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Updated: Nov 20, 2025
A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
Published on: May 11, 2020
Navigation and robotics improved alignment compared with PSI and conventional instrument, while clinical outcomes
Kai Lei1, LiMing Liu1, Xin Chen1
1Center for Joint Surgery, Southwest Hospital, Third Military Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400036, China.
Purpose:
To achieve the desired alignment more accurately and improve postoperative outcomes, new techniques such as computer navigation (Navigation), patient-specific instruments (PSI) and surgical robots (Robot) are applied in Total Knee Arthroplasty (TKA). This network meta-analysis aims to compare the radiological and clinical outcomes among the above-mentioned techniques and conventional instruments (CON).
Methods:
A PRISMA network meta-analysis was conducted and study protocol was published online at INPLASY (INPLASY202060018). Three databases (PubMed, EMBASE and Cochrane) were searched up to June 1, 2020. Randomised controlled trials (RCTs) comparing any two of the four techniques were included. A Bayesian network meta-analysis was performed focusing on radiological and clinical outcomes. The odds ratio (OR) or mean difference (MD) in various outcomes were calculated, and the interventions were ranked by the surface under the cumulative ranking area (SUCRA) value.
Results:
Seventy-three RCTs were included, with a total of 4209 TKAs. Navigation and Robot could significantly reduce the occurrence of malalignment and malposition compared with PSI and CON, and Navigation could obtain higher medium-and-long-term KSS knee scores than CON. Robot had the greatest advantage in achieving the desired alignment accurately, followed by Navigation; Navigation had the greatest advantage in the KSS score.
Conclusion:
Navigation and Robot did improve the accuracy of alignment compared with PSI and conventional instrument in TKA, but the above four techniques showed no clinical significance in postoperative outcomes.
Level Of Evidence:
I.
