TiRobot‑assisted versus conventional fluoroscopy-assisted percutaneous sacroiliac screw fixation for pelvic ring injuries: a meta‑analysis

Abstract

Background The TiRobot is the only robot that has been reported in the literature for posterior pelvic injuries. We aim to compare TiRobot-assisted pelvic screw fixation with the conventional fluoroscopy-assisted percutaneous sacroiliac screw fixation. Methods We conducted a meta-analysis to identify studies involving TiRobot‑assisted versus conventional percutaneous sacroiliac screw fixation for pelvic ring injuries in electronic databases, including Web of Science, Embase, PubMed, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CBM, CNKI, VIP, and WanFang database, up to April 2022. The following keywords were used: “TiRobot,” “robot,” “robotic,” “pelvic fracture,” “screw fixation,” “percutaneous,” and “pelvic ring injury.” Pooled effects of this meta-analysis were calculated using STATA SE version 15.0. Results Compared with conventional fluoroscopy-assisted percutaneous sacroiliac screw fixation, TiRobot will result in less radiation exposure time of screw implantation (P = 0.000), less frequency of intraoperative fluoroscopy (P = 0.000), fewer guide wire attempts (P = 0.000), less intraoperative blood loss (P = 0.005), better screw accuracy (P = 0.011), better Majeed score (P = 0.031), and higher overall excellent and good rates of Majeed score (P = 0.018). However, there were no significant differences in terms of operative time (P = 0.055), fracture healing time (P = 0.365), and overall excellent and good rate of reduction accuracy (P = 0.426) between the two groups. Conclusion TiRobot-assisted fixation has less intraoperative fluoroscopy and intraoperative blood loss, superior screw accuracy, and Majeed score compared with conventional percutaneous sacroiliac screw fixation. TiRobot has no significant effect on operative time, fracture healing time, and reduction accuracy. Given the relevant possible biases in our meta-analysis, we required more adequately powered and better-designed RCT studies with long-term follow-up to reach a firmer conclusion.

Analysis of the therapeutic efficacy of robot-assisted percutaneous screw fixation in the minimally invasive treatment of pelvic fractures

“…The question surrounding the potential of robot-assisted surgery to enhance patient prognosis remains a topic of debate, as most studies have not observed discernible disparities in postoperative functional scores among patients ( 14 ). However, in this study, the robot-assisted group exhibited superior Majeed scores compared to the control group at 3 and 6 months postoperatively, plausibly attributable to the patients experiencing milder postoperative pain and shorter hospital stays.…”

TiRobot-assisted modified sacroiliac screw combined with LC-II screw for dislocation of Day type II crescent fracture of the pelvis

“…Faced with the problems encountered in the clinical treatment of the traditional SIS technique and inspired by the advantages of the S2AIS technique, we changed the direction of screw placement and proposed a modi ed SIS placement technique, changing from the traditional posterior-anterior or horizontal direction to the anterolateral to posterior-inferior sacral wing direction of the external plate of the ilium. With the widespread use of robotic navigation devices, the number of intraoperative uoroscopies has been greatly reduced and the accuracy of screw placement has been greatly improved [22,23]. In our clinical practice, we adopted robot-assisted modi ed SIS combined with LC-II screws to treat patients with Day II CFDP, and achieved satisfactory results.…”