Renaissance脊柱手术机器人在中上胸椎骨折中的应用  

Application of Renaissance spinal surgical robot in middle and upper thoracic fractures

作　　者：侯海涛 邵诗泽 王亚楠 王振宇 付松 刘海军 黄相鹏 王欢 王龙强 Hou Haitao;Shao Shize;Wang Yanan;Wang Zhenyu;Fu Song;Liu Haijun;Huang Xiangpeng;Wang Huan;Wang Longqiang(Department of Spinal and Spinal Cord,Shandong Wendeng Orthopaedic Hospital,Wendeng 264400,China)

机构地区：[1]山东省文登整骨医院脊柱脊髓科,264400

出　　处：《中华骨科杂志》2021年第12期763-769,共7页Chinese Journal of Orthopaedics

摘　　要：目的探讨Renaissance脊柱手术机器人在中上胸椎骨折中的置钉安全性和有效性。方法前瞻性分析2015年3月至2019年3月治疗中上胸椎骨折患者62例,按随机数字表法分为机器人组(Renaissance脊柱手术机器人辅助置钉)和徒手置钉组(透视下徒手置钉)。机器人组32例,男25例,女7例;年龄(43.1±8.91)岁(范围18~65岁);体重指数(26.15±3.97)kg/m2(范围16.3~41.7 kg/m2);术前Cobb角20.9°±2.83°(范围10.7°~33.9°)。徒手置钉组30例,男24例,女6例;年龄(44.2±9.10)岁(范围20~67岁),体重指数(25.97±4.02)kg/m2(范围17.1~43.2 kg/m2);术前Cobb角21.3°±3.01°(范围11.6°~35.1°)。比较两组置钉准确率、置钉一次成功率、完成置钉时间、总手术时间、椎体前缘穿透率、机器人组螺钉置入角度与术前规划一致性。结果所有患者均顺利完成手术。机器人组骨折椎体数为37个;置钉时间为(16.11±5.82)min;置入螺钉总数为230枚,其中227枚一次置钉成功,成功率98.70%(227/230);1枚螺钉穿透椎体前缘,穿透率为0.43%(1/230)。徒手置钉组骨折椎体数为35个;置钉时间为(21.09±7.31)min;置入螺钉总数216枚,其中195枚一次置钉成功,成功率90.28%(195/216);12枚螺钉穿透椎体前缘,穿透率5.56%(12/216)。两组置钉时间、一次置钉成功率、穿透率比较差异均有统计学意义。机器人组和徒手置钉组总手术时间分别为(137.23±12.68)min和(140.23±13.13)min,两组比较差异无统计学意义。机器人组术前规划图像和术后CT扫描的轴位、矢状位图像中,螺钉置入角度差异无统计学意义。结论Renaissance脊柱手术机器人辅助治疗中上胸椎骨折,椎弓根螺钉置入准确性高、术中风险明显降低、手术安全性高,置钉效果满意。Objective To explore the safety and effectiveness of the Renaissance spine surgery robot in the middle and upper thoracic spine fractures.Methods 62 patients with middle and upper thoracic vertebra fractures from March 2015 to March 2019 were prospectively analyzed.These patients were randomly divided into robot group(Renaissance robot-assisted nailing)and free hand group(unarmed nailing under perspective).There were 32 patients in robot group,including 25 males and 7 females with an average age of 43.1±8.91 years(range,18-65 years).Body mass index(BMI)was 26.15±3.97 kg/m2(range,16.3-41.7 kg/m2).The preoperative Cobb angle was 20.9°±2.83°(range,10.7°-33.9°).In the free hand group,there were 30 cases,including 24 males and 6 females;Age 44.2±9.10 years(range,20-67 years),BMI 25.97±4.02 kg/m2(range,17.1-43.2 kg/m2);The preoperative Cobb angle was 21.3°±3.01°(range,11.6°-35.1°).The 2 groups were compared in terms of accuracy of screw placement,one-time success rate of screw placement,completion time of screw placement,time of total operation and penetration rate of anterior vertebral margin.The robot group also compared the consistency of screw placement angle with preoperative planning.Results All patients completed the operation successfully.The number of fractured vertebrae in the robot group was 37;the screw placement time was 16.11±5.82 min;the total number of screws was 230,of which 227 were successfully placed at one time,with a success rate of 98.70%(227/230);1 screw was inserted through the anterior edge of the vertebral body,and the penetration rate was 0.43%(1/230).The number of fractured vertebrae in the free hand group was 35;the nail placement time was 21.09±7.31 min;the total number of screws was 216,of which 195 were successfully placed at one time,with a success rate of 90.28%(195/216);12 screws was inserted through the anterior edge of the vertebral body,and the penetration rate was 5.56%(12/216).There were significant differences in the time,success rate and penetration rate betwee

关 键 词：胸椎 骨折 机器人手术 

分 类 号：R687.3[医药卫生—骨科学]