SynthesisJournal of the Chinese Medical Association : JCMA2023
Superior facet joint violation between open and minimally invasive techniques in lumbar fusion surgery: An updated systematic review and meta-analysis.
Synthesis in Journal of the Chinese Medical Association : JCMA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Impact of fixed-point rotational reduction of the spine on pain scores and lower limb motor function in patients with lumbar facet joint disorder.BMC musculoskeletal disorders · 2025Trial
- Evaluation of pedicle screw accuracy and deviation from preoperative planning in intraoperative Cone-Beam Computed Tomography-Navigated lumbar spinal fusion: a prospective study.Brain & spine · 2026Article
- Enhancing precision in robotic navigated minimally invasive transforaminal lumbar interbody fusion using a streamlined surgical workflow: a technical note.Brain & spine · 2026Article
- Article
- Minimally invasive approach is preferred for clinical stage 1 endometrioid-type endometrial cancer.Journal of the Chinese Medical Association : JCMA · 2024Article
- Early oral diet may enhance recovery from benign gynecologic surgery: A single center prospective study.Journal of the Chinese Medical Association : JCMA · 2023Article
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Authors and funding
7 authors.
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Abstract
backgroundSuperior facet joint violation (FJV) is a potential risk factor for adjacent segment disease following lumbar fusion surgery. We sought to conduct a systematic review and meta-analysis to compare screw-related superior FJV rates between the open and different minimally invasive (MI) techniques-fluoroscopy-based, 3D-image navigation, and navigation with robotic assistance-in adult lumbar fusion surgery.
methodsWe searched original articles comparing the rates of screw-related FJV between the open and different MI techniques in adult lumbar fusion surgery for lumbar degenerative diseases in PubMed, EMBASE, and the Cochrane Library from inception to September 2021. We compared the numbers of top-level pedicle screws and associated superior FJVs in the main analyses and performed subgroup analysis based on different MI techniques to examine whether individual MI approaches differed in superior FJV rate. Risk ratio (RR) and 95% confidence interval (CI) were calculated in a random-effect meta-analysis.
resultsIncluded in the meta-analysis were 16 articles with 2655 patients and 4638 top-level pedicle screws. The pooled analysis showed no significant difference in superior FJV rates between the MI and open groups (RR: 0.89, 95% CI: 0.62-1.28). The subgroup analysis demonstrated that the overall rates of superior FJV were 27.1% (411/1518) for fluoroscopy-based, 7.1% (43/603) for 3D-image navigation, and 3.2% (7/216) for navigation with robotic assistance. Compared with the open method, the overall RRs were 1.53 (95% CI: 1.19-1.96) for fluoroscopy-based, 0.41 (95% CI: 0.22-0.75) for 3D-image navigation, and 0.25 (95% CI: 0.08-0.72) for navigation with robotic assistance.
conclusionAmong the three common MI techniques, fluoroscopy-based can be associated with a higher risk of superior FJV, while both 3D-image navigation and navigation with robotic assistance may be associated with lower risks as compared with the open method. Considering the limitations of the study, more trials are needed to prove these clinical findings.
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