国内首次机器人辅助椎弓根螺钉置入脊柱侧凸矫形手术(附14例报告)  

Robot-assisted pedicle screw insertion for scoliosis:first 14 cases in China

作　　者：翟骁[1] 陈自强[1] 杨明园[1] 赵颖川[1] 倪海键[1] 朱晓东[1] 赵检[1] 王飞[1] 赵云飞[1] 李明[1] 

机构地区：[1]第二军医大学长海医院骨科,上海200433

出　　处：《第二军医大学学报》2015年第11期1161-1166,共6页Academic Journal of Second Military Medical University

基　　金：国家自然科学基金(81101396);上海市卫生和计划生育委员会科研课题(12411950800);上海市科委课题(15ZR1412700);第二军医大学校级课题(2014QN15)~~

摘　　要：目的总结国内首次机器人辅助椎弓根螺钉置入脊柱侧凸矫形手术的经验体会并验证其置钉的准确性。方法选择14例脊柱侧凸患者行后路机器人辅助椎弓根螺钉内固定矫形手术。男性6例,女性8例;特发性脊柱侧凸12例,先天性脊柱侧凸2例。术中记录机器人置钉时间、透视次数和注册时间等,术后采用CT检查螺钉位置。结果共使用机器人置入螺钉148枚,平均配准次数（移动平台）为（1.7±0.9）次,平均透视次数为（11.2±7.7）次,平均配准时间（平台安装＋透视配准）为（19.3±6.2）min。从配准完成后,平均每枚螺钉置钉时间为（2.4±0.9）min。冠状面Cobb角由术前50.1°（40°~63°）矫正至12.8°（2°~28°）,平均矫正率74.9%。术后CT平扫显示,机器人辅助置钉的准确率为95.3%（141/148）。结论 Mazor机器人辅助脊柱手术定位精度高、手术安全性好,将成为未来脊柱外科发展的趋势。Objective To report our experience on robot-assisted pedicle screw insertion for scoliosis surgery and to verify the insertion accuracy. Methods A total of 14 patients with scoliosis were treated with robot-assisted pedicle screw insertion surgery （6 males and 8 females）, including 12 suffering from idiopathic scoliosis and 2 suffering from congenital scoliosis. The time used by the robotic operation, times of X-ray used, and time for the robotic registration were recorded. CT images were used for evaluating the position of screws after the surgery. Results A total of 148 screws were inserted by the robot-guided machine. Averagely it took （1. 7±0. 9） times to set the platform for registration, （11.2±7. 7） times for using X-ray per operation, and （19.3±6. 2） min for each registration（time needed for setting the platform plus X-ray）. After finishing the registration, it took an average of （2.4±0. 9） min to insert a screw. The coronal Cobb angle was corrected from 50. 1° （40°- 63°） before operation to 12. 8° （20-28°） after operation, with a correction rate of 74. 9% on average. CT images showed that the accuracy of robot-assisted pedicle screw insertion was 95. 3%（141/148）. Conclusion Mazor robot-guided pedicle screw placement is accurate and safe for scoliosis, and it may be a promising trend in spine surgery.

关 键 词：脊柱侧凸 机器人 导航 矫形外科手术 

分 类 号：R681.53[医药卫生—骨科学]