{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T19:16:37Z","timestamp":1793819797057,"version":"4.6.1"},"reference-count":47,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T00:00:00Z","timestamp":1747699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["World Neurosurgery"],"published-print":{"date-parts":[[2025,7]]},"DOI":"10.1016\/j.wneu.2025.124109","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T11:33:35Z","timestamp":1748000015000},"page":"124109","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":5,"special_numbering":"C","title":["Precision versus Tradition: A Meta-Analysis Comparing Robotic and Conventional Minimally Invasive Pedicle Screw Instrumentation in Thoracolumbar Fractures"],"prefix":"10.1016","volume":"199","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0281-5417","authenticated-orcid":false,"given":"Pawe\u0142","family":"\u0141ajczak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0001-0390","authenticated-orcid":false,"given":"Oguz K.","family":"Sahin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1058-2137","authenticated-orcid":false,"given":"Eshita","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9155-8471","authenticated-orcid":false,"given":"Ayesha","family":"Ayesha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4376-0660","authenticated-orcid":false,"given":"Anna","family":"\u0141ajczak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.wneu.2025.124109_bib1","doi-asserted-by":"crossref","first-page":"72","DOI":"10.4103\/0019-5413.143914","article-title":"Management of thoracolumbar spine trauma an overvie","volume":"49","author":"Rajasekaran","year":"2015","journal-title":"Indian J Orthop"},{"key":"10.1016\/j.wneu.2025.124109_bib2","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.spinee.2012.10.041","article-title":"Management of thoracolumbar spine fractures","volume":"14","author":"Wood","year":"2014","journal-title":"Spine J"},{"key":"10.1016\/j.wneu.2025.124109_bib3","doi-asserted-by":"crossref","first-page":"2028","DOI":"10.1097\/BRS.0b013e3182a8a381","article-title":"AOSpine thoracolumbar spine injury classification system: fracture description, neurological status, and key modifiers","volume":"38","author":"Vaccaro","year":"2013","journal-title":"Spine"},{"key":"10.1016\/j.wneu.2025.124109_bib4","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1097\/00005131-199611000-00006","article-title":"Functional outcome of thoracolumbar burst fractures without neurological deficit","volume":"10","author":"Kraemer","year":"1996","journal-title":"J Orthop Trauma"},{"key":"10.1016\/j.wneu.2025.124109_bib5","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1097\/00007632-199208001-00018","article-title":"Pedicle screw instrumentation for thoracolumbar burst fractures and fracture-dislocations","volume":"17","author":"Carl","year":"1992","journal-title":"Spine"},{"key":"10.1016\/j.wneu.2025.124109_bib6","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.ijsp.2012.09.002","article-title":"Pedicle screw instrumentation of thoracolumbar burst fractures: biomechanical evaluation of screw configuration with pedicle screws at the level of the fracture","volume":"6","author":"Bolesta","year":"2012","journal-title":"Int J Spine Surg"},{"key":"10.1016\/j.wneu.2025.124109_bib7","doi-asserted-by":"crossref","first-page":"2491","DOI":"10.1007\/s00586-020-06479-4","article-title":"Pedicle screw fixation of thoracolumbar fractures: conventional short segment versus short segment with intermediate screws at the fracture level\u2014a systematic review and meta-analysis","volume":"29","author":"Kapoen","year":"2020","journal-title":"Eur Spine J"},{"key":"10.1016\/j.wneu.2025.124109_bib8","doi-asserted-by":"crossref","first-page":"2502","DOI":"10.1007\/s00586-022-07327-3","article-title":"Minimally invasive versus open surgery for degenerative lumbar pathologies:a systematic review and meta-analysis","volume":"31","author":"Pokorny","year":"2022","journal-title":"Eur Spine J"},{"key":"10.1016\/j.wneu.2025.124109_bib9","first-page":"1","article-title":"Minimally invasive versus open lumbar spinal fusion: a matched study investigating patient-reported and surgical