脊柱微创手术机器人系统辅助打孔的实验研究  

Drilling into cattle spines assisted by a spinal minimally invasive robot system

作　　者：张鹤[1] 韩建达[1] 周跃[1] 

机构地区：[1]第三军医大学新桥医院骨科,重庆400030

出　　处：《中华创伤骨科杂志》2011年第12期1166-1169,共4页Chinese Journal of Orthopaedic Trauma

基　　金：军队临床高新技术重大项目（2010gxjs072）

摘　　要：目的探讨应用脊柱微创手术机器人系统进行牛骨标本打孔的可行性。方法脊柱微创手术机器人系统是由沈阳自动化研究所机器人重点实验室与第三军医大学新桥医院骨科合作研发的一种基于机械臂技术的可用于骨科临床进行遥控打孔操作的机器人系统。由于该系统尚不能与导航系统结合，故本研究设计了一种以术中C型臂C线机影像为依据，结合“克氏针置入计划”来判断该系统精确性的方法。使用该方法对17具牛脊骨标本进行打孔操作，分别置人克氏针。对C型臂C线机屏幕上显示的实际置入克氏针情况与“克氏针置入计划”进行对比，同时记录打孔操作过程中C型臂C线机透视次数、累计时间及打孔操作时间，并对置入克氏针的实际情况进行分析。结果脊柱微创手术机器人系统C型臂X线透视侧位片的精确度要比正位片高。侧位片偏离在1mm内者占91．6％，在2mm内者占99．5％，全部偏差均在3mm内。正位片偏离在1mm内者占71．1％，在2mm内者占89．6％，在3mm内者占94．8％。通过脊柱微创手术机器人系统的辅助打孔时间平均为420s／孔（330-577S），平均透视13次（8-21次），平均透视累计时问为9s（8-19S）。同时，该系统存在一定的学习曲线，经过一段时间训练之后，系统C型臂X线透视正、侧位片精度均可控制在2mm内，且C型臂X线正位片偏差在1mm内达92．1％，侧位片偏差在1mm内者达95．6％。结论脊柱微创手术机器人系统可遥控进行打孔操作，避免了操作过程中X射线对术者的损害，同时其精确性呵满足临床需求，但该系统存在一定的学习曲线。Objective To assess the accuracy and safety of inserting K-wires by a spinal minimally invasive robot system into cattle spines. Methods With a program shown on the screen of a C-arm flu- oroscopy system, 194 nails were placed into 17 cattle spines by a spinal minimal invasive robot system which had been developed jointly by Shenyang Institute of Automation Chinese Academy of Sciences amt our institute. Radiation frequency, radiation exposure time, operation time and deviation of drills were recorded and analyzed. Results The mean deviation in the lateral projections by the spinal minimally invasive robot system was smaller than in the anteroposterior projections. In lateral projection, the deviations within 1 mm, 2 mm amt 3 mm accounted respectively for 91.6% , 99.5% and 100%. In anteroposterior projection, the deviations within l ram, 2 mm and 3 mm accounted respectively for 71. 1%, 89.6% and 94. 8%. The mean drilling time, the mean radiation frequency and the mean radiation time per hole by the robot system were respectively 420 seconds （from 330 to 577 seconds）, 13 times （from 8 to 21 times） and 9 seconds （from 8 to 19 seconds） . There was a learning curve in mastering the system. Training for a period of time made the accuracy within 2 mm in both lateral and anteroposterior films. 95.6% of the deviations in lateral films anti 92. 1% of the deviations in anteroposterior films were less than one mm. Conclusions Operators of the spinal minimally invasive robot system can avoid intraoperative X-ray radiation. The flexibility anti aecuraey of the system can completely satisfy the clinical needs of spinal surgeons, but there must be a learning curve.

关 键 词：外科手术 计算机辅助 机器人 外科手术 微创性 

分 类 号：R687.3[医药卫生—骨科学]