Comparison of accuracy, revision, and perioperative outcomes in robot-assisted spine surgeries: systematic review and meta-analysis

作者：Luke MacLean, Andrew M. Hersh, Meghana Bhimreddy, Kelly Jiang, A. Daniel Davidar, Carly Weber-Levine, Safwan Omar Alomari, Brendan F. Judy, Daniel Lubelski, Nicholas Theodore · 发表于：Journal of Neurosurgery Spine · 年份：2024 · DOI：10.3171/2024.4.spine23917 · 被引用次数：46 · 研究领域：Spinal Fractures and Fixation Techniques、Intraoperative Neuromonitoring and Anesthetic Effects、Cervical and Thoracic Myelopathy

OBJECTIVE: Pedicle screw placement guidance is critical in spinal fusions, and spinal surgery robots aim to improve accuracy and reduce complications. Current literature has yet to compare the relative merits of available robotic systems. In this review, the authors aimed to 1) assess the current state of spinal robotics literature; 2) conduct a meta-analysis of robotic performance based on accuracy, speed, and safety; and 3) offer recommendations for robotic system selection. METHODS: Following PRISMA guidelines, the authors conducted a systematic literature review across PubMed, Embase, Cochrane Library, Web of Science, and Scopus as of April 28, 2022, for studies on approved robots for placing lumbar pedicle screws. Three reviewers screened and extracted data relating to the study characteristics, accuracy rate, intraoperative revisions, and reoperations. Secondary performance metrics included operative time, blood loss, and radiation exposure. The authors statistically compared the performance of the robots using a random-effects model to account for variation within and between the studies. Each robot was also compared with performance benchmarks of traditional techniques including freehand, fluoroscopic, and CT-navigated insertion. Finally, we performed a Duval and Tweedie trim-and-fill test to assess for the presence of publication bias. RESULTS: The authors identified 46 studies, describing 4670 patients and 25,054 screws, that evaluated 4 different robotic systems: M...