{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T23:16:55Z","timestamp":1786576615963,"version":"build-2736575974"},"reference-count":51,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T00:00:00Z","timestamp":1689638400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Posterior spinal fusion and segmental spinal instrumentation using pedicle screws (PS) is the most used procedure to correct adolescent idiopathic scoliosis. Computed navigation, robotic navigation, and patient-specific drill templates are available, besides the first described free-hand technique. None of these techniques are recognized as the gold standard. This review compares the PS placement accuracy and misplacement-related complication rates achieved with the techniques mentioned above. It further reports PS accuracy classifications and anatomic PS misplacement risk factors. The literature suggests a higher PS placement accuracy for robotic relative to computed navigation and for the latter relative to the free-hand technique (misplacement rates: 0.4\u20137.2% versus 1.9\u201311% versus 1.5\u201350.7%) using variable accuracy classifications. The reported PS-misplacement-related complication rates are, however, uniformly low (0\u20131.4%) for every technique, while robotic and computed navigation induce a roughly fourfold increase in the patient\u2019s intraoperative radiation exposure relative to the free-hand technique with fluoroscopic implant positioning control. The authors, therefore, recommend dedicating robotic and computed navigation for complex deformities or revisions with altered landmarks, underline the need for a generally accepted PS accuracy classification, and advise against PS placement in grade 4 pedicles yielding higher misplacement rates (22.2\u201331.5%).<\/jats:p>","DOI":"10.3390\/diagnostics13142402","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T00:54:01Z","timestamp":1689728041000},"page":"2402","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Accuracy and Safety of Pedicle Screw Placement for Treating Adolescent Idiopathic Scoliosis: A Narrative Review Comparing Available Techniques"],"prefix":"10.3390","volume":"13","author":[{"given":"Alexandre","family":"Ansorge","sequence":"first","affiliation":[{"name":"Department of Spine Surgery, Lucerne Cantonal Hospital, 6000 Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal","family":"Sarwahi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedics, Cohen Children\u2019s Medical Center, Northwell Health System, New Hyde Park, NY 11040, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludmilla","family":"Bazin","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedic Unit, Geneva University Hospital, 1211 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Vazquez","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedic Unit, Geneva University Hospital, 1211 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"De Marco","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedic Unit, Geneva University Hospital, 1211 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Dayer","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedic Unit, Geneva University Hospital, 1211 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1097\/BPO.0000000000000683","article-title":"Which Pediatric Orthopaedic Procedures Have the Greatest Risk of Adverse Outcomes?","volume":"37","author":"Basques","year":"2017","journal-title":"J. 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Orthop."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1007\/s11999.0000000000000204","article-title":"Increased Radiation but No Benefits in Pedicle Screw Accuracy with Navigation versus a Freehand Technique in Scoliosis Surgery","volume":"476","author":"Urbanski","year":"2018","journal-title":"Clin. Orthop. Relat. 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