World Neurosurg
Department of Orthopedics and Spine Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China. Electronic address:
Published: February 2021
Background: Robotic guidance (RG) pedicle screw placement has been increasingly used to improve the rate of insertion accuracy. However, the superiority of the RG technique over computer-assisted navigation (CAN) remains debatable.
Objective: To determine whether the Mazor RG technique is superior to CAN in terms of the rate of insertion accuracy and 4 other clinical indices, namely, intraoperative time, blood loss, complications and revision surgery caused by malposition.
Methods: A search of PubMed, Embase, Cochrane, Web of Science, CNKI, and WanFang was conducted. We mainly aimed to evaluate the accuracy of pedicle screw placement between the Mazor RG and CAN techniques. The secondary objectives were intraoperative time, blood loss, complications, and revision surgery caused by malposition. The meta-analysis was conducted using the RevMan 5.3 and Stata 15.1 software.
Results: A randomized controlled trial and 5 comparative cohort studies consisting of 529 patients and 4081 pedicle screws were included in this meta-analysis. The RG technique has a significantly higher accuracy than CAN in terms of optimal (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.85-2.76; P < 0.01) and clinically acceptable (OR, 1.69; 95% CI, 1.22-2.34; P = 0.002) pedicle screw insertions. Furthermore, the RG technique showed significantly less blood loss (mean difference, -42.49; 95% CI, -78.38 to -6.61; P = 0.02) than did the CAN technique but has equivalent intraoperative time (mean difference, 0.75; 95% CI, -5.89 to 7.40; P = 0.82), complications (OR, 0.65; 95% CI, 0.32-1.33, P = 0.24), and revision surgery caused by malposition (OR, 0.46; 95% CI, 0.15-1.43, P = 0.18).
Conclusions: The Mazor RG technique is superior to CAN concerning the accuracy of pedicle screw placement. Thus, the Mazor RG technique is accurate and safe in clinical application.
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http://dx.doi.org/10.1016/j.wneu.2020.10.055 | DOI Listing |
Neuromodulation
January 2025
Division of Gastroenterology and Hepatology, University of Michigan School of Medicine, Ann Arbor, MI, USA. Electronic address:
Objectives: Gastrointestinal (GI) disturbance is a frequent complication in patients with thoracolumbar vertebral fracture (TVF). Transcutaneous electrical acustimulation (TEA) has been reported to effectively accelerate postoperative GI function recovery after abdominal surgery. This study aimed to investigate the effects of TEA on postoperative recovery and the associated mechanisms.
View Article and Find Full Text PDFGlobal Spine J
January 2025
Department of Orthopaedics, University Clinic Heidelberg, Heidelberg, Germany.
Study Design: Retrospective Cohort Study.
Objectives: Flexibility radiographs such as traction or bending radiographs are essential in preoperative imaging to assess for curve flexibility and to estimate the amount of operative correction in order to determine the type and length of instrumentation in growth-accompanying scoliosis treatment. Both traction and bending radiographs are controversially discussed in the literature.
J Clin Med
January 2025
Department of Orthopaedics, Phramongkutklao Hospital and College of Medicine, Bangkok 10400, Thailand.
Injuries involving the Atlas (C1) and Axis (C2) vertebrae of the cervical spine present significant clinical challenges due to their complex anatomy and potential for severe neurological impairment. Traditional imaging methods often lack the detailed visualization required for precise surgical planning. This study aimed to develop high-resolution 3D models of the C1 and C2 vertebrae to perform a comprehensive morphometric analysis, identify gender differences, and assess bilateral symmetry to enhance surgical accuracy.
View Article and Find Full Text PDFAnimals (Basel)
December 2024
Department of Veterinary Medicine, Kangwon National University, Chuncheon-si 24341, Gangwon-do, Republic of Korea.
A 3D-printed guide is an effective method for accurately placing pedicle screws in dog vertebrae. While a conventional drill guide allows precise pilot hole formation, it can lead to potential screw wobbling during insertion. In this study, we applied a technique that assists with both drilling and screw insertion, and we compared the accuracy of screw placement using this approach with that achieved by the conventional drill guide.
View Article and Find Full Text PDFJ Orthop Surg Res
January 2025
Department of Orthopaedic Surgery, Spine Section, Bone and Joint Research Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Objective: Combining oblique lumbar interbody fusion (OLIF) with posterior pedicle screw fixation (PPSF) has been proposed to reduce cage subsidence, especially in osteoporotic spines. Recently, anterolateral screw-rod fixation has gained interest as it allows direct pathology observation and avoids a posterior approach. However, controversies exist between anterolateral screw fixation systems and traditional PPSF due to variations in osteoporotic vertebral mineral density, screw fixation positions, and fixation methods (bicortical vs.
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