European Spine Journal

, Volume 19, Issue 3, pp 370–375 | Cite as

Functional outcome of computer-assisted spinal pedicle screw placement: a systematic review and meta-analysis of 23 studies including 5,992 pedicle screws

  • Rajeev Verma
  • Sonal Krishan
  • Kurt Haendlmayer
  • A. Mohsen
Review Article


A number of studies have shown increased accuracy of pedicle screw placement in spine with the help of computer-assisted navigation. The literature is lacking in regard to functional benefit derived from this technique. The aim of this systematic review was to look at the functional outcomes following computer-assisted pedicle screw placement in spine. A ‘Dialog Datastar’ search was used using optimized search strategy covering the period from 1950 to July 2009; 23 papers were finally included which met our inclusion criteria. We report on a total of 1,288 patients with 5,992 pedicle screws. The comparison of neurological complications in two groups demonstrated an odds ratio of 0.25 (95% CI 0.06, 1.14) in favour of using navigation for pedicle screw insertion (p = 0.07). Comparative trials demonstrated a significant advantage in terms of accuracy of navigation over conventional pedicle screw insertion with a relative risk of 1.12 (95% CI 1.09, 1.15) (p < 0.00001). Navigation does not show statistically significant benefit in reducing neurological complications and there was insufficient data in the literature to infer a conclusion in terms of fusion rate, pain relief and health outcome scores.


Spine Pedicle screws Navigation Conventional 


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Rajeev Verma
    • 1
    • 5
  • Sonal Krishan
    • 2
  • Kurt Haendlmayer
    • 3
  • A. Mohsen
    • 4
  1. 1.Trauma and OrthopaedicsHuddersfield Royal InfirmaryHuddersfieldUK
  2. 2.Radiology AcademyLeeds General InfirmaryLeedsUK
  3. 3.Trauma and OrthopaedicsLeeds General InfirmaryLeedsUK
  4. 4.Trauma and OrthopaedicsHull Royal InfirmaryHullUK
  5. 5.LeedsUK

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