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Purpose <p>Robot-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.</p> Methods <p>A 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&#xa0;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.</p> Results <p>Fifteen 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&#xa0;mL (95% CI: 534.27–841.43), and the mean operation time was 306.03&#xa0;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.</p> Conclusion <p>RAS 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.</p>

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Single-arm meta-analysis on robotic spine instrumentation for young patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月4日

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  • Paweł Łajczak,
  • Anna Łajczak

摘要

Purpose

Robot-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.

Methods

A 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.

Results

Fifteen 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.

Conclusion

RAS 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.