Meta-analysis on application of computer-assisted navigation in lumbar pedicle screw fixation / 中国组织工程研究

ABSTRACT

BACKGROUND:Computer-assisted navigation technique has been widely applied in spinal surgery, but there is stil lack of systematic reviews on this technique in lumbar pedicle screw fixation. OBJECTIVE:To evaluate the application of computer-assisted navigation technique in lumbar pedicle screw fixation. METHODS:Databases such as PubMed, Embase and China journal ful-text database CNKI were searched for articles about computer-assisted navigation in lumbar pedicle screw fixation, and related studies and literatures were hand-searched as wel , and then insertion accuracy, intraoperative blood loss, operative time consumption and rate of insertion-related complications between computer-assisted navigation technique group and conservative technique group were compared. RESULTS AND CONCLUSION:Final y 7 studies which met the inclusion criteria were included with 784 patients and 4 101 lumbar pedicle screws in total. Meta-analysis indicated that malposition rate [relative risk (RR)=0.44, 95%confidence interval (CI)(0.27, 0.69), P=0.000 4] and intraoperative blood loss [weighted mean difference (WMD)=-172.40, 95%CI(-246.26,-98.53), P<0.000 01] had statistical y significant differences between computer-assisted navigation technique group and conservative insertion group. However, operative time consumption [WMD=-31.45, 95%CI(-85.56, 22.66), P=0.25] and incidence of complications [RR=0.41, 95%CI(0.12, 1.41), P=0.16] did not show significant differences between groups. Application of computer-assisted navigation technique in lumbar pedicle screw fixation would improve insertion accuracy. However, further study is stil needed to make clear whether this technique can improve final outcome in post-operative patients.