Objective:Robot-assisted pedicle screw insertion has recently emerged as an alternative to the traditional free-hand technique.However,discrepancies in the accuracy of screw placement between the 2 methods have been h...Objective:Robot-assisted pedicle screw insertion has recently emerged as an alternative to the traditional free-hand technique.However,discrepancies in the accuracy of screw placement between the 2 methods have been highlighted by some comparative studies.This meta-analysis was conducted to synthesize evidence comparing these techniques.Methods:Searches were conducted in 5 electronic databases adhering to specific eligibility criteria for randomized and observational studies.The data were analyzed using RevMan software and the results are presented as odds ratios(ORs),mean differences,or standard mean differences(SMDs)with 95%confidence intervals(CIs).Our analysis included 12 studies(7 randomized trials and 5 observational studies,involving 883 patients and 4903 screws).Results:The results demonstrated a higher rate of Grade A Gertzbein and Robbins pedicle placement score(OR:1.77;95%CI:1.10e2.87),a lower rate of revision surgeries(OR:0.21;95%CI:0.09e0.52),and a shorter radiation exposure duration(SMD?1.38,95%CI:2.32 to0.44)in the robot-assisted group compared with the free-hand group.Nonetheless,the length of hospital stay,volume of intraoperative blood loss,postoperative visual analogue scale scores for back pain,and rate of wound infection were similar between the 2 groups.Significant heterogeneity was observed in some outcomes.Conclusion:Compared with the free-hand method,the robot-assisted technique provides greater accuracy and reduced radiation exposure.The efficacy of the robot-assisted technique is expected to improve further as experience with its use in surgery grows.展开更多
Objective To evaluate the clinical effect of the free-hand cervical pedicle screw fixation in treatment of the upper cervical fracture and instability. Methods A retrospective review was performed on 15 patients
Objective:To compare the application effects of Tianji orthopedic robot-assisted screw placement and traditional free-hand screw placement in posterior pedicle screw internal fixation for upper cervical fractures,and ...Objective:To compare the application effects of Tianji orthopedic robot-assisted screw placement and traditional free-hand screw placement in posterior pedicle screw internal fixation for upper cervical fractures,and to provide a more optimal treatment plan for clinical practice.Methods:A retrospective analysis was conducted on 58 patients with upper cervical fracture who underwent surgery at Baise People’s Hospital from January 2017 to October 2023.The patients were divided into the robot-assisted group(RA group,27 cases)and the traditional free-hand group(FH group,31 cases).General data(gender,age,BMI,fracture site,etc.),screw placement accuracy(postoperative CT combined with Gertzbein-Robbins criteria),perioperative indicators(intraoperative blood loss,operation time,postoperative hospital stay),and prognosis(VAS score,NDI score,complications)were compared between the two groups.Results:There was no statistically significant difference in general data between the two groups(P>0.05).In the RA group,among 112 screws,109 were grade A+B(97.3%),with a perfect screw placement rate of 85.7%;in the FH group,among 137 screws,123 were grade A+B(89.8%),with a perfect screw placement rate of 68.6%,and the difference in screw placement accuracy between the two groups was significant(P<0.05).The intraoperative blood loss in the RA group was less than that in the FH group(245.93±216.44 vs 380.65±328.04,P<0.05),the operation time was longer(P<0.05),and the vertebral artery injury rate was lower(7.4%vs 22.6%).The postoperative VAS and NDI scores of both groups were improved compared with those before surgery(P<0.05),and there were no statistically significant differences in postoperative hospital stay and total complications between the two groups(P>0.05).Conclusion:Tianji orthopedic robot-assisted surgery has more advantages in improving screw placement accuracy,reducing blood loss,and lowering the risk of vertebral artery injury.It is safe,effective,and precise in operation,and is worthy of promotion.展开更多
基金the Human Research Ethics Committee,Faculty of Medicine Ramathibodi Hospital,Mahidol University,IRB No.(COA.MURA2020/1934).
文摘Objective:Robot-assisted pedicle screw insertion has recently emerged as an alternative to the traditional free-hand technique.However,discrepancies in the accuracy of screw placement between the 2 methods have been highlighted by some comparative studies.This meta-analysis was conducted to synthesize evidence comparing these techniques.Methods:Searches were conducted in 5 electronic databases adhering to specific eligibility criteria for randomized and observational studies.The data were analyzed using RevMan software and the results are presented as odds ratios(ORs),mean differences,or standard mean differences(SMDs)with 95%confidence intervals(CIs).Our analysis included 12 studies(7 randomized trials and 5 observational studies,involving 883 patients and 4903 screws).Results:The results demonstrated a higher rate of Grade A Gertzbein and Robbins pedicle placement score(OR:1.77;95%CI:1.10e2.87),a lower rate of revision surgeries(OR:0.21;95%CI:0.09e0.52),and a shorter radiation exposure duration(SMD?1.38,95%CI:2.32 to0.44)in the robot-assisted group compared with the free-hand group.Nonetheless,the length of hospital stay,volume of intraoperative blood loss,postoperative visual analogue scale scores for back pain,and rate of wound infection were similar between the 2 groups.Significant heterogeneity was observed in some outcomes.Conclusion:Compared with the free-hand method,the robot-assisted technique provides greater accuracy and reduced radiation exposure.The efficacy of the robot-assisted technique is expected to improve further as experience with its use in surgery grows.
文摘Objective To evaluate the clinical effect of the free-hand cervical pedicle screw fixation in treatment of the upper cervical fracture and instability. Methods A retrospective review was performed on 15 patients
基金Baise Science and Technology Research and Development Program of Guangxi(No.Baike 20233628)。
文摘Objective:To compare the application effects of Tianji orthopedic robot-assisted screw placement and traditional free-hand screw placement in posterior pedicle screw internal fixation for upper cervical fractures,and to provide a more optimal treatment plan for clinical practice.Methods:A retrospective analysis was conducted on 58 patients with upper cervical fracture who underwent surgery at Baise People’s Hospital from January 2017 to October 2023.The patients were divided into the robot-assisted group(RA group,27 cases)and the traditional free-hand group(FH group,31 cases).General data(gender,age,BMI,fracture site,etc.),screw placement accuracy(postoperative CT combined with Gertzbein-Robbins criteria),perioperative indicators(intraoperative blood loss,operation time,postoperative hospital stay),and prognosis(VAS score,NDI score,complications)were compared between the two groups.Results:There was no statistically significant difference in general data between the two groups(P>0.05).In the RA group,among 112 screws,109 were grade A+B(97.3%),with a perfect screw placement rate of 85.7%;in the FH group,among 137 screws,123 were grade A+B(89.8%),with a perfect screw placement rate of 68.6%,and the difference in screw placement accuracy between the two groups was significant(P<0.05).The intraoperative blood loss in the RA group was less than that in the FH group(245.93±216.44 vs 380.65±328.04,P<0.05),the operation time was longer(P<0.05),and the vertebral artery injury rate was lower(7.4%vs 22.6%).The postoperative VAS and NDI scores of both groups were improved compared with those before surgery(P<0.05),and there were no statistically significant differences in postoperative hospital stay and total complications between the two groups(P>0.05).Conclusion:Tianji orthopedic robot-assisted surgery has more advantages in improving screw placement accuracy,reducing blood loss,and lowering the risk of vertebral artery injury.It is safe,effective,and precise in operation,and is worthy of promotion.
