{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T11:18:36Z","timestamp":1785151116864,"version":"3.55.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"name":"the Science and Technology Project of Jiangxi Provincial Health Commission, China","award":["No.202410014"],"award-info":[{"award-number":["No.202410014"]}]},{"name":"Key Research and Development Program of Jiangxi Province, China","award":["No.20252BCG330016"],"award-info":[{"award-number":["No.20252BCG330016"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Orthop Surg Traumatol"],"DOI":"10.1007\/s00590-026-04787-x","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T03:34:20Z","timestamp":1781494460000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["AI-planned and robotic-assisted pedicle screw placement improves accuracy and reduces loosening in lumbar fusion for patients with low bone mass: a multicenter study"],"prefix":"10.1007","volume":"36","author":[{"given":"Xu","family":"Xiong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weicheng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liuxue","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiong","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiangwei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongping","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhili","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William Weijia","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaming","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"4787_CR1","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1177\/2192568218770769","volume":"8","author":"VM Ravindra","year":"2018","unstructured":"Ravindra VM, Senglaub SS, Rattani A et al (2018) Degenerative lumbar spine disease: estimating global incidence and worldwide volume. Glob Spine J 8:784\u2013794. https:\/\/doi.org\/10.1177\/2192568218770769","journal-title":"Glob Spine J"},{"key":"4787_CR2","doi-asserted-by":"publisher","first-page":"907","DOI":"10.26355\/eurrev_202402_35328","volume":"28","author":"Y-X Hu","year":"2024","unstructured":"Hu Y-X, Yang R, Liu S-M, Wang H (2024) Bibliometric analysis of transforaminal lumbar interbody fusion in lumbar spine surgery. Eur Rev Med Pharmacol Sci 28:907\u2013923. https:\/\/doi.org\/10.26355\/eurrev_202402_35328","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"4787_CR3","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.1007\/s00198-007-0370-8","volume":"18","author":"DK Chin","year":"2007","unstructured":"Chin DK, Park JY, Yoon YS et al (2007) Prevalence of osteoporosis in patients requiring spine surgery: incidence and significance of osteoporosis in spine disease. Osteoporos Int 18:1219\u20131224. https:\/\/doi.org\/10.1007\/s00198-007-0370-8","journal-title":"Osteoporos Int"},{"key":"4787_CR4","doi-asserted-by":"publisher","DOI":"10.4081\/or.2010.e3","volume":"2","author":"M R\u00f6llinghoff","year":"2010","unstructured":"R\u00f6llinghoff M, Schl\u00fcter-Brust K, Groos D et al (2010) Mid-range outcomes in 64 consecutive cases of multilevel fusion for degenerative diseases of the lumbar spine. Orthop Rev 2:e3. https:\/\/doi.org\/10.4081\/or.2010.e3","journal-title":"Orthop Rev"},{"key":"4787_CR5","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1227\/neu.0000000000002373","volume":"93","author":"W Yu","year":"2023","unstructured":"Yu W, Liang D, Yao Z et al (2023) The potential impact of basivertebral foramen morphology and pedicle screw placement on epidural cement leakage with cement-augmented fenestrated pedicle screw fixation: a multicenter retrospective study of 282 patients and 1404 augmented screws. Neurosurgery 93:66\u201374. https:\/\/doi.org\/10.1227\/neu.0000000000002373","journal-title":"Neurosurgery"},{"key":"4787_CR6","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1007\/s00402-011-1439-6","volume":"132","author":"Z