数据的研究，收集术前、术后及随访指标和影像学参数，包括螺钉置入准确性、术中透视次数、出血量、手术时间、术后视觉模拟评分（VAS）和术后Cobb角。
本荟萃分析纳入6项研究，干预组154例患者，对照组171例患者。结果显示，螺钉置入准确性（加权均数差1.07，95%置信区间（1.01，1.14），P = 0.03）高于对照组。机器人组术中透视次数（加权均数差 -6.11，95%置信区间（-9.60，-2.62），P = 0.0006）和手术时间（加权均数差31.52，95%置信区间（5.70，57.35），P = 0.02）较少，差异有统计学意义。与对照组相比，机器人组术中出血量（加权均数差 -59.05，95%置信区间（-212.81，94.70），P = 0.45）、术后VAS评分（加权均数差 -0.07, 95%置信区间（-0.24, 0.11），P = 0.46）、术前Cobb角（加权均数差0.79，95%置信区间（-1.12，2.69），P = 0.42）（图7）、术后Cobb角（加权均数差 -0.25，95%置信区间（-1.12，0.62）, P = 0.57）（图8）无统计学意义。
机器人导航系统可提高螺钉置入准确性，减少手术中的手术时间及辐射暴露。
