机器人辅助下椎弓根螺钉固定治疗胸腰椎骨折  

Effect of robot assisted pedicle screw fixation in the treatment of thoracolumbar fracture

作　　者：徐鹏[1] 葛鹏[1] 章仁杰[1] 李伟[1] 张银顺[1] 董福龙[1] 钱军[1] 申才良[1] XU Peng;GE Peng;ZHANG Ren-jie(Department of Spinal Surgery,The First Affiliated Hospital of Anhui Medical University,Hefei,Anhui,230032,China)

机构地区：[1]安徽医科大学第一附属医院脊柱外科,安徽合肥230032

出　　处：《颈腰痛杂志》2018年第6期687-690,共4页The Journal of Cervicodynia and Lumbodynia

基　　金：安徽省重点研究与开发计划项目(1704a0802158)

摘　　要：目的探讨手术机器人(天玑骨科手术机器人系统)辅助椎弓根螺钉置钉与传统透视引导徒手置钉两种手术方式的临床效果。方法于2018-01-06期间纳入43例因胸腰椎骨折接受椎弓根螺钉内固定术的患者,随机分为机器人辅助组(24例)和传统透视引导组(19例)。记录两组患者的手术置钉情况及术后并发症情况,并进行组间对比。结果机器人辅助组与传统透视引导组的平均透视次数分别为(8.6±2.5)次、(14.2±3.8)次,差异有统计学意义(P=0.028)。机器人辅助组的手术时间略长,术中出血量略多,但两组差异无统计学意义(P>0.05)。机器人辅助组的置钉准确率为96.2%;传统透视引导组为73.6%,组间差异有统计学意义(P<0.01)。两组术后3d及末次随访时的VAS评分、ODI指数均有显著改善,但组间差异无统计学意义(P>0.05)。结论骨科手术机器人系统不延长手术时间和增加术中出血量,并能显著提高椎弓根螺钉植入的精确度。Objective To explore the clinical application of two operative methods betweenrobot-assisted and conventional freehand pedicle screw surgical procedures. Methods Forty-threepatients with thoracolumbar fractures who underwent pedicle screw fixation were randomly divided intorobot-assisted group （24 cases） and conventional fluoroscopy-guided group （19 cases）. The operativenailing and postoperative complications of the two groups were recorded and compared between thetwo groups. Results The average fluoroscopy times of the robot -assisted group and the traditionalfluoroscopy -guided group were （8.6 ±2.5） and （14.2 ±3.8） respectively, and the difference wasstatistically significant （P=0.028）. The operation time was slightly longer and the amount of bleedingwas slightly more in the robot-assisted group, but there was no significant difference between the twogroups （P〉0.05）. The accuracy of nail placement was 96.2% in the robot-assisted group, and that was73.6% in the traditional fluoroscopy-guided group （P〈0.01）. VAS score and ODI index in two groupswere significantly improved at 3 days after operation and at the last follow -up, but there was nosignificant difference between the two groups （P〉0.05）. Conclusion Orthopedic surgery robot systemdoes not prolong the operation time and increase the amount of bleeding, and can significantly improvethe accuracy of pedicle screw implantation.｜

关 键 词：脊柱骨折 机器人 椎弓根钉 

分 类 号：R687.3[医药卫生—骨科学]