Wu","year":"2012","unstructured":"Wu Z, Gong F, Liu L et al (2012) A comparative study on screw loosening in osteoporotic lumbar spine fusion between expandable and conventional pedicle screws. Arch Orthop Trauma Surg 132:471\u2013476. https:\/\/doi.org\/10.1007\/s00402-011-1439-6","journal-title":"Arch Orthop Trauma Surg"},{"key":"4787_CR7","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1186\/s13018-023-03820-7","volume":"18","author":"Y Wang","year":"2023","unstructured":"Wang Y, Kahaer A, Maimaiti A et al (2023) Complication, fusion, and revision rate in the lumbar cortical bone trajectory and pedicle screw fixation techniques: a systematic review and meta-analysis. J Orthop Surg Res 18:382. https:\/\/doi.org\/10.1186\/s13018-023-03820-7","journal-title":"J Orthop Surg Res"},{"key":"4787_CR8","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/j.bone.2013.06.022","volume":"56","author":"Y Wang","year":"2013","unstructured":"Wang Y, Owoc JS, Boyd SK et al (2013) Regional variations in trabecular architecture of the lumbar vertebra: associations with age, disc degeneration and disc space narrowing. Bone 56:249\u2013254. https:\/\/doi.org\/10.1016\/j.bone.2013.06.022","journal-title":"Bone"},{"key":"4787_CR9","doi-asserted-by":"publisher","DOI":"10.3171\/2022.1.FOCUS21721","volume":"52","author":"C Ma","year":"2022","unstructured":"Ma C, Zou D, Qi H et al (2022) A novel surgical planning system using an AI model to optimize planning of pedicle screw trajectories with highest bone mineral density and strongest pull-out force. Neurosurg Focus 52:E10. https:\/\/doi.org\/10.3171\/2022.1.FOCUS21721","journal-title":"Neurosurg Focus"},{"key":"4787_CR10","doi-asserted-by":"publisher","first-page":"1058","DOI":"10.1097\/BRS.0000000000005147","volume":"50","author":"FCS Altorfer","year":"2025","unstructured":"Altorfer FCS, Kelly MJ, Avrumova F et al (2025) Pedicle screw placement with augmented reality versus robotic-assisted surgery. Spine 50:1058\u20131064. https:\/\/doi.org\/10.1097\/BRS.0000000000005147","journal-title":"Spine"},{"key":"4787_CR11","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1097\/BSD.0000000000001687","volume":"38","author":"X Xiong","year":"2025","unstructured":"Xiong X, Liu J-M, Lu WW et al (2025) The effectiveness of artificial intelligence-based pedicle screw trajectory planning in patients with different levels of bone mineral density. Clin Spine Surg 38:154\u2013160. https:\/\/doi.org\/10.1097\/BSD.0000000000001687","journal-title":"Clin Spine Surg"},{"key":"4787_CR12","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1097\/00007632-199001000-00004","volume":"15","author":"SD Gertzbein","year":"1990","unstructured":"Gertzbein SD, Robbins SE (1990) Accuracy of pedicular screw placement in vivo. Spine 15:11\u201314. https:\/\/doi.org\/10.1097\/00007632-199001000-00004","journal-title":"Spine"},{"key":"4787_CR13","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1302\/0301-620x.86b3.14323","volume":"86","author":"B Sand\u00e9n","year":"2004","unstructured":"Sand\u00e9n B, Olerud C, Petr\u00e9n-Mallmin M et al (2004) The significance of radiolucent zones surrounding pedicle screws. Definition of screw loosening in spinal instrumentation. J Bone Joint Surg Br 86:457\u2013461. https:\/\/doi.org\/10.1302\/0301-620x.86b3.14323","journal-title":"J Bone Joint Surg Br"},{"key":"4787_CR14","doi-asserted-by":"publisher","first-page":"2150","DOI":"10.1111\/os.13420","volume":"14","author":"D Zhang","year":"2022","unstructured":"Zhang D, Zeng T, Chen K, Jin S (2022) Applications of the crenel lateral interbody fusion procedure in treatment for adjacent segments degeneration of the lumbar spine. Orthop Surg 14:2150\u20132158. https:\/\/doi.org\/10.1111\/os.13420","journal-title":"Orthop Surg"},{"key":"4787_CR15","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1186\/s13018-022-03239-6","volume":"17","author":"Z