Evidence map›Paper›PMID 39930288›Full record

ArticleSpine deformity2025

A single-centre early experience of the Pulse™ navigation system for posterior spinal fusion in adolescent idiopathic scoliosis (AIS).

Adam P Lloyd, Haiming Jin, George McKay, Mathew Sewell, Jwalant Mehta, David S Marks, Morgan E B Jones

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Article in Spine deformity, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Comparison of navigation and fluoroscopic assisted posterior spinal fusion in adolescent idiopathic scoliosis surgery.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 · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Adam P LloydThe Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK. adamlloyd1@nhs.net.ORCID http://orcid.org/0000-0002-7537-6315
Haiming JinDepartment of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
George McKayThe Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.
Mathew SewellThe Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.
Jwalant MehtaThe Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.
David S MarksThe Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.
Morgan E B JonesThe Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePedicle screw-based constructs are the standard of surgical management in AIS. Several manufacturers have developed navigation systems utilising intraoperative 3D imaging to improve screw placement accuracy. However, concerns remain regarding intraoperative radiation exposure utilising these systems compared to traditional techniques. The aim of this study was to evaluate our experience of 3D intraoperative imaging compared to techniques utilising 2D fluoroscopy for pedicle screw placement in cases of posterior spinal fusion (PSF) for AIS.

methodsThis was a single-centre, retrospective analysis of cases undergoing PSF for AIS using 3D navigation or freehand screw insertion techniques. The two groups were matched for curve type, curve magnitude, implant density and fused levels. We compared the correction achieved, intraoperative radiation exposure, operating time and rates of intraoperative screw repositioning.

resultsA total of 52 cases were identified (26 navigated and 26 freehand). No significant differences were observed in baseline characteristics between the two groups. There were no significant differences observed in correction achieved between groups; however, mean radiation exposure in the navigated cases was approximately 11 times higher. Operative time was significantly longer in the navigated group but there was a significant reduction in requirement for intraoperative screw repositioning using navigation at 0.2% versus the freehand group at 1.5%.

conclusionsOur early experience of intraoperative 3D imaging for navigated implant insertion for AIS has shown equivalence to freehand techniques in achieved correction, with fewer changes in intraoperative screw positioning at the expense of significantly increased overall radiation exposure and procedure duration. LEVEL OF EVIDENCE: II.

Indexed as

ScoliosisSpinal FusionSurgery, Computer-AssistedSurgical Navigation SystemsAdolescentChildFemaleFluoroscopyHumansImaging, Three-DimensionalMaleOperative TimePedicle ScrewsRadiation ExposureRetrospective StudiesTreatment OutcomeAccuracyNavigationPedicleScoliosisScrew

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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.