Accuracy, safety, and ergonomic benefits of the power-assisted technique in spinal pedicle screw insertion: A systematic review

Document Type : Review Article

Authors

1 Faculty Member of Nursing Department, Department of Nursing, Arak University of Medical Sciences, Arak, Iran

2 Iranian Social Security Organization, Arak, Iran

3 MSc of Biomedical engineer, Arak, Iran

4 Faculty Member of Nursing Department, Department of Nursing, Arak University of Medical Sciences, Arak, Iran.

10.22038/nnj.2025.92715.1523

Abstract

Background and Aims: Pedicle screws are considered the gold standard for treating spinal deformities and injuries; however, their placement is a complex and technically demanding procedure with significant risks. Incorrect screw placement can lead to neurological, vascular, pulmonary, and visceral complications. Consequently, surgeons have a persistent interest in refining screw placement techniques to enhance accuracy and achieve safer, more robust fixation. In recent years, there has been a growing interest among spine surgeons in utilizing Power-Assisted systems.
Materials and Methods: This systematic review was conducted by searching international databases (including Scopus, PubMed, Google Scholar, CINAHL, and Trip) and Iranian databases (including SID and Magiran) from 2012 to 2025. The search utilized keywords such as "Power-Assisted" and "Pedicle Screw" and their Persian equivalents. Out of 40 identified records, 11 studies meeting the inclusion criteria were selected and analyzed.
Results: Based on the available evidence, the use of Power-Assisted systems for pedicle screw placement is a safe and accurate method, with a reported accuracy ranging from 95.8% to 96.12%. This technique reduces the "wobble" phenomenon, decreases the screw strip-out rate to 0.3%, and lowers the rate of clinically significant perforations to 1.32%. It also reduces the screw insertion time by up to 62% (10.5 seconds per screw compared to 27.4 seconds). Fluoroscopy time and, consequently, radiation exposure risk for both the surgeon and patient are significantly shortened. From an ergonomic perspective, this technique reduces the surgeon's muscle exertion by up to 80% and maintains it within a safe threshold throughout 100% of the procedure duration.
Conclusion: The Power-Assisted technique is a safe and accurate method with high accuracy. It is associated with reduced complications such as "wobble," screw failure, and radiation exposure time, while also preventing surgeon musculoskeletal injuries.

Keywords

References

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Navid No
Volume 29, Issue 97
June 2026
Pages 65-76

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