SynthesisEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025
Single-arm meta-analysis on robotic spine instrumentation for young patients.
Synthesis in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeRobot-assisted surgery (RAS) is increasingly used among younger patients. However, current literature often focuses on pairwise comparisons, which limits a comprehensive evaluation of robotic effectiveness across diverse conditions. This single-arm meta-analysis aimed to evaluate the effectiveness of RAS among younger patients undergoing posterior spinal fusion.
methodsA systematic search was conducted across PubMed, Embase, Scopus, Web of Science, and Cochrane Library from inception to December 2024. Studies were included if they reported outcomes of RAS for pedicle screw placement in patients with a mean age under 25 years. The primary outcome was the accuracy of pedicle screw placement, assessed using the Gertzbein and Robbins (GR) grading system. Secondary outcomes included intraoperative outcomes, radiation exposure, and correction of deformity.
resultsFifteen studies encompassing 13,325 screws and 920 patients were included. The pooled rate of clinically acceptable screws (GR A + B) was 95.66% (95% CI: 94.04-97.28), with 88.54% (95% CI: 83.60-93.48) achieving perfect placement (GR A). The incidence of heavily misplaced screws (GR D + E) was 0.59% (95% CI: 0.18-1.16). Blood loss averaged 687.85 mL (95% CI: 534.27-841.43), and the mean operation time was 306.03 min (95% CI: 273.19-338.88). Curve correction rates and Cobb angle improvements were consistent with existing scoliosis treatment benchmarks. Heterogeneity was observed, likely due to variability in study designs, robotic systems, and patient populations.
conclusionRAS demonstrates high pedicle screw accuracy and safety in pediatric and adolescent spine surgery, with low rates of extreme screw misplacement. Adoption of this technology requires overcoming current limitations.
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