Evidence map›Paper›PMID 39982552›Full record

SynthesisNeurosurgical review2025

Comparison of accuracy of pedicle screw placement for adolescent idiopathic scoliosis using freehand fluoroscopic, navigation, and robotic-assisted techniques - a systematic review and bayesian network meta-analysis.

Paweł Łajczak, Ayesha Ayesha, Rabbia Jabbar, Yasmin Picanço Silva, Eshita Sharma, Oguz Kagan Sahin, Kaike Eduardo da Silva Lobo, Iago Nathan Simon Petry, Aisha Rizwan Ahmed, Fabio Victor Vieira Rocha and 2 more

Expression of concernAbstract readComparative StudyNetwork Meta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It carries an expression of concern. Cited by 11 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 3 pooled it
–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

11 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Single-arm meta-analysis on robotic spine instrumentation for young patients.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
    Pooled it
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Paweł ŁajczakMedical University of Silesia, Katowice, Poland. pawel.lajczak03@gmail.com.ORCID http://orcid.org/0000-0003-0281-5417
Ayesha AyeshaGeneuro - International Research Group in Neuroscience, Vitoria, Espirito Santo, Brazil.ORCID http://orcid.org/0009-0003-9155-8471
Rabbia JabbarGeneuro - International Research Group in Neuroscience, Vitoria, Espirito Santo, Brazil.ORCID http://orcid.org/0009-0009-8721-2930
Yasmin Picanço SilvaGeneuro - International Research Group in Neuroscience, Vitoria, Espirito Santo, Brazil.ORCID http://orcid.org/0009-0003-5728-4964
Eshita SharmaGeneuro - International Research Group in Neuroscience, Vitoria, Espirito Santo, Brazil.ORCID http://orcid.org/0009-0000-1058-2137
Oguz Kagan SahinGeneuro - International Research Group in Neuroscience, Vitoria, Espirito Santo, Brazil.ORCID http://orcid.org/0009-0006-0001-0390
Kaike Eduardo da Silva LoboGeneuro - International Research Group in Neuroscience, Vitoria, Espirito Santo, Brazil.ORCID http://orcid.org/0009-0000-4844-2877
Iago Nathan Simon PetryGeneuro - International Research Group in Neuroscience, Vitoria, Espirito Santo, Brazil.ORCID http://orcid.org/0009-0008-9169-2992
Aisha Rizwan AhmedGeneuro - International Research Group in Neuroscience, Vitoria, Espirito Santo, Brazil.ORCID http://orcid.org/0009-0002-4467-611X
Fabio Victor Vieira RochaGeneuro - International Research Group in Neuroscience, Vitoria, Espirito Santo, Brazil.ORCID http://orcid.org/0009-0004-5385-7005
Walter FagundesGeneuro - International Research Group in Neuroscience, Vitoria, Espirito Santo, Brazil.ORCID http://orcid.org/0000-0002-1861-3564
Yan G M D SilvaGeneuro - International Research Group in Neuroscience, Vitoria, Espirito Santo, Brazil.ORCID http://orcid.org/0000-0002-3010-7664

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Adolescent idiopathic scoliosis (AIS) is a prevalent spinal deformity, often requiring surgical intervention. Posterior pedicle spine instrumentation, a common procedure for correcting AIS, can be performed using freehand fluoroscopic (FHF), navigation-assisted (NVA), or robotic-assisted (RBA) techniques for pedicle screw insertion. This study aimed to evaluate the accuracy and clinical outcomes of these techniques through a Bayesian network meta-analysis (BNMA) of 764 patients and 8,144 screws from twelve studies. Our findings suggest that RBA offers superior accuracy in pedicle screw placement compared to both FHF and NVA. However, RBA is associated with longer operative times. NVA, in contrast, provides a balanced approach by offering good accuracy with relatively shorter surgery times. No significant differences were observed in blood loss, Cobb angle correction, or hospital stay between the techniques. Additionally, no statistically significant differences were found between RBA and NVA in terms of operative duration or blood loss. These results have important clinical implications, indicating that RBA may be the preferred option for achieving high precision, particularly in complex cases, while NVA remains a viable alternative for quicker procedures. Further research is needed to assess the long-term outcomes, radiation exposure, and cost-effectiveness of these techniques in clinical practice.

Indexed as

Pedicle ScrewsRobotic Surgical ProceduresScoliosisSpinal FusionAdolescentBayes TheoremFluoroscopyHumansOperative TimeAdolescent idiopathic scoliosisFreehand surgeryIntraoperative navigationPosterior spine fixationRobotic-assisted surgery

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.