ObjectiveTo re-evaluate the systematic review and meta-analysis (SR/MAs) of the efficacy of robot-assisted pedicle screw placement. MethodsThe CNKI, VIP, WanFang Data, SinoMed, PubMed, Embase, Cochrane Library, and Web of Science databases were electronically searched to collect SR/MAs of robot-assisted pedicle screw placement from inception to April 28, 2023. Two reviewers independently screened literature, extracted data and then assessed the quality of reports, methodological quality, risk of bias, and the strength of evidence quality by using PRISMA, AMSTAR-Ⅱ, ROBIS, and GRADE tool. ResultsA total of 20 SR/MAs were included. The results of the included studies showed that robot-assisted pedicle screw placement was more accurate and had a lower number of complications compared with freehand pedicle screw placement. The quality of reports, methodology, and evidence for pedicle screw placement efficiency in all SR/MAs were low or extremely low, with a high risk of bias. The main reasons included high heterogeneity of included studies, unclear research methods and selection criteria, and missing key reporting processes. ConclusionRobot-assisted pedicle screw placement may have better clinical efficiency than traditional freehand pedicle screw placement. But the quality of relational SR/MAs is low.
The spine is one of the most common sites for bone metastases from malignant tumors, and its incidence is increasing year by year. It often leads to severe pain, pathological fractures, nerve compression, and spinal cord dysfunction, seriously affecting the quality of life of patients. The comprehensive treatment of spinal metastases with both traditional Chinese and Western medicine has shown significant efficacy, especially in improving clinical symptoms, promoting postoperative recovery as soon as possible, and enhancing the quality of life. Based on the latest research progress at home and abroad and from the perspective of clinical application, this guideline, grounded in evidence-based medical evidence, has formed 25 recommendations covering treatment objectives, efficacy evaluation, rational selection of traditional Chinese medicine, treatment plans, and postoperative rehabilitation. It provides diagnostic and therapeutic suggestions for orthopedic oncologists, oncologists, radiologists, pain specialists, and other professionals engaged in traditional Chinese medicine, Western medicine, or integrated traditional Chinese and Western medicine, as well as specialized nurses.