机器人辅助椎弓根置钉临床疗效的系统评价再评价  

Efficacy of robot-assisted pedicle screw placement:an overview of systematic review

作　　者：孙文熙 高泽辉 丘明旺 林锐 王洪伸 陈博来 林涌鹏 SUN Wenxi;GAO Zehui;QIU Mingwang;LIN Rui;WANG Hongshen;CHEN Bolai;LIN Yongpeng(Second Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510405,P.R.China;Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,P.R.China;State Key Laboratory of Traditional Chinese Medicine Syndrome,The Second Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510120,P.R.China)

机构地区：[1]广州中医药大学第二临床医学院,广州510405 [2]广东省中医院,广州510120 [3]广州中医药大学第二附属医院/中医证候全国重点实验室,广州510120

出　　处：《中国循证医学杂志》2024年第5期584-590,共7页Chinese Journal of Evidence-based Medicine

基　　金：国家自然科学基金(编号:82174396、82274554);广东省普通高校创新团队项目(编号:2021KCXTD020);广州中医药大学中医学学科中医基础理论研究“揭榜挂帅”项目(第二批);广州市科技计划项目(编号:202201020554、202201020324);广东省中医院第十三届朝阳人才项目(编号:2022KT1214)。

摘　　要：目的 对机器人辅助椎弓根置钉疗效的系统评价/Meta分析(SR/MA)进行再评价。方法 计算机检索CNKI、VIP、WanFang Data、SinoMed、PubMed、Embase、Cochrane Library、Web of Science数据库,搜集有关机器人辅助椎弓根置钉的SR/MA,检索时限均为建库至2023年4月28日。由2名研究者独立筛选文献、提取资料后,分别使用PRISMA、AMSTAR-Ⅱ、ROBIS和GRADE工具评价纳入研究的报告质量、方法学质量、偏倚风险以及证据质量强度。结果 共纳入20篇SR/MA。纳入研究结论显示机器人辅助椎弓根置钉准确性相比徒手置钉可能更高,并发症数量更少。所有SR/MA的报告质量、方法学及置钉疗效的证据质量均为低或极低,偏倚风险为高风险。其主要原因包括纳入研究的异质性偏高,研究方法和选择标准模糊、关键报告流程缺失等。结论 机器人辅助椎弓根置钉相比传统徒手置钉可能具有更好的临床疗效,但相关SR/MA的质量较低。Objective To re-evaluate the systematic review and meta-analysis(SR/MAs)of the efficacy of robotassisted pedicle screw placement.Methods The CNKI,VIP,WanFang Data,SinoMed,PubMed,Embase,Cochrane Library,and Web of Science databases were electronically searched to collect SR/MAs of robot-assisted pedicle screw placement from inception to April 28,2023.Two reviewers independently screened literature,extracted data and then assessed the quality of reports,methodological quality,risk of bias,and the strength of evidence quality by using PRISMA,AMSTAR-Ⅱ,ROBIS,and GRADE tool.Results A total of 20 SR/MAs were included.The results of the included studies showed that robot-assisted pedicle screw placement was more accurate and had a lower number of complications compared with freehand pedicle screw placement.The quality of reports,methodology,and evidence for pedicle screw placement efficiency in all SR/MAs were low or extremely low,with a high risk of bias.The main reasons included high heterogeneity of included studies,unclear research methods and selection criteria,and missing key reporting processes.Conclusion Robot-assisted pedicle screw placement may have better clinical efficiency than traditional freehand pedicle screw placement.But the quality of relational SR/MAs is low.

关 键 词：骨科手术机器人 椎弓根螺钉 系统评价再评价 

分 类 号：R687.3[医药卫生—骨科学]