A Systematic Review and Meta-Analysis of Perioperative Parameters in Robot-Guided, Navigated, and Freehand Thoracolumbar Pedicle Screw Instrumentation
World Neurosurgery, ISSN: 1878-8750, Vol: 127, Page: 576-587.e5
2019
- 29Citations
- 64Captures
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
Citation Benchmarking is provided by Scopus and SciVal and is different from the metrics context provided by PlumX Metrics.
Metrics Details
- Citations29
- Citation Indexes27
- 27
- CrossRef26
- Policy Citations2
- Policy Citation2
- Captures64
- Readers64
- 64
Review Description
Robotic guidance (RG) and navigation (NV) have been shown to reduce radiologic and clinically relevant pedicle screw malpositions. It remains unknown if there are any additional benefits to these techniques in intraoperative and perioperative end points. We conducted a systematic review in MEDLINE, Embase, Scopus, and the Cochrane Library and identified controlled studies comparing RG, NV, and freehand (FH) thoracolumbar pedicle screw insertion and carried out random-effects meta-analyses. Thirty-two studies (24,008 patients) were included. Only 8 studies (26%) were randomized, and study quality was rated as very low or low in 24 cases (77%). Compared with NV, FH procedures showed longer length of hospital stay (Δ, 0.7 days; 95% confidence interval, 0.2–1.2; P = 0.006) and more overall complications (odds ratio, 1.6; 95% confidence interval, 1.3–1.9; P < 0.001). No statistically significant differences among RG and FH were identified, likely because of lack in statistical power (all P > 0.05). In particular, both RG and NV did not show increased intraoperative radiation use, as determined by seconds of fluoroscopy, compared with FH (both P > 0.05). It seems that navigation may offer potential benefits in perioperative outcomes such as length of hospital stay and overall complications, without significant increase in intraoperative radiation, which cannot yet be said for robotic guidance. The findings must be interpreted with caution, because the evidence is severely limited in both quantity and quality. Further evaluation will establish any demonstrable intraoperative or perioperative benefits to computer assistance, which may warrant the high costs often associated with these devices.
Bibliographic Details
http://www.sciencedirect.com/science/article/pii/S1878875019308769; http://dx.doi.org/10.1016/j.wneu.2019.03.196; http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85064943676&origin=inward; http://www.ncbi.nlm.nih.gov/pubmed/30954747; https://linkinghub.elsevier.com/retrieve/pii/S1878875019308769; https://dx.doi.org/10.1016/j.wneu.2019.03.196
Elsevier BV
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