Robot-assisted placement of pedicle screws for treatment of spine degenerative diseases: A Meta-Analysis

Objective To compare the accuracy and security between robot-assisted and fluoroscopy-guided pedicle screw placement s in the treatment of spine degenerative disease. Methods This study included clinical trials published both at demestic and abroad from April 2008 to April 2018. The retrieval was performed inonline databases include Embase, Pubmed, CNKI, CQVIP, Wanfang Data, etc. Based on the search strategy, a total of 377 related literatures were retrieved and 10 foreign documents and 1 Chinese document were included. After data extraction, statistical software Review manager 5.3 was used for data-analysis. Results It was found that when the pedicle screws were used to treat elderly patients with degenerative diseases of the spine, the accuracy of placement of the robot-assisted group was superior to that of the fluoroscopy-guided group (95% CI: 1.38-2.43, P<0.001). The robot-assisted number of adverse events (95% CI: 0.22-0.90, P=0.02) and revisions (95% CI: 0.17-0.91, P=0.03) were less than the fluoroscopy guidance group. But fluoroscopy exposure was more than the robot-assisted group (95% CI: 0.09-0.89, P=0.02). Other differences between the two groups were not statistically significant. Conclusions In the treatment of elderly degenerative diseases of the spine, robot-assisted pedicle screw implantation has higher accuracy and fewer complications than conventional fluoroscopy guided. Although intraoperative fluoroscopy exposure is slightly higher the fluoroscopy-guided group, robot-assisted technology is still a safe and reliable treatment option. Key words: Spinal diseases; Surgery, computer-assisted; Pedicle screws; Robot-assisted