Wang","year":"2022","unstructured":"Wang Z, Mei J, Feng X et al (2022) Low cervical vertebral CT value increased early subsidence of titanium mesh cage after anterior cervical corpectomy and fusion. J Orthop Surg Res 17:355. https:\/\/doi.org\/10.1186\/s13018-022-03239-6","journal-title":"J Orthop Surg Res"},{"key":"4787_CR16","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1097\/01.BRS.0000061988.93175.74","volume":"28","author":"ERG Santos","year":"2003","unstructured":"Santos ERG, Goss DG, Morcom RK, Fraser RD (2003) Radiologic assessment of interbody fusion using carbon fiber cages. Spine 28:997\u20131001. https:\/\/doi.org\/10.1097\/01.BRS.0000061988.93175.74","journal-title":"Spine"},{"key":"4787_CR17","doi-asserted-by":"publisher","first-page":"B27","DOI":"10.1097\/BRS.0000000000000431","volume":"39","author":"Q Yuan","year":"2014","unstructured":"Yuan Q, Han X, Han X et al (2014) Krag versus caudad trajectory technique for pedicle screw insertion in osteoporotic vertebrae: biomechanical comparison and analysis. Spine 39:B27-35. https:\/\/doi.org\/10.1097\/BRS.0000000000000431","journal-title":"Spine"},{"key":"4787_CR18","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1080\/10255842.2021.1959558","volume":"25","author":"S Caprara","year":"2022","unstructured":"Caprara S, Fasser M-R, Spirig JM et al (2022) Bone density optimized pedicle screw instrumentation improves screw pull-out force in lumbar vertebrae. Comput Methods Biomech Biomed Eng 25:464\u2013474. https:\/\/doi.org\/10.1080\/10255842.2021.1959558","journal-title":"Comput Methods Biomech Biomed Eng"},{"key":"4787_CR19","doi-asserted-by":"publisher","first-page":"1420","DOI":"10.1109\/TMI.2016.2514530","volume":"35","author":"D Knez","year":"2016","unstructured":"Knez D, Likar B, Pernus F, Vrtovec T (2016) Computer-assisted screw size and insertion trajectory planning for pedicle screw placement surgery. IEEE Trans Med Imaging 35:1420\u20131430. https:\/\/doi.org\/10.1109\/TMI.2016.2514530","journal-title":"IEEE Trans Med Imaging"},{"key":"4787_CR20","doi-asserted-by":"publisher","first-page":"3263","DOI":"10.1111\/os.13882","volume":"15","author":"K Wang","year":"2023","unstructured":"Wang K, Wang X, Li Z et al (2023) The influence of screw positioning on cage subsidence in patients with oblique lumbar interbody fusion combined with anterolateral fixation. Orthop Surg 15:3263\u20133271. https:\/\/doi.org\/10.1111\/os.13882","journal-title":"Orthop Surg"},{"key":"4787_CR21","doi-asserted-by":"publisher","first-page":"337","DOI":"10.3390\/bioengineering12040337","volume":"12","author":"A Jacob","year":"2025","unstructured":"Jacob A, Feist A, Zderic I et al (2025) Augmenting screw technique to prevent TLIF cage subsidence: a biomechanical in vitro study. Bioengineering 12:337. https:\/\/doi.org\/10.3390\/bioengineering12040337","journal-title":"Bioengineering"},{"key":"4787_CR22","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1302\/0301-620X.105B5.BJJ-2022-0810.R3","volume":"105-B","author":"F Abel","year":"2023","unstructured":"Abel F, Avrumova F, Goldman SN et al (2023) Robotic-navigated assistance in spine surgery. Bone Joint J 105-B:543\u2013550. https:\/\/doi.org\/10.1302\/0301-620X.105B5.BJJ-2022-0810.R3","journal-title":"Bone Joint J"},{"key":"4787_CR23","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1016\/j.jos.2018.06.009","volume":"23","author":"JH Cho","year":"2018","unstructured":"Cho JH, Hwang CJ, Kim H et al (2018) Effect of osteoporosis on the clinical and radiological outcomes following one-level posterior lumbar interbody fusion. J Orthop Sci 23:870\u2013877. https:\/\/doi.org\/10.1016\/j.jos.2018.06.009","journal-title":"J Orthop Sci"},{"key":"4787_CR24","doi-asserted-by":"publisher","first-page":"364","DOI":"10.3171\/2017.7.SPINE17625","volume":"28","author":"T-S