Evidence map›Paper›PMID 42479318›Full record

ReviewMusculoskeletal surgery2026

Robotic versus intraoperative image-based navigated thoraco-lumbar pedicle screw fixation: a systematic review and meta-analysis.

G F Papalia, N Nardi, G Maltese, G Marcello, N Fazzi, F Russo, G Vadalà, R Papalia, V Denaro

Abstract readReview
PubMed Publisher
In one paragraph

Review in Musculoskeletal surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

9 authors.

G F PapaliaOperative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.
N NardiOperative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.
G MalteseOperative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.
G MarcelloOperative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.
N FazziOperative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.
F RussoOperative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.
G VadalàOperative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy. g.vadala@policlinicocampus.it.
R PapaliaOperative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.
V DenaroOperative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.

Funding

Istituto Nazionale per l'Assicurazione Contro Gli Infortuni sul Lavoro BRIC-2022 ID30Ministero della Salute PNRR-MAD-2022-12376692
6 · The paper itself

Abstract

purposeSpondylodesis is performed to stabilize and immobilize spinal regions impacted by conditions such as degenerative disorders, deformities, trauma, tumors, or infections. To improve the accuracy of pedicle screw placement, computer-assisted navigation systems were introduced in spine surgery. The objective of this study was to compare the accuracy of pedicle screw placement and the patient outcomes in robotic-guided versus intraoperative 3D navigation techniques for thoraco-lumbar spine surgery.

methodsThe search was conducted on 30 September 2025 on Scopus, Cochrane Central Library and PubMed. Prospective and retrospective studies that compared pedicle screw placement, clinical outcomes and complications using robotic versus intraoperative 3D navigation technique in the thoracolumbar segment were included. Hospital stay, operative time and blood loss were evaluated as continuous outcomes with mean difference. Screw accuracy, FJV, intraoperative and postoperative screw revisions, complications and complications were evaluated as dichotomous outcomes with odds ratio. Statistical significance was set at p < 0.05.

resultsAmong the 14 studies included in the meta-analysis, statistically significant results in favor of robotic group were described for hospital stay (p = 0.003) and pedicle screw accuracy (p < 0.00001). However, no significant differences were observed in terms of intraoperative or postoperative screw revisions, facet joint violations, operative time and blood loss.

conclusionRobotic-guided pedicle screw fixation represents a safe and highly effective technique, showing statistically significant superiority in screw placement accuracy compared to CT-guided navigation.

Indexed as

AccuracyMeta-analysisNavigationPedicle screwRobotic

Identifiers

PMID42479318

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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.