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Functional outcome of computer-assisted spinal pedicle screw placement: a systematic review and meta-analysis of 23 studies including 5,992 pedicle screws

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Abstract

A number of studies have shown increased accuracy of pedicle screw placement in spine with the help of computer-assisted navigation. The literature is lacking in regard to functional benefit derived from this technique. The aim of this systematic review was to look at the functional outcomes following computer-assisted pedicle screw placement in spine. A ‘Dialog Datastar’ search was used using optimized search strategy covering the period from 1950 to July 2009; 23 papers were finally included which met our inclusion criteria. We report on a total of 1,288 patients with 5,992 pedicle screws. The comparison of neurological complications in two groups demonstrated an odds ratio of 0.25 (95% CI 0.06, 1.14) in favour of using navigation for pedicle screw insertion (p = 0.07). Comparative trials demonstrated a significant advantage in terms of accuracy of navigation over conventional pedicle screw insertion with a relative risk of 1.12 (95% CI 1.09, 1.15) (p < 0.00001). Navigation does not show statistically significant benefit in reducing neurological complications and there was insufficient data in the literature to infer a conclusion in terms of fusion rate, pain relief and health outcome scores.

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Authors and Affiliations

  1. Trauma and Orthopaedics, Huddersfield Royal Infirmary, Lindley, Huddersfield, HD3 3EA, UK

    Rajeev Verma

  2. Radiology Academy, Leeds General Infirmary, Leeds, LS1 3EX, UK

    Sonal Krishan

  3. Trauma and Orthopaedics, Leeds General Infirmary, Leeds, LS1 3EX, UK

    Kurt Haendlmayer

  4. Trauma and Orthopaedics, Hull Royal Infirmary, Anlaby Road, Hull, HU3 2JZ, UK

    A. Mohsen

  5. 20 Linton Road, Leeds, LS17 8QH, UK

    Rajeev Verma

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  1. Rajeev Verma
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  2. Sonal Krishan
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  3. Kurt Haendlmayer
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  4. A. Mohsen
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Correspondence to Rajeev Verma.

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Verma, R., Krishan, S., Haendlmayer, K. et al. Functional outcome of computer-assisted spinal pedicle screw placement: a systematic review and meta-analysis of 23 studies including 5,992 pedicle screws. Eur Spine J 19, 370–375 (2010). https://doi.org/10.1007/s00586-009-1258-4

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  • DOI: https://doi.org/10.1007/s00586-009-1258-4

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