Renaissance机器人辅助下精准经皮骶骨成形术治疗骶骨功能不全骨折  

Precise percutaneous sacroplasty assisted by a Renaissance robot for sacral insufficiency fractures

作　　者：杨小彬[1] 郝定均[1] 贺园 孔令擘 陈其昕[3] 朱悦[4] 闫亮[1] 刘仲凯[1] 惠华[1] 贺宝荣[1] Yang Xiaobin;Hao Dingjun;He Yuan;Kong Lingbo;Chen Qixin;Zhu Yue;Yan Liang;Liu Zhongkai;Hui Hua;He Baorong(Department of Spinal Surgery,Honghui Hospital,Xi'an Jiaotong University,Xi'an 710054,China;Department of Orthopedics,Xi'an No.5 Hospital,Xi'an 710082,China;The Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310009,China;The First Affiliated Hospital to China Medical University,Shenyang 110005,China)

机构地区：[1]西安交通大学医学院附属红会医院脊柱外科,710054 [2]西安市第五医院骨科,710082 [3]浙江大学医学院附属第二医院,杭州310009 [4]中国医科大学附属第一医院,沈阳110005

出　　处：《中华创伤骨科杂志》2019年第8期665-669,共5页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金(81401843);卫生部医药卫生科技发展研究中心基金(W2014ZT313)

摘　　要：目的探讨Renaissance机器人辅助引导精准经皮骶骨成形术(PSP)治疗骶骨功能不全骨折(SIF)的临床疗效。方法回顾性分析2016年3月至2018年3月西安交通大学医学院附属红会医院脊柱外科治疗的12例SIF患者资料。男5例,女7例;年龄为55~76岁,平均67.5岁。所有患者采用Renaissance机器人辅助下PSP治疗,记录手术时间、住院时间、患者暴露辐射量。术前、术后1 d、术后3个月及术后12个月采用疼痛视觉模拟量表(VAS)、Oswestry功能障碍指数(ODI)评分评估临床疗效。结果12例患者均顺利完成手术,无骨水泥渗漏等并发症。手术时间32~47 min(平均36.8 min);住院时间12~25 h(平均17.5 h);患者术中暴露辐射量0.87~1.53 mSv(平均1.27 mSv)。所有患者术后获12~18个月(平均15.8个月)随访。与术前VAS评分、ODI评分[(7.6±0.9)、(43.7±4.6)分]比较,术后1 d[(1.7±0.7)、(22.8±4.1)分]均有所下降,差异均有统计学意义(P<0.05)。术后3、12个月VAS评分分别为(2.0±0.8)、(2.4±0.8)分,ODI评分分别为(21.5±4.3)、(23.0±4.6)分,与术后1 d比较差异均无统计学意义(P>0.05)。结论Renaissance机器人辅助PSP治疗SIF可精准注射骨水泥于骨折靶区,手术安全,临床疗效满意。Objective To evaluate the precise percutaneous sacroplasty(PSP)assisted by a Renaissance robot for sacral insufficiency fractures(SIF).Methods The clinical data of 12 SIF patients were retrospectively analyzed who had been treated from March 2016 to March 2018 at Department of Spinal Surgery,Honghui Hospital.They were 5 males and 7 females,aged from 55 to 76 years(average,67.5 years).They all received PSP assisted by a Renaissance robot.Their operation time,hospital stay and intraoperative radiation were recorded.The clinical efficacy was evaluated by comparing their visual analogue scale(VAS)and Oswestry disability index(ODI)before surgery,1 day,3 and 12 months after surgery.Results All the 12 patients underwent surgery successfully with no complications like cement leakage.Their operation time ranged from 32 to 47 minutes(mean,36.8 minutes),their hospital stay from 12 to 25 hours(mean 17.5 hours)and their intraoperative exposure to radiation from 0.87 to 1.53 mSv(mean,1.27 mSv).All the patients were followed up for 12 to 18 months(mean,15.8 months).Their VAS(1.7±0.7)and ODI(22.8±4.1)one day after surgery were significantly decreased than the preoperative values(7.6±0.9 and 43.7±4.6)(P<0.05).At 3 and 12 months after surgery,their VAS scores were 2.0±0.8 and 2.4±0.8 and their ODI scores 21.5±4.3 and 23.0±4.6,respectively,showing no significant differences from the values at 1 day after surgery(P>0.05).Conclusion The PSP assisted by a Renaissance robot is safe and leads to satisfactory clinical efficacy for SIF as bone cement can be accurately injected into the target area of the fracture.

关 键 词：骶骨 骨质疏松 骨折 椎体成形术 Renaissance脊柱机器人 

分 类 号：R68[医药卫生—骨科学]