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Effects of robot-assisted minimally invasive surgery on osteoporotic vertebral compression fracture: a systematic review, meta-analysis, and meta-regression of retrospective study

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Abstract

Objective

To conduct a systematic review on the effect of robot-assisted minimally invasive surgery (R-MIS) on the clinical outcomes and complications of patients with osteoporotic vertebral compression fractures (OVCFs).

Methods

The researchers searched the papers published on PubMed, The Cochrane Library, Web of Science, Embase, Scopus, Ovid MEDLINE, Wiley Online Library, China National Knowledge Infrastructure (CNKI), Chinese biomedical literature service system (SinoMed), and China Medical Association Data. The standardized mean difference (SMD) or mean difference (MD), relative risk (RR), and 95% confidence interval (CI) were calculated. Besides, the data was merged through the random-effect model or common-effect model. A meta-regression mixed-effects single-factor model was utilized to analyze the sources of heterogeneity.

Results

Twelve studies were included, involving 1042 OVCFs cases. The prognosis of patients treated with R-MIS was significantly improved, such as Oswestry disability index (ODI) score (MD = -0.65, P = 0.0171), Cobb's angles (MD = -1.03, P = 0.0027), X-ray fluoroscopy frequency (SMD = -2.41, P < 0.0001), Length of hospital stay (MD = -0.33, P = 0.0002), and Cement leakage (RR = 0.37, P < 0.0001). However, no obvious improvement was found in the results of Visual analog scale (VAS) score (MD = -0.16, P = 0.1555), Volume of bone cement (MD = 0.22, P = 0.8339), and Operation time (MD = -3.20, P = 0.3411) after being treated by R-MIS. The meta-regression analysis demonstrated that R-MIS presented no significant impact on the covariates of VAS and Operation time.

Conclusion

R-MIS can significantly reduce the patients’ ODI, Cobb’s angles, X-ray fluoroscopy frequency, and Cement leakage ratio, and shorten the Length of hospital stay. Therefore, R-MIS may be an effective method to promote the patients’ functional recovery, correct spinal deformity, reduce the X-ray fluoroscopy frequency, shorten the Length of hospital stay, and reduce the complications of OVCFs bone Cement leakage.

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Abbreviations

MIS:

Minimally invasive surgery

R-MIS:

Robot-assisted minimally invasive surgery

OVCFs:

Osteoporotic vertebral compression fractures

PKP:

Percutaneous kyphoplasty

PVP:

Percutaneous vertebroplasty

R-PKP:

Robot-assisted percutaneous kyphoplasty

R-PVP:

Robot-assisted percutaneous vertebroplasty

VAS:

Visual analog scale

ODI:

Oswestry disability index

NOS:

Newcastle-Ottawa scale

RR:

Relative risk

MD:

Mean difference

SMD:

Standardized mean difference

SD:

Standard deviations

CI:

Confidence interval

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Authors and Affiliations

  1. Graduate Students’ Affairs Department, Shenyang Sport University, No. 36 Jinqiansong East Road, Sujiatun District, Shenyang, 110102, China

    Haoqian Chen

  2. Sports Training College, Shenyang Sport University, No. 36 Jinqiansong East Road, Sujiatun District, Shenyang, 110102, China

    Haoqian Chen

  3. Basic Research Department, Shenyang Sport University, No. 36 Jinqiansong East Road, Sujiatun District, Shenyang, 110102, China

    Jia Li

  4. College of Exercise and Health, Shenyang Sport University, No. 36 Jinqiansong East Road, Sujiatun District, Shenyang, 110102, China

    Xin Wang

  5. Laboratory Management Center, Shenyang Sport University, No. 36 Jinqiansong East Road, Sujiatun District, Shenyang, 110102, China

    Yanming Fu

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YMF, XW contributed to the study concept and design. HQC, JL, and YMF conducted the literature review and statistical analysis. All authors contributed to the interpretation of data. HQC and YMF contributed to drafting the paper. All authors revised the text for intellectual content and have read and approved the final version of the manuscript.

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Correspondence to Yanming Fu.

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This meta-analysis met the guidelines provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

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Chen, H., Li, J., Wang, X. et al. Effects of robot-assisted minimally invasive surgery on osteoporotic vertebral compression fracture: a systematic review, meta-analysis, and meta-regression of retrospective study. Arch Osteoporos 18, 46 (2023). https://doi.org/10.1007/s11657-023-01234-w

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