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Updated: Mar 19, 2026
A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
Published on: May 11, 2020
Comparison of the accuracy between robot-assisted and conventional freehand pedicle screw placement: a systematic
Hao Liu1, Weikai Chen1, Zongyi Wang1
1Department(s) and institution(s), Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Purpose:
To perform a systematic review and meta-analysis to investigate the different of accuracy between robot-assisted and conventional freehand pedicle screw placement.
Methods:
The electronic databases of PubMed, Ovid MEDLINE, EMBASE, and Web of Science were searched for the literatures published up to January, 2016. Statistical analysis was performed using the Review Manager 5.3. The dichotomous data for the pedicle violation rate were summarized using relative risk (RR) and 95 % confidence intervals (CIs). The level of significance was set at [Formula: see text].
Results:
A total of 257 patients and 1105 screws were included in the five studies for this meta-analysis. The results revealed that there was no difference in the accuracy between robot-assisted and conventional freehand pedicle screw placement at the 0 mm grading criteria (RR 1.08, 95 % CI 0.86, 1.35, [Formula: see text], [Formula: see text]) and at 2 mm grading criteria (RR 1.02, 95 % CI 0.68, 1.51, [Formula: see text], [Formula: see text]). Among percutaneous robot-assisted technique, open robot-assisted technique and conventional freehand technique, there was also no significant difference at 0mm grading criteria (RO(P) vs FH : RR 1.10, 95 % CI 0.87, 1.40, [Formula: see text], [Formula: see text]; RO(O) versus FH : RR 0.87, 95 % CI 0.55, 1.38, [Formula: see text], [Formula: see text]; RO(P) vs RO(O): RR 1.20, 95 % CI 0.65, 2.24, [Formula: see text]) and at 2 mm grading criteria(RO(P) vs FH : RR 1.07, 95 % CI 0.43, 2.67, [Formula: see text], [Formula: see text]; RO(O) vs FH : RR 0.71, 95 % CI 0.36, 1.39, [Formula: see text], [Formula: see text]; RO(P) vs RO(O) : RR 0.84, 95 % CI 0.36, 1.94, [Formula: see text]).
Conclusion:
Further high-quality studies are required to unequivocally recommend one surgical technique over the other. With the more application of robot-assisted navigation system, accuracy and clinical benefit of the technique will be gradually improved.