Fu","year":"2018","unstructured":"Fu T-S, Li Y-D (2018) Fluoroscopy-guided percutaneous vertebroplasty for symptomatic loosened pedicle screw and instrumentation-associated vertebral fracture: an evaluation of initial experiences and technical note. J Neurosurg Spine 28:364\u2013371. https:\/\/doi.org\/10.3171\/2017.7.SPINE17625","journal-title":"J Neurosurg Spine"},{"key":"4787_CR25","doi-asserted-by":"publisher","first-page":"678","DOI":"10.3389\/fphys.2016.00678","volume":"7","author":"V Glatt","year":"2016","unstructured":"Glatt V, Evans CH, Tetsworth K (2016) A concert between biology and biomechanics: the influence of the mechanical environment on bone healing. Front Physiol 7:678. https:\/\/doi.org\/10.3389\/fphys.2016.00678","journal-title":"Front Physiol"},{"key":"4787_CR26","doi-asserted-by":"publisher","first-page":"1142","DOI":"10.7507\/1002-1892.202001070","volume":"34","author":"H Chen","year":"2020","unstructured":"Chen H, Liu S, Zhang J et al (2020) A comparative study on treatment of lumbar degenerative disease with osteoporosis by manual and robot-assisted cortical bone trajectory screws fixation. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi = Chin J Reparative Reconstr Surg 34:1142\u20131148. https:\/\/doi.org\/10.7507\/1002-1892.202001070","journal-title":"Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi = Chin J Reparative Reconstr Surg"},{"key":"4787_CR27","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1227\/neu.0000000000002899","volume":"95","author":"A Sarikonda","year":"2024","unstructured":"Sarikonda A, Tecce E, Leibold A et al (2024) What is the marginal cost of using robot assistance or navigation for transforaminal lumbar interbody fusion? A time-driven activity-based cost analysis. Neurosurgery 95:556\u2013565. https:\/\/doi.org\/10.1227\/neu.0000000000002899","journal-title":"Neurosurgery"},{"key":"4787_CR28","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.wneu.2024.08.018","volume":"191","author":"D Sturgill","year":"2024","unstructured":"Sturgill D, How J, Blajda T et al (2024) Are the clinical outcomes and cost-effectiveness of robot-assisted pedicle screw placement in lumbar fusion surgery superior to computed tomography navigation and freehand fluoroscopy-guided techniques? A systematic review and network meta-analysis. World Neurosurg 191:81\u201390. https:\/\/doi.org\/10.1016\/j.wneu.2024.08.018","journal-title":"World Neurosurg"},{"key":"4787_CR29","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1177\/21925682221107652","volume":"14","author":"C Yu","year":"2024","unstructured":"Yu C, Owens RK, Crawford CH et al (2024) Cost-effectiveness of intraoperative electromyography to determine adequate screw position. Glob Spine J 14:407\u2013410. https:\/\/doi.org\/10.1177\/21925682221107652","journal-title":"Glob Spine J"}],"container-title":["European Journal of Orthopaedic Surgery &amp; Traumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00590-026-04787-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00590-026-04787-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00590-026-04787-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T03:34:31Z","timestamp":1781494471000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00590-026-04787-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,15]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4787"],"URL":"https:\/\/doi.org\/10.1007\/s00590-026-04787-x","relation":{},"ISSN":["1432-1068"],"issn-type":[{"value":"1432-1068","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,15]]},"assertion":[{"value":"30 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This study was conducted in accordance with the principles of the Declaration of Helsinki. Approval was granted by the institutional research ethics committee.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}],"article-number":"243"}}