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Meta-Analysis
. 2024 Dec;16(6):948-961.
doi: 10.4055/cios24086. Epub 2024 Nov 15.

Effect of Robot-Assisted Surgery on Clinical Outcomes in Patients with Osteoporotic Vertebral Compression Fractures after Percutaneous Vertebral Augmentation: a Meta-Analysis and a Validation Cohort

Haibo Li  1 , Juan Zou  2 , Jianlin Yu  3
Affiliations
Meta-Analysis

Effect of Robot-Assisted Surgery on Clinical Outcomes in Patients with Osteoporotic Vertebral Compression Fractures after Percutaneous Vertebral Augmentation: a Meta-Analysis and a Validation Cohort

Haibo Li et al. Clin Orthop Surg. 2024 Dec.

Abstract

Background: The objective of this study was to investigate the impact of robot-assisted surgery (RA) on the risk of new vertebral compression fracture (NVCF) and bone cement leakage in patients with osteoporotic vertebral compression fractures (OVCF) after percutaneous vertebral augmentation (PVA), including percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP).

Methods: A meta-analysis was performed to evaluate the clinical outcomes and adverse effects of RA-PVA versus fluoroscopy-assisted (FA)-PVA in patients with OVCF. A validation cohort of 385 patients who underwent PVP or PKP was retrospectively analyzed. In addition, we attempted to create well-calibrated nomograms to estimate the risk of NVCF and bone cement leakage.

Results: The meta-analysis revealed that the incidence of NVCF and bone cement leakage was significantly lower in RA-PVA than in FA-PVA. The validation cohort confirmed that RA-PVA provided better results than FA-PVA in terms of NVCF and bone cement leakage.

Conclusions: The meta-analysis and the validation cohort suggest that RA reduced the risk of NVCF and bone cement leakage in patients with OVCF after PVA. The nomograms are accurate and easy-to-implement methods for clinicians to estimate the risk of NVCF and bone cement leakage after PVA.

Keywords: Bone cements; Osteoporosis; Robot-assisted surgery; Spinal Fractures; Vertebroplasty.

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Conflict of interest statement

CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Nomogram for the risk of new vertebral compression fracture (NVCF) after percutaneous vertebroplasty (PVP). (A) Nomogram for predicting NVCF after PVP. (B) Receiver operating characteristic curve of tenfold cross-validation for predicting NVCF after PVP based on the nomogram. BMI: body mass index, RA: robot-assisted, FA: fluoroscopy-assisted, AUC: area under the curve.
Fig. 2
Fig. 2. Nomogram for the risk of bone cement leakage after percutaneous vertebroplasty (PVP). (A) Nomogram for predicting bone cement leakage after PVP. (B) Receiver operating characteristic curve of tenfold cross-validation for predicting bone cement leakage after PVP based on the nomogram. BMD: bone mineral density, RA: robot-assisted, FA: fluoroscopy-assisted, AUC: area under the curve.
Fig. 3
Fig. 3. Nomogram for the risk of new vertebral compression fracture (NVCF) after percutaneous kyphoplasty (PKP). (A) Nomogram for predicting NVCF after PKP. (B) Receiver operating characteristic curve of tenfold cross-validation for predicting NVCF after PKP based on the nomogram. AUC: area under the curve.
Fig. 4
Fig. 4. Nomogram for the risk of bone cement leakage after percutaneous kyphoplasty (PKP). (A) Nomogram for predicting bone cement leakage after PKP. (B) Receiver operating characteristic curve of tenfold cross-validation for predicting bone cement leakage after PKP based on the nomogram. NVCF: new vertebral compression fracture, AUC: area under the curve.
See this image and copyright information in PMC

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