Robot-assisted vs conventional lumbar interbody fusion: A systematic review and meta-analysis of perioperative, radiographic, and clinical outcomes

Figure 3 Forest plots of robot-assisted vs conventional lumbar interbody fusion outcomes. A: Forest plot of screw placement accuracy (grade A) comparing robot-assisted and conventional lumbar interbody fusion techniques. Each horizontal line represents the 95% confidence interval (CI) of the odds ratio (OR) for perfect pedicle screw placement (grade A) in robot-assisted vs conventional techniques for individual studies. The black marker indicates the pooled OR estimated using a random-effects model. An OR > 1 favors robot-assisted techniques. Substantial heterogeneity was observed (I² = 78.2%); B: Forest plot of standardized mean differences (SMD) in estimated blood loss between robot-assisted and conventional lumbar procedures. Each study presents the SMD in estimated blood loss (mL) between the robot-assisted and fluoroscopy-guided groups, with 95%CIs. A negative SMD favors the robot-assisted approach. The pooled estimate was calculated using a random-effects model; C: Forest plot of SMD in operative time between robot-assisted and conventional lumbar procedures. Each study presents the SMD in operative time (minutes), with 95%CIs. A random-effects model was used to estimate the pooled effect. An SMD of 0 indicates no difference between groups.