outcomes","volume":"36","author":"Mooney","year":"2021","journal-title":"J Neurosurg Spine"},{"key":"10.1016\/j.wneu.2025.124109_bib10","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1007\/s11701-022-01442-5","article-title":"Comparison of robot-assisted versus fluoroscopy-assisted minimally invasive transforaminal lumbar interbody fusion for degenerative lumbar spinal diseases: 2-year follow-up","volume":"17","author":"Wang","year":"2022","journal-title":"J Robotic Surg"},{"key":"10.1016\/j.wneu.2025.124109_bib11","doi-asserted-by":"crossref","first-page":"2479","DOI":"10.12659\/MSM.913124","article-title":"Accuracy of robot-assisted percutaneous pedicle screw placement for treatment of lumbar spondylolisthesis: a comparative cohort study","volume":"25","author":"Yang","year":"2019","journal-title":"Med Sci Monitor"},{"key":"10.1016\/j.wneu.2025.124109_bib12","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1007\/s00586-012-2634-z","article-title":"L5 spinal nerve injury caused by misplacement of outwardly-inserted S1 pedicle screws","volume":"22","author":"Inoue","year":"2012","journal-title":"Eur Spine J"},{"key":"10.1016\/j.wneu.2025.124109_bib13","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s10143-025-03256-z","article-title":"An early evaluation of robot-assisted and conventional techniques for posterior approach atlantoaxial displacement instrumentation - a systematic review and meta-analysis","volume":"48","author":"\u0141ajczak","year":"2025","journal-title":"Neurosurg Rev"},{"key":"10.1016\/j.wneu.2025.124109_bib14","series-title":"Cochrane Handbook for Systematic Reviews of Interventions","year":"2019"},{"key":"10.1016\/j.wneu.2025.124109_bib15","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"Br Med J"},{"key":"10.1016\/j.wneu.2025.124109_bib16","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1097\/00007632-199001000-00004","article-title":"Accuracy of pedicular screw placement in vivo","volume":"15","author":"Gertzbein","year":"1990","journal-title":"Spine"},{"key":"10.1016\/j.wneu.2025.124109_bib17","doi-asserted-by":"crossref","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"10.1016\/j.wneu.2025.124109_bib18","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1002\/jrsm.1411","article-title":"Risk-of-bias VISualization (robvis): an R package and Shiny web app for visualizing risk-of-bias assessments","volume":"12","author":"McGuinness","year":"2020","journal-title":"Res Synth Methods"},{"key":"10.1016\/j.wneu.2025.124109_bib19","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1136\/ebmental-2019-300117","article-title":"How to perform a meta-analysis with R: a practical tutorial","volume":"22","author":"Balduzzi","year":"2019","journal-title":"Evid Based Ment Health"},{"key":"10.1016\/j.wneu.2025.124109_bib20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v036.i03","article-title":"Conducting Meta-Analyses in R with the metafor package","volume":"36","author":"Viechtbauer","year":"2010","journal-title":"J Stat Softw"},{"key":"10.1016\/j.wneu.2025.124109_bib21","series-title":"Ggplot2: Elegant graphics for data analysis","first-page":"260","author":"Wickham","year":"2016"},{"key":"10.1016\/j.wneu.2025.124109_bib22","series-title":"Doing Meta-Analysis with R: A Hands-On Guide","author":"Harrer","year":"2021"},{"key":"10.1016\/j.wneu.2025.124109_bib23","series-title":"Version 0.9.5.10 Beta. The Copenhagen Trial Unit, Centre for Clinical Intervention Research, The Capital Region","year":"2021"},{"key":"10.1016\/j.wneu.2025.124109_bib24","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1136\/bmj.39489.470347.AD","article-title":"GRADE: an emerging consensus on rating quality of evidence and strength of recommendations","volume":"336","author":"Guyatt","year":"2008","journal-title":"BMJ"},{"key":"10.1016\/j.wneu.2025.124109_bib25","first-page":"113","article-title":"[Treatment of ankylosing spondylitis with thoracolumbar fractures by robot-assisted internal fixation in lateral decubitus position]","volume":"35","author":"Shi","year":"2022","journal-title":"Zhongguo Gu Shang"},{"key":"10.1016\/j.wneu.2025.124109_bib26","first-page":"69","article-title":"[A comparative study