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Review: Inconclusive data to recommend fluoroscopy, robot-assisted placement of pedicle screws
In a retrospective review comparing fluoroscopy and robot-assisted pedicle screw placement, researchers from London noted their review had mixed results and could not recommend either technique.
“There is insufficient evidence to unequivocally recommend one surgical technique over the other,” Hani J. Marcus, MRCS, and colleagues wrote in the study abstract.
Marcus and colleagues used the PubMed, EMBASE and Cochrane Central Register of Controlled Trials database to find articles that compared robot-assisted and fluoroscopy-guided surgery, included pedicle screw placement, provided adequate numbers for comparison and assessed outcomes for these methods.
They found 5 articles that met the inclusion criteria for a total of 729 robot-assisted and 579 fluoroscopy-guided pedicle screw placements. However, the results were mixed: studies with a higher level of evidence supported fluoroscopy-guided placement, while comparative studies supported robot-assisted placement.
“Given the high cost of robotic systems, and the high risk of spinal surgery, further high quality studies are required to address unresolved clinical equipoise in this field,” Marcus and colleagues wrote.
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