{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:51:40Z","timestamp":1781650300074,"version":"3.54.5"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University-Level Natural Science Project (Young Scholars Program), North Sichuan Medical College"},{"name":"Nanchong Philosophy and Social Sciences Research Planning Project"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Robotic Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>To compare the clinical effectiveness and safety of the TiRobot and Mazor robotic systems in spinal deformity surgery, with additional stratified analyses based on deformity type, including adolescent idiopathic scoliosis (AIS) and adult degenerative scoliosis (ADS). PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched for comparative studies published up to February 1, 2026. Subgroup analyses were prespecified according to robotic platform (TiRobot vs. Mazor) and deformity type (AIS vs. ADS). Perioperative outcomes, radiographic parameters, pedicle screw accuracy, and safety endpoints were quantitatively synthesized. Compared with conventional techniques, robotic-assisted surgery was associated with prolonged operative time (MD\u2009=\u200929.64 min, P\u2009&lt;\u20090.01), significantly improved pedicle screw accuracy (OR\u2009=\u20096.51, P\u2009&lt;\u20090.01), and reduced radiation exposure (MD\u2009=\u2009\u2212\u20095.27, P\u2009&lt;\u20090.01), while no significant differences were observed in blood loss, hospital stay, or Cobb angle correction. Platform-based subgroup analyses indicated that TiRobot was associated with reduced intraoperative blood loss and shorter hospitalization, whereas Mazor demonstrated greater improvements in thoracic kyphosis and MT values. Disease-based subgroup analyses showed that operative time remained significantly longer in the AIS subgroup, whereas a shorter length of hospital stay was observed in ADS patients. No significant differences were detected in other outcomes across disease subtypes. Robotic assistance enhances pedicle screw accuracy and reduces radiation exposure. Both platform-specific and disease-specific differences exist in perioperative and radiographic outcomes, highlighting the importance of individualized surgical strategy based on both robotic system and deformity type.<\/jats:p>","DOI":"10.1007\/s11701-026-03410-9","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T02:54:30Z","timestamp":1776048870000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative clinical performance of robotic-assisted systems in spinal deformity surgery: focus on perioperative outcomes and pedicle screw accuracy"],"prefix":"10.1007","volume":"20","author":[{"given":"Yu","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruoyan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guohang","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junlei","family":"Liao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Mu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yupei","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nurul Azira","family":"Ismail","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"3410_CR1","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1007\/s43390-025-01196-8","volume":"14","author":"DC Gabriel","year":"2026","unstructured":"Gabriel DC et al (2026) Curve stabilization at 2 years despite declining brace adherence in adolescent idiopathic scoliosis: a single-center cohort with sociodemographic analysis. Spine Deform 14:59\u201365. https:\/\/doi.org\/10.1007\/s43390-025-01196-8","journal-title":"Spine Deform"},{"key":"3410_CR2","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1007\/s43390-025-01161-5","volume":"14","author":"JJM Renkens","year":"2026","unstructured":"Renkens JJM et al (2026) Double claw construct with hooks for proximal fixation in adolescent idiopathic scoliosis: a randomized controlled trial. Spine Deform 14:119\u2013128. https:\/\/doi.org\/10.1007\/s43390-025-01161-5","journal-title":"Spine Deform"},{"key":"3410_CR3","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1007\/s43390-025-01163-3","volume":"14","author":"S Sasao","year":"2026","unstructured":"Sasao S et al (2026) Age and in-brace Cobb angle predict brace failure