of spinal robot-assisted and traditional fluoroscopy-assisted percutaneous reduction and internal fixation for single-level thoracolumbar fractures without neurological symptoms]","volume":"34","author":"Tian","year":"2020","journal-title":"Zhongguo Gu Shang"},{"key":"10.1016\/j.wneu.2025.124109_bib27","first-page":"1034","article-title":"[Clinical application of Orthopedic Tianji Robot in surgical treatment of thoracolumbar fracture]","volume":"34","author":"Zhang","year":"2021","journal-title":"Zhongguo Gu Shang"},{"key":"10.1016\/j.wneu.2025.124109_bib28","first-page":"118","article-title":"[Application of spinal surgical robots in minimally invasive surgery for thoracolumbar fracture]","volume":"35","author":"Wu","year":"2022","journal-title":"Zhongguo Gu Shang"},{"key":"10.1016\/j.wneu.2025.124109_bib29","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s12893-022-01502-5","article-title":"Rates and risk factors of intrapedicular accuracy and cranial facet joint violation among robot-assisted, fluoroscopy-guided percutaneous, and freehand techniques in pedicle screw fixation of thoracolumbar fractures: a comparative cohort study","volume":"22","author":"Zhang","year":"2022","journal-title":"BMC Surg"},{"key":"10.1016\/j.wneu.2025.124109_bib30","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1111\/os.12993","article-title":"Application of spinal robotic navigation technology to minimally invasive percutaneous treatment of spinal fractures: a clinical, non-randomized, controlled study","volume":"13","author":"Shi","year":"2021","journal-title":"Orthop Surg"},{"key":"10.1016\/j.wneu.2025.124109_bib31","doi-asserted-by":"crossref","first-page":"2955","DOI":"10.1111\/os.13504","article-title":"Comparison of the accuracy and safety of TiRobot -assisted and fluoroscopy-assisted percutaneous pedicle screw placement for the treatment of thoracolumbar fractures","volume":"14","author":"Lin","year":"2022","journal-title":"Orthop Surg"},{"key":"10.1016\/j.wneu.2025.124109_bib32","article-title":"Robot-assisted versus fluoroscopy-guided pedicle screw fixation of thoracolumbar compression fractures","volume":"102","author":"Li","year":"2023","journal-title":"Medicine"},{"key":"10.1016\/j.wneu.2025.124109_bib33","doi-asserted-by":"crossref","first-page":"e731","DOI":"10.1016\/j.wneu.2021.04.117","article-title":"Robotic-navigated percutaneous pedicle screw placement has less facet joint violation than fluoroscopy-guided percutaneous screws","volume":"151","author":"Katsevman","year":"2021","journal-title":"World Neurosurg"},{"key":"10.1016\/j.wneu.2025.124109_bib34","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1186\/s12893-022-01814-6","article-title":"Size selection and placement of pedicle screws using robot-assisted versus fluoroscopy-guided techniques for thoracolumbar fractures: possible implications for the screw loosening rate","volume":"22","author":"Du","year":"2022","journal-title":"BMC Surg"},{"key":"10.1016\/j.wneu.2025.124109_bib35","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1007\/s10143-024-03039-y","article-title":"Pedal to the metal: accelerating intracerebral hemorrhage treatment with robotic-assisted surgery. A systematic review & meta-analysis of clinical effectiveness","volume":"47","author":"\u0141ajczak","year":"2024","journal-title":"Neurosurg Rev"},{"key":"10.1016\/j.wneu.2025.124109_bib36","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1007\/s11701-023-01768-8","article-title":"Effectiveness and safety of robot-assisted minimally invasive transforaminal lumbar interbody fusion for degenerative lumbar spinal diseases: a systematic review and meta-analysis","volume":"18","author":"Wang","year":"2024","journal-title":"J Robotic Surg"},{"key":"10.1016\/j.wneu.2025.124109_bib37","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2022.101421","article-title":"Association of robot-assisted techniques with the accuracy rates of pedicle screw placement: a network pooling analysis","volume":"48","author":"Wei","year":"2022","journal-title":"eClinicalMedicine"},{"key":"10.1016\/j.wneu.2025.124109_bib38","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1186\/s12891-022-05206-y","article-title":"Accuracy