SynthesisJournal of orthopaedic surgery and research2020
Accuracy and safety of C2 pedicle or pars screw placement: a systematic review and meta-analysis.
Synthesis in Journal of orthopaedic surgery and research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 20 citations in OpenAlex.
- Evaluation of a novel C2 pedicle screw insertion technique: a retrospective comparative clinical study and finite element analysis.Scientific reports · 2026Article
- Minimally Invasive, CT Neuronavigated Posterolateral Pedicle Screw Placement in Upper Cervical Spine: A Retrospective Accuracy and Safety Analysis.Journal of clinical medicine · 2026Article
- Article
- Intraoperative Navigation in Cervical Spine Surgery.Journal of clinical medicine · 2026Review
- 3D-printed patient-specific guides improve screw accuracy in upper cervical spine surgery: a comparative study.Frontiers in neurology · 2026Article
- Os odontoideum-induced sudden onset myelopathy following cervical extension injury in an adult-case report on challenges and management with 3D navigation technology.Frontiers in surgery · 2025Article
- Navigated percutaneous placement of cervical pedicle screws: An anatomical feasibility study.Brain & spine · 2025Article
- Axis screw parallel to the sagittal plane versus traditional pedicle screw in the treatment of atlantoaxial fixation: a finite element study.BMC musculoskeletal disorders · 2024Article
- Comparison of iCT-based navigation and fluoroscopic-guidance for atlantoaxial screw placement in 78 patients with traumatic cervical spine injuries.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- The effect of C2 screw type on perioperative outcomes and long-term stability after C2-T2 posterior cervical decompression and fusion.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- The summit of the isthmic crest of the axis as a new entry point for C2 pedicle screw: an anatomical study.Neurosurgical review · 2024Article
- Effect of High-Riding Vertebral Artery on the Accuracy and Safety of C2 Pedicle Screw Placement in Basilar Invagination and Related Risk Factors.Global spine journal · 2024Article
- Novelties for increased safety in cranio-vertebral surgery: a review.Acta neurochirurgica · 2023Review
- Comparison of Perpendicular to the Coronal Plane versus Medial Inclination for C2 Pedicle Screw Insertion Assisted by 3D Printed Navigation Template.Orthopaedic surgery · 2023Article
- Case report: Interdisciplinary treatment of complex C1/C2 fractures in a patient with concomitant three-vessel coronary artery disease requiring bypass surgery.Frontiers in surgery · 2023Article
- C2 Screw fixation techniques in atlantoaxial instability: A technical review.Journal of craniovertebral junction & spineReview
- Comparison of freehand versus navigation-assisted C2 pedicle screw fixation: A retrospective accuracy and safety analysis.Journal of craniovertebral junction & spineArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designSystematic review and meta-analysis.
aimThe purpose of this study was to compare the safety and accuracy of the C2 pedicle versus C2 pars screws placement and free-hand technique versus navigation for upper cervical fusion patients.
methodsDatabases searched included PubMed, Scopus, Web of Science, and Cochrane Library to identify all papers published up to April 2020 that have evaluated C2 pedicle/pars screws placement accuracy. Two authors individually screened the literature according to the inclusion and exclusion criteria. The accuracy rates associated with C2 pedicle/pars were extracted. The pooled accuracy rate estimated was performed by the CMA software. A funnel plot based on accuracy rate estimate was used to evaluate publication bias.
resultsFrom 1123 potentially relevant studies, 142 full-text publications were screened. We analyzed data from 79 studies involving 4431 patients with 6026 C2 pedicle or pars screw placement. We used the Newcastle-Ottawa Scale (NOS) to evaluate the quality of studies included in this review. Overall, funnel plot and Begg's test did not indicate obvious publication bias. The pooled analysis reveals that the accuracy rates were 93.8% for C2 pedicle screw free-hand, 93.7% for pars screw free-hand, 92.2% for navigated C2 pedicle screw, and 86.2% for navigated C2 pars screw (all, P value < 0.001). No statistically significant differences were observed between the accuracy of placement C2 pedicle versus C2 pars screws with the free-hand technique and the free-hand C2 pedicle group versus the navigated C2 pedicle group (all, P value > 0.05).
conclusionOverall, there was no difference in the safety and accuracy between the free-hand and navigated techniques. Further well-conducted studies with detailed stratification are needed to complement our findings.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.