in adolescent idiopathic scoliosis. Spine Deform 14:77\u201384. https:\/\/doi.org\/10.1007\/s43390-025-01163-3","journal-title":"Spine Deform"},{"key":"3410_CR4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/bpb.0000000000001293","volume":"35","author":"CY Hung","year":"2026","unstructured":"Hung CY et al (2026) Vertebral rotation as a predictor of residual deformity following scoliosis correction in spinal muscular atrophy: a retrospective analysis. J Pediatr Orthop B 35:1\u20139. https:\/\/doi.org\/10.1097\/bpb.0000000000001293","journal-title":"J Pediatr Orthop B"},{"key":"3410_CR5","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1007\/s00586-025-09165-5","volume":"35","author":"EE \u00d6zcan Ek\u015fi","year":"2026","unstructured":"\u00d6zcan Ek\u015fi EE et al (2026) Extent of fatty infiltration in lumbar paraspinal muscles in adults with degenerative scoliosis: segmental differences in muscle involvement. Eur Spine J 35:234\u2013248. https:\/\/doi.org\/10.1007\/s00586-025-09165-5","journal-title":"Eur Spine J"},{"key":"3410_CR6","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1007\/s43390-025-01160-6","volume":"14","author":"AA Jamnik","year":"2026","unstructured":"Jamnik AA et al (2026) Defining anatomical landmarks for simulated juxtapedicular screw placement for posterior spinal fusion in adolescent patients with scoliosis. Spine Deform 14:175\u2013185. https:\/\/doi.org\/10.1007\/s43390-025-01160-6","journal-title":"Spine Deform"},{"key":"3410_CR7","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1177\/21925682251335919","volume":"16","author":"Y Li","year":"2026","unstructured":"Li Y et al (2026) The Effect of Comprehensive Spinal Correction Rehabilitation in Children With Early-Onset Idiopathic Scoliosis: A Clinical Controlled Trial. Global Spine J 16:25\u201335. https:\/\/doi.org\/10.1177\/21925682251335919","journal-title":"Global Spine J"},{"key":"3410_CR8","doi-asserted-by":"publisher","first-page":"670","DOI":"10.14444\/8822","volume":"19","author":"AT Hantouly","year":"2025","unstructured":"Hantouly AT et al (2025) Vertebral Body Tethering for Adolescent Idiopathic Scoliosis: Quality of Evidence and Recommendations From a Systematic Overview of Systematic Reviews in Literature. Int J Spine Surg 19:670\u2013682. https:\/\/doi.org\/10.14444\/8822","journal-title":"Int J Spine Surg"},{"key":"3410_CR9","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1007\/s00586-025-08742-y","volume":"35","author":"J Li","year":"2026","unstructured":"Li J et al (2026) Determining the risk factors for postoperative mechanical complication in degenerative scoliosis: a machine learning approach based on musculoskeletal metrics. Eur Spine J 35:156\u2013166. https:\/\/doi.org\/10.1007\/s00586-025-08742-y","journal-title":"Eur Spine J"},{"key":"3410_CR10","doi-asserted-by":"publisher","DOI":"10.1007\/s43390-025-01251-4","author":"U Kapoor","year":"2025","unstructured":"Kapoor U et al (2025) Recent national improvements in length of stay and complications after posterior spinal fusion for adolescent idiopathic scoliosis: a database analysis and review of literature. Spine Deform. https:\/\/doi.org\/10.1007\/s43390-025-01251-4","journal-title":"Spine Deform"},{"key":"3410_CR11","doi-asserted-by":"publisher","unstructured":"Popescu MB et al (2025) Preoperative Halo Traction Versus Direct Posterior Fusion in Severe Adolescent Idiopathic Scoliosis: A Comparative Study. J Clin Med 15. https:\/\/doi.org\/10.3390\/jcm15010142","DOI":"10.3390\/jcm15010142"},{"key":"3410_CR12","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.1186\/s12891-025-09309-0","volume":"26","author":"T Sun","year":"2025","unstructured":"Sun T et al (2025) Impact of scoliosis-specific exercises on adolescents with idiopathic scoliosis. BMC Musculoskelet Disord 26:1113. https:\/\/doi.org\/10.1186\/s12891-025-09309-0","journal-title":"BMC Musculoskelet Disord"},{"key":"3410_CR13","doi-asserted-by":"publisher","first-page":"841","DOI":"10.1530\/eor-23-0125","volume":"8","author":"WX Sun","year":"2023","unstructured":"Sun WX et al (2023) Clinical efficacy of robotic spine surgery: an updated systematic review of 20 randomized controlled trials. EFORT Open Rev 