and safety of robot-assisted cortical bone trajectory screw placement: a comparison of robot-assisted technique with fluoroscopy-assisted approach","volume":"23","author":"Li","year":"2022","journal-title":"BMC Musculoskelet Disord"},{"key":"10.1016\/j.wneu.2025.124109_bib39","doi-asserted-by":"crossref","first-page":"e323","DOI":"10.1016\/j.wneu.2020.02.110","article-title":"Learning curve of robot-assisted percutaneous kyphoplasty for osteoporotic vertebral compression fractures","volume":"138","author":"Yuan","year":"2020","journal-title":"World Neurosurg"},{"key":"10.1016\/j.wneu.2025.124109_bib40","doi-asserted-by":"crossref","first-page":"10134","DOI":"10.12998\/wjcc.v9.i33.10134","article-title":"Learning curves of robot-assisted pedicle screw fixations based on the cumulative sum test","volume":"9","author":"Yu","year":"2021","journal-title":"World J Clin Cases"},{"key":"10.1016\/j.wneu.2025.124109_bib41","doi-asserted-by":"crossref","first-page":"223","DOI":"10.4103\/jcvjs.jcvjs_94_21","article-title":"Autonomous lumbar spine pedicle screw planning using machine learning","volume":"12","author":"Siemionow","year":"2021","journal-title":"J Craniovertebral Junction Spine"},{"key":"10.1016\/j.wneu.2025.124109_bib42","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1159\/000078321","article-title":"Vascular injuries caused by orthopaedic screws","volume":"13","author":"Safar","year":"2004","journal-title":"Med Principles Pract"},{"key":"10.1016\/j.wneu.2025.124109_bib43","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1007\/s00586-010-1291-3","article-title":"Accuracy and complications of transpedicular C2 screw placement without the use of spinal navigation","volume":"19","author":"Mueller","year":"2010","journal-title":"Eur Spine J"},{"key":"10.1016\/j.wneu.2025.124109_bib44","first-page":"176","article-title":"Comparative cost analysis of robotic-assisted and jig-based manual primary total knee arthroplasty","volume":"35","author":"Cotter","year":"2020","journal-title":"J Knee Surg"},{"key":"10.1016\/j.wneu.2025.124109_bib45","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.wneu.2024.08.018","article-title":"Are the clinical outcomes and cost-effectiveness of robot-assisted pedicle screw placement in lumbar fusion surgery superior to CT-navigated and freehand fluoroscopy-guided techniques? A systematic review and network meta-analysis","volume":"191","author":"Sturgill","year":"2024","journal-title":"World Neurosurg"},{"key":"10.1016\/j.wneu.2025.124109_bib46","doi-asserted-by":"crossref","first-page":"216","DOI":"10.14245\/ns.1836082.041","article-title":"A cost-effectiveness analysis of the integration of robotic spine technology in spine surgery","volume":"15","author":"Menger","year":"2018","journal-title":"Neurospine"},{"key":"10.1016\/j.wneu.2025.124109_bib47","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.lers.2023.11.004","article-title":"Cost-effectiveness of robotic-assisted spinal surgery: a single-center retrospective study","volume":"6","author":"Chumnanvej","year":"2023","journal-title":"Laparosc Endoscopic Robotic Surg"}],"container-title":["World Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1878875025004656?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1878875025004656?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T20:13:25Z","timestamp":1752869605000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1878875025004656"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":47,"alternative-id":["S1878875025004656"],"URL":"https:\/\/doi.org\/10.1016\/j.wneu.2025.124109","relation":{},"ISSN":["1878-8750"],"issn-type":[{"value":"1878-8750","type":"print"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Precision versus Tradition: A Meta-Analysis Comparing Robotic and Conventional Minimally Invasive Pedicle Screw Instrumentation in Thoracolumbar Fractures","name":"articletitle","label":"Article Title"},{"value":"World Neurosurgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.wneu.2025.124109","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Author(s). Published by Elsevier Inc.","name":"copyright","label":"Copyright"}],"article-number":"124109"}}