ArticleInternational journal of spine surgery2024
A Network Meta-Analysis Comparing the Efficacy and Safety of Pedicle Screw Placement Techniques Using Intraoperative Conventional, Navigation, Robot-Assisted, and Augmented Reality Guiding Systems.
Article in International journal of spine surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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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.
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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.
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Who cites it
6 citing papers in PubMed.
- Minimally Invasive, CT Neuronavigated Posterolateral Pedicle Screw Placement in Upper Cervical Spine: A Retrospective Accuracy and Safety Analysis.Journal of clinical medicine · 2026Article
- The accuracy of pedicle screw placement in thoracolumbar fractures: A comparative study of automated cone-beam CT-based navigation and conventional fluoroscopy.Brain & spine · 2026Article
- Article
- Revolutionizing spine surgery with emerging AI-FEA integration.Journal of robotic surgery · 2025Review
- Innovative Pedicle Screw Insertion with Mixed Reality Technology Improves Insertion Accuracy in Spinal Surgery.Sensors (Basel, Switzerland) · 2025Article
- Robotic-Guided Spine Surgery: Implementation of a System in Routine Clinical Practice-An Update.Journal of clinical medicine · 2025Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStudies were reviewed and collected to compare different image guidance systems for pedicle screw placement (PSP) regarding accuracy and safety outcomes. Included were conventional, navigation, robot-assisted, and recent technology such as augmented reality (AR) guiding systems.
methodsThis network meta-analysis obtained human comparative studies and randomized controlled trials (RCTs) regarding PSP found in 3 databases (Cochrane, PubMed, and Scopus). Data extraction for accuracy, safety, and clinical outcomes were collected. The network meta-analysis was analyzed, and a surface under the cumulative ranking curve (SUCRA) was used to rank the treatment for all outcomes.
resultsThe final 61 studies, including 13 RCTs and 48 non-RCTs, were included in the meta-analysis. These studies included a total of 17,023 patients and 35,451 pedicle screws. The surface under the cumulative ranking curve ranking demonstrated the supremacy of robotics in almost all accuracy outcomes except for the facet joint violation. Regarding perfect placement, the risk difference for AR was 19.1 (95% CI: 8.1-30.1), which was significantly higher than the conventional method. The robot-assisted and navigation systems had improved outcomes but were not significantly different in accuracy vs the conventional technique. There was no statistically significant difference concerning safety or clinical outcomes.
conclusionsThe accuracy of PSP achieved by robot-assisted technology was the highest, whereas the safety and clinical outcomes of the different methods were comparable. The recent AR technique provided better accuracy compared with navigation and conventional methods. LEVEL OF EVIDENCE: 2:
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