The Clinical Impact of Augmented Reality Surgical Navigation on Pedicle Screw Placement and its Effect on Perioperative Outcomes: A Systematic Review
Background: Spinal fusion is a common form of orthopedic surgery, the most common of which involves pedicle screw placement (PSP). Despite well-documented benefits, pedicle screws are associated with several intraoperative complications. This area of surgery has subsequently been recipient to many s...
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The Japanese Society for Spine Surgery and Related Research
2025-05-01
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| Series: | Spine Surgery and Related Research |
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| Online Access: | https://www.jstage.jst.go.jp/article/ssrr/9/3/9_2024-0223/_pdf/-char/en |
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| author | Charles Taylor Chuck Lam Nikhil Manoj Omkaar Divekar |
| author_facet | Charles Taylor Chuck Lam Nikhil Manoj Omkaar Divekar |
| author_sort | Charles Taylor |
| collection | DOAJ |
| description | Background: Spinal fusion is a common form of orthopedic surgery, the most common of which involves pedicle screw placement (PSP). Despite well-documented benefits, pedicle screws are associated with several intraoperative complications. This area of surgery has subsequently been recipient to many surgical developments. Currently, augmented reality surgical navigation (ARSN) is at the forefront of surgical interest. This systematic review evaluates whether, when compared to freehand, fluoroscopic, and intraoperative image-guided navigation, ARSN results in superior screw accuracy and operative outcomes for patients undergoing PSP surgery.
Methods: Data collection was performed on PubMed, Ovid MEDLINE, the Cochrane Library, Embase, and the Web of Science between January 7, 2023, and January 8, 2024. PRISMA guidelines were followed and the level of evidence was graded per the Centre for Evidence-Based Medicine's recommendations. Risk of bias was assessed per the ROBINS-I tool and the Cochrane guide for assessing study quality. A modified version of the Newcastle-Ottawa Scale was used to determine the certainty of the body of evidence.
Results: A total of 521 papers were obtained from all bibliographical databases, 31 of which were included in the final review. ARSN resulted in a significantly greater number of screws placed as Gertzbein and Robbins grade 1 or 2 (93.33% vs 85.86%, p<0.000), significantly reduced intraoperative blood loss (470.32 vs 802.44 ml, p=0.050), comparative operative duration (281.6 vs 255.5 min, p=0.819), comparative time to place a screw (2.71 vs 3.1 min, p=0.703), and a nonsignificant reduction in hospital stay (5.4 vs 7.5 days, p=0.097). Maximum follow-up was more than 14 days.
Conclusions: ARSN results in a significantly greater number of screws placed at Gertzbein-Robertson grade 1 or 2 than non-ARSN surgery. Therefore, ARSN can be considered as a safe and efficacious technical innovation within PSP surgery. |
| format | Article |
| id | doaj-art-ed69c67ff91844758d845fc302cde345 |
| institution | OA Journals |
| issn | 2432-261X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | The Japanese Society for Spine Surgery and Related Research |
| record_format | Article |
| series | Spine Surgery and Related Research |
| spelling | doaj-art-ed69c67ff91844758d845fc302cde3452025-08-20T02:08:40ZengThe Japanese Society for Spine Surgery and Related ResearchSpine Surgery and Related Research2432-261X2025-05-019326928210.22603/ssrr.2024-02232024-0223The Clinical Impact of Augmented Reality Surgical Navigation on Pedicle Screw Placement and its Effect on Perioperative Outcomes: A Systematic ReviewCharles Taylor0Chuck Lam1Nikhil Manoj2Omkaar Divekar3Department of Education, St George's University of LondonSchool of Medicine and Dentistry, University of BirminghamDepartment of Education, St George's University of LondonDepartment of Acute Medicine, Morriston Hospital, NHS Foundation Trust Swansea Bay University Health BoardBackground: Spinal fusion is a common form of orthopedic surgery, the most common of which involves pedicle screw placement (PSP). Despite well-documented benefits, pedicle screws are associated with several intraoperative complications. This area of surgery has subsequently been recipient to many surgical developments. Currently, augmented reality surgical navigation (ARSN) is at the forefront of surgical interest. This systematic review evaluates whether, when compared to freehand, fluoroscopic, and intraoperative image-guided navigation, ARSN results in superior screw accuracy and operative outcomes for patients undergoing PSP surgery. Methods: Data collection was performed on PubMed, Ovid MEDLINE, the Cochrane Library, Embase, and the Web of Science between January 7, 2023, and January 8, 2024. PRISMA guidelines were followed and the level of evidence was graded per the Centre for Evidence-Based Medicine's recommendations. Risk of bias was assessed per the ROBINS-I tool and the Cochrane guide for assessing study quality. A modified version of the Newcastle-Ottawa Scale was used to determine the certainty of the body of evidence. Results: A total of 521 papers were obtained from all bibliographical databases, 31 of which were included in the final review. ARSN resulted in a significantly greater number of screws placed as Gertzbein and Robbins grade 1 or 2 (93.33% vs 85.86%, p<0.000), significantly reduced intraoperative blood loss (470.32 vs 802.44 ml, p=0.050), comparative operative duration (281.6 vs 255.5 min, p=0.819), comparative time to place a screw (2.71 vs 3.1 min, p=0.703), and a nonsignificant reduction in hospital stay (5.4 vs 7.5 days, p=0.097). Maximum follow-up was more than 14 days. Conclusions: ARSN results in a significantly greater number of screws placed at Gertzbein-Robertson grade 1 or 2 than non-ARSN surgery. Therefore, ARSN can be considered as a safe and efficacious technical innovation within PSP surgery.https://www.jstage.jst.go.jp/article/ssrr/9/3/9_2024-0223/_pdf/-char/enpedicle screwpedicle screw fixationspinal fusionaugmented reality surgical navigationspinal surgery |
| spellingShingle | Charles Taylor Chuck Lam Nikhil Manoj Omkaar Divekar The Clinical Impact of Augmented Reality Surgical Navigation on Pedicle Screw Placement and its Effect on Perioperative Outcomes: A Systematic Review Spine Surgery and Related Research pedicle screw pedicle screw fixation spinal fusion augmented reality surgical navigation spinal surgery |
| title | The Clinical Impact of Augmented Reality Surgical Navigation on Pedicle Screw Placement and its Effect on Perioperative Outcomes: A Systematic Review |
| title_full | The Clinical Impact of Augmented Reality Surgical Navigation on Pedicle Screw Placement and its Effect on Perioperative Outcomes: A Systematic Review |
| title_fullStr | The Clinical Impact of Augmented Reality Surgical Navigation on Pedicle Screw Placement and its Effect on Perioperative Outcomes: A Systematic Review |
| title_full_unstemmed | The Clinical Impact of Augmented Reality Surgical Navigation on Pedicle Screw Placement and its Effect on Perioperative Outcomes: A Systematic Review |
| title_short | The Clinical Impact of Augmented Reality Surgical Navigation on Pedicle Screw Placement and its Effect on Perioperative Outcomes: A Systematic Review |
| title_sort | clinical impact of augmented reality surgical navigation on pedicle screw placement and its effect on perioperative outcomes a systematic review |
| topic | pedicle screw pedicle screw fixation spinal fusion augmented reality surgical navigation spinal surgery |
| url | https://www.jstage.jst.go.jp/article/ssrr/9/3/9_2024-0223/_pdf/-char/en |
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