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Robot-Assisted versus Conventional Vertebral Augmentation Procedures-Bayesian Meta-Analysis and Trial Sequential
Anna Łajczak1, Ayesha Ayesha2, Oguz Kagan Sahin3
1Department of Biophysics, Medical University of Silesia, Katowice, Poland.
World Neurosurgery
|October 12, 2025
Summary
Robot-assisted vertebral augmentation (RA-VA) is a safe and effective minimally invasive procedure. Compared to conventional methods, RA-VA significantly reduces cement leaks, procedure time, and fluoroscopy use, enhancing precision.
Area of Science:
- Minimally Invasive Surgery
- Orthopedic Surgery
- Medical Technology
Background:
- Robot-assisted vertebral augmentation (RA-VA) is increasingly used in minimally invasive procedures.
- No meta-analysis has specifically evaluated RA-VA versus conventional VA using only randomized controlled trials (RCTs).
Purpose of the Study:
- To compare the clinical effectiveness of robot-assisted vertebral augmentation (RA-VA) against conventional vertebral augmentation (VA).
- To analyze outcomes from randomized controlled trials (RCTs) using Bayesian meta-analysis.
Main Methods:
- Systematic literature search of PubMed, Embase, and Web of Science for eligible RCTs.
- Bayesian meta-analysis with noninformative priors and random effects model.
- Trial sequential analysis to assess the reliability of findings.
Main Results:
- RA-VA demonstrated a significantly lower incidence of cement leak events (RR 0.24).
- RA-VA was associated with reduced fluoroscopy use (MD -5.66 minutes) and shorter procedure times (MD -17.65 minutes).
- Included studies (n=4, all from China) showed some heterogeneity and quality concerns.
Conclusions:
- RCTs indicate that RA-VA procedures are safe and effective.
- Computer-aided navigation in RA-VA enhances procedural precision, leading to improved outcomes.
- Further research with a larger number of randomized studies is warranted.