8:841\u2013853. https:\/\/doi.org\/10.1530\/eor-23-0125","journal-title":"EFORT Open Rev"},{"key":"3410_CR14","doi-asserted-by":"publisher","first-page":"2714","DOI":"10.1007\/s00586-025-08882-1","volume":"34","author":"J Ueno","year":"2025","unstructured":"Ueno J et al (2025) Factors causing deviation of robot-assisted pedicle screw placement for adolescent idiopathic scoliosis: why does deviation still occur even with robotics? Eur Spine J 34:2714\u20132722. https:\/\/doi.org\/10.1007\/s00586-025-08882-1","journal-title":"Eur Spine J"},{"key":"3410_CR15","doi-asserted-by":"publisher","DOI":"10.1093\/nutrit\/nuaf218","author":"FM Silva","year":"2026","unstructured":"Silva FM et al (2026) Reporting Completeness of Systematic Reviews of Nutrition or Diet-Related Randomised Controlled Trials: A Meta-Research on Adherence to PRISMA Items. Nutr Rev. https:\/\/doi.org\/10.1093\/nutrit\/nuaf218","journal-title":"Nutr Rev"},{"key":"3410_CR16","doi-asserted-by":"publisher","first-page":"112097","DOI":"10.1016\/j.jclinepi.2025.112097","volume":"190","author":"R Guelimi","year":"2026","unstructured":"Guelimi R et al (2026) Comparison between risk of bias-1 and risk of bias-2 tool and impact on network meta-analysis results-A case study from a living Cochrane review on psoriasis. J Clin Epidemiol 190:112097. https:\/\/doi.org\/10.1016\/j.jclinepi.2025.112097","journal-title":"J Clin Epidemiol"},{"key":"3410_CR17","doi-asserted-by":"publisher","first-page":"e49061","DOI":"10.7759\/cureus.49061","volume":"15","author":"T Akazawa","year":"2023","unstructured":"Akazawa T et al (2023) Comparison of Radiographic and Patient-Reported Outcomes After Surgery in Adolescent Idiopathic Scoliosis Between Robotics and Navigation: An Analysis Using Propensity Score Matching. Cureus 15:e49061. https:\/\/doi.org\/10.7759\/cureus.49061","journal-title":"Cureus"},{"key":"3410_CR18","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1007\/s00586-022-07502-6","volume":"32","author":"T Akazawa","year":"2023","unstructured":"Akazawa T et al (2023) Accuracy of computer-assisted pedicle screw placement for adolescent idiopathic scoliosis: a comparison between robotics and navigation. Eur Spine J 32:651\u2013658. https:\/\/doi.org\/10.1007\/s00586-022-07502-6","journal-title":"Eur Spine J"},{"key":"3410_CR19","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1186\/s13018-020-01796-2","volume":"15","author":"X Chen","year":"2020","unstructured":"Chen X et al (2020) Robot-assisted orthopedic surgery in the treatment of adult degenerative scoliosis: a preliminary clinical report. J Orthop Surg Res 15:282. https:\/\/doi.org\/10.1186\/s13018-020-01796-2","journal-title":"J Orthop Surg Res"},{"key":"3410_CR20","doi-asserted-by":"publisher","first-page":"1344802","DOI":"10.3389\/fsurg.2024.1344802","volume":"11","author":"YS Chen","year":"2024","unstructured":"Chen YS et al (2024) Radiographic and clinical outcomes of robot-assisted pedicle screw instrumentation for adolescent idiopathic scoliosis. Front Surg 11:1344802. https:\/\/doi.org\/10.3389\/fsurg.2024.1344802","journal-title":"Front Surg"},{"key":"3410_CR21","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1038\/s41598-017-19054-7","volume":"8","author":"Y Fan","year":"2018","unstructured":"Fan Y et al (2018) Radiological and clinical differences among three assisted technologies in pedicle screw fixation of adult degenerative scoliosis. Sci Rep 8:890. https:\/\/doi.org\/10.1038\/s41598-017-19054-7","journal-title":"Sci Rep"},{"key":"3410_CR22","doi-asserted-by":"publisher","first-page":"1085580","DOI":"10.3389\/fsurg.2022.1085580","volume":"9","author":"C Hou","year":"2022","unstructured":"Hou C et al (2022) Comparison of robot versus fluoroscopy-assisted pedicle screw instrumentation in adolescent idiopathic scoliosis surgery: A retrospective study. Front Surg 9:1085580. https:\/\/doi.org\/10.3389\/fsurg.2022.1085580","journal-title":"Front Surg"},{"key":"3410_CR23","doi-asserted-by":"publisher","first-page":"1337","DOI":"10.1177\/21925682221143076","volume":"14","author":"C Li","year":"2024","unstructured":"Li C et al (2024) Comparison of the Accuracy of Pedicle Screw Placement Using a Fluoroscopy-Assisted Free-Hand Technique with Robotic-Assisted Navigation Using an O-Arm or 3D C-Arm in