AI Article Synopsis
- The study aims to evaluate various computer-assisted navigation platforms for pedicle screw placement by examining factors like accuracy, surgery duration, neurological complications, and blood loss.
- Stryker showed the highest accuracy for screw placement, while BrainLab had significantly faster operative times compared to Medtronic, with all platforms reducing the risk of major breaches in placement.
- Overall, the analysis indicates a 60% reduction in major breach risk with computer-assisted navigation versus traditional methods, providing valuable insights for future research and technology procurement.
Article Abstract
Purpose: The objective of this meta-analysis is to compare available computer-assisted navigation platforms by key performance metrics including pedicle screw placement accuracy, operative time, neurological complications, and blood loss.
Methods: A systematic review was conducted using major databases for articles comparing pedicle screw accuracy of computer-assisted navigation to conventional (freehand or fluoroscopy) controls via post-operative computed tomography. Outcome data were extracted and pooled by random-effects model for analysis.
Results: All navigation platforms demonstrated significant reduction in risk of breach, with Stryker demonstrating the highest accuracy compared to controls (OR 0.16 95% CI 0.06 to 0.41, P < 0.00001, I = 0%) followed by Medtronic. There were no significant differences in accuracy or most surgical outcome measures between platforms; however, BrainLab demonstrated significantly faster operative time compared to Medtronic by 30 min (95% CI - 63.27 to - 2.47, P = 0.03, I = 74%). Together, there was significantly lower risk of major breach in the navigation group compared to controls (OR 0.42, 95% CI 0.27-0.63, P < 0.0001, I = 56%).
Conclusions: When comparing between platforms, Stryker demonstrated the highest accuracy, and Brainlab the shortest operative time, both followed by Medtronic. No significant difference was found between platforms regarding neurologic complications or blood loss. Overall, our results demonstrated a 60% reduction in risk of major breach utilizing computer-assisted navigation, coinciding with previous studies, and supporting its validity. This study is the first to directly compare available navigation platforms offering insight for further investigation and aiding in the institutional procurement of platforms. LEVEL 3 EVIDENCE: Meta-analysis of Level 3 studies.
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| http://dx.doi.org/10.1007/s00586-023-07865-4 | DOI Listing |
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