Comparison of the effect of navigation template assisted spinal pedicle fixation and traditional pedicle screw fixation:a Meta-analysis / 中国骨伤

ABSTRACT

OBJECTIVE@#To systematically evaluate the efficacy of rapid prototyping drill navigation template-assisted pedicle screw fixation and traditional anatomic landmark-based fixation in the treatment of spinal disease by accessing and searching some relevant literatures home and abroad.@*METHODS@#Randomized Controlled Trials (RCTs) and prospective case-control studies or retrospective case-control studies about rapid prototyping drill templates-assisted pedicle screw fixation and traditional anatomic landmark-based fixation for the treatment of spinal disease were searched electronically in PubMed, The Cochrane Library(Issue 5, 2017), Clinical Trial, Google Scholar, Web of Science, CNKI, Wanfang database and VIP database before June 2017. According to the inclusion and exclusion criteria, two researchers independently screened the literatures, and extracted the data. The methodological quality of randomized controlled trials were evaluated by the Cochrane Handbook, and prospective case-control studies and retrospective case-control studies were evaluated by the NOS scale. The outcomes were analyzed using RevMan 5.3 software provided by the Cochrane information management system.@*RESULTS@#A total of 7 articles were included, including 2 RCTs, 1 prospective case-control study and 4 retrospective case-control studies. A total of 237 patients were implanted with 1 688 pedicle screws, including 898 screws in the navigation template group, 790 screws in the conventional method group. Meta-analysis results showed that there was significant difference in the excellent rate of screw implantation between navigation template group and conventional method group [OR=5.05, 95% CI(3.13, 8.16), <0.000 01], there was significant difference in operative time, intraoperative blood loss for thoracolumbar surgery [WMD=-27.19, 95% CI(-38.21, -16.17), <0.000 01; WMD=-100.82, 95% CI(-182.26, -19.37), =0.02].@*CONCLUSIONS@#Compared with traditional pedicle screw fixation, navigation template spine pedicle screw fixation has better clinical effect, which can improve the excellent rate of screw placement, reduce the operation time and intraoperative bleeding.