Scoliosis Surgery. Global Spine J 14:1337\u20131346. https:\/\/doi.org\/10.1177\/21925682221143076","journal-title":"Global Spine J"},{"key":"3410_CR24","doi-asserted-by":"publisher","first-page":"3094","DOI":"10.1007\/s00586-023-07710-8","volume":"32","author":"C Li","year":"2023","unstructured":"Li C et al (2023) Safety and accuracy of cannulated pedicle screw placement in scoliosis surgery: a comparison of robotic-navigation, O-arm-based navigation, and freehand techniques. Eur Spine J 32:3094\u20133104. https:\/\/doi.org\/10.1007\/s00586-023-07710-8","journal-title":"Eur Spine J"},{"key":"3410_CR25","first-page":"3254","volume":"15","author":"S Li","year":"2023","unstructured":"Li S et al (2023) Comparison of surgical efficacy between O-arm combined with CT 3D real-time navigation system and Tinavi robot-assisted treatment of adolescent congenital scoliosis. Am J Transl Res 15:3254\u20133266","journal-title":"Am J Transl Res"},{"key":"3410_CR26","doi-asserted-by":"publisher","unstructured":"Linden GS et al (2022) Pedicle Screw Placement in Adolescent Idiopathic Scoliosis: A Comparison between Robotics Coupled with Navigation versus the Freehand Technique. Sens (Basel) 22. https:\/\/doi.org\/10.3390\/s22145204","DOI":"10.3390\/s22145204"},{"key":"3410_CR27","doi-asserted-by":"publisher","first-page":"124585","DOI":"10.1016\/j.wneu.2025.124585","volume":"204","author":"B Ma","year":"2025","unstructured":"Ma B et al (2025) Research on Optimizing Early-Onset Scoliosis Correction Strategies Using Robotic Navigation Technology. World Neurosurg 204:124585. https:\/\/doi.org\/10.1016\/j.wneu.2025.124585","journal-title":"World Neurosurg"},{"key":"3410_CR28","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1186\/s40001-025-03607-y","volume":"31","author":"W Liang","year":"2025","unstructured":"Liang W et al (2025) Effect of sensory integration training combined with Schroth therapy on adolescents with mild idiopathic scoliosis: a 12-week randomized controlled trial. Eur J Med Res 31:59. https:\/\/doi.org\/10.1186\/s40001-025-03607-y","journal-title":"Eur J Med Res"},{"key":"3410_CR29","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1016\/j.bjae.2025.09.002","volume":"25","author":"S Sathasivam","year":"2025","unstructured":"Sathasivam S et al (2025) Neuromuscular scoliosis surgery in children. BJA Educ 25:493\u2013501. https:\/\/doi.org\/10.1016\/j.bjae.2025.09.002","journal-title":"BJA Educ"},{"key":"3410_CR30","doi-asserted-by":"publisher","first-page":"e70148","DOI":"10.1002\/jsp2.70148","volume":"8","author":"Z Wu","year":"2025","unstructured":"Wu Z et al (2025) Thoracolumbar Biomechanical Analysis of Lenke Type 1 Adolescent Idiopathic Scoliosis Across Roussouly Classifications. JOR Spine 8:e70148. https:\/\/doi.org\/10.1002\/jsp2.70148","journal-title":"JOR Spine"},{"key":"3410_CR31","doi-asserted-by":"publisher","unstructured":"Nassar JE et al (2026) Return to Sport After Posterior Spinal Fusion in Adolescent Idiopathic Scoliosis: A Systematic Review and Clinical Recommendations. Am J Sports Med 3635465251390546. https:\/\/doi.org\/10.1177\/03635465251390546","DOI":"10.1177\/03635465251390546"}],"container-title":["Journal of Robotic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11701-026-03410-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11701-026-03410-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11701-026-03410-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T21:53:47Z","timestamp":1781646827000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11701-026-03410-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,13]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3410"],"URL":"https:\/\/doi.org\/10.1007\/s11701-026-03410-9","relation":{},"ISSN":["1863-2491"],"issn-type":[{"value":"1863-2491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,13]]},"assertion":[{"value":"9 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 April 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":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval and Informed Consent"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Considerations"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical Trial Registration"}}],"article-number":"432"}}