Radiation Exposure and Dose Estimates of Robot-Guided Versus Fluoroscopy-Guided Spinal Fusion
Bibliographic record
Abstract
STUDY DESIGN: Systematic review and meta-analysis. SUMMARY OF BACKGROUND DATA: Robot-guided (RG) pedicle screw placement offers several advantages over fluoroscopy-guided (FG) surgery to patients undergoing spinal fusion. Radiation exposure and detrimental risks associated with RG surgery are poorly described in the literature. OBJECTIVES: We perform a systematic review and meta-analysis of randomized controlled trials comparing RG to FG spinal fusion to assess radiation exposure to patients and clinicians. METHODS: MEDLINE, Embase, Web of Science, and Cochrane Central were systematically queried. Inclusion was restricted to RCTs in adults. Version 2 of the Cochrane risk-of-bias tool for RCTs (RoB 2) was used to evaluate risk of bias and quality was appraised using the GRADE assessment tool. Continuous data were pooled across trials with inverse variance weighting to mean difference (MD) and dichotomous data were pooled with Mantel-Haenszel weighting to odds ratio (OR) with corresponding 95% CI. RESULTS: A total of 1042 patients (RG: 651; FG: 391) from 8 RCTs were included. Radiation time was reduced in the RG group by 39.6% (MD: -25.65 seconds, 95% CI: -51.07 to -0.22) with an estimated anteroposterior and lateral dose-area product in the RG group measuring 123.85±73.12 and 241.08±142.33 cGycm 2 , respectively. Estimated cancer risk and detrimental hereditary disorder risk were reduced by 40.2% in the RG group (3.60×10 -5 ±2.12×10 -5 and 1.31×10 -6 ±7.72×10 -7 , respectively). Intraoperative bleeding volume was reduced in the RG group (MD: -61.52 mL, 95% CI: -100.16 to -22.87, P =0.002, I2 =48%). However, surgical duration was significantly higher in the RG group (MD: 12.01 min, 95% CI: 1.63-22.39). Pedicle screw accuracy and length of hospital stay differences were not significant. CONCLUSIONS: Radiation exposure to patients undergoing spinal fusion is lower in RG surgery compared with FG surgery. These findings can be supported with long-term studies that better characterize radiation dosages associated with these procedures. LEVEL OF EVIDENCE: Level I.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.026 | 0.074 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.025 | 0.051 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".