机器人辅助椎体成形骨水泥注射治疗胸腰椎多椎体病理性骨折  

Robot-assisted percutaneous vertebroplasty in the treatment of pathological fractures of thoracolumbar multivertebra

作　　者：俞阳[1] 唐六一[1] 胡豇[1] 万仑[1] 张伟[1] 林书[1] 王飞[1] Yu Yang;Tang Liuyi;Hu Jiang;Wan Lun;Zhang Wei;Lin Shu;Wang Fei(Department of Orthopedics,Affiliated Hospital of University of Electronic Science and Technology,Sichuan Provincial People’s Hospital,Chengdu 610072,Sichuan Province,China)

机构地区：[1]四川省人民医院·电子科技大学附属医院骨科,四川省成都市610072

出　　处：《中国组织工程研究》2022年第16期2467-2472,共6页Chinese Journal of Tissue Engineering Research

基　　金：四川省科技厅科技支撑项目(2019YFS0268),项目负责人:胡豇。

摘　　要：背景:椎体成形可有效治疗脊柱病理性骨折,但该手术造成的副损伤和骨水泥渗漏常见报道。目的:探讨机器人辅助下椎体成形骨水泥注射治疗胸腰椎多个椎体病理性骨折的临床疗效。方法:选择四川省人民医院2017年6月至2019年12月收治的胸腰椎病理性骨折患者25例,男7例,女18例,年龄57-80岁;骨质疏松性椎体骨折10例,椎体肿瘤15例;3个病椎16例,4个病椎6例,5个以上病椎3例。其中13例(50个椎体)接受机器人辅助椎体成形骨水注射治疗(机器人组),12例(38个椎体)接受常规的椎体成形骨水注射治疗(常规组),比较两组的穿刺次数、透视次数、手术时间、术中出血量、骨水泥分布、骨水泥渗漏和术者术中辐射剂量等,以及手术前后的Oswestry功能障碍指数和目测类比评分。研究获得四川省人民医院伦理委员会批准。结果与结论:(1)机器人组的手术时间、穿刺次数、透视次数、术中出血量、术者术中辐射剂量及骨水泥渗漏均少于常规组(P<0.05),骨水泥分布优于常规组(P<0.05);(2)两组术后第2天的目测类比评分与Oswestry功能障碍指数均较术前明显改善(P<0.05),两组间术前与术后第2天的目测类比评分、Oswestry功能障碍指数评分比较差异均无显著性意义(P>0.05);(3)结果表明对于多个椎体病理性骨折患者,机器人辅助椎体成形骨水泥注射治疗提高了穿刺精准度,不但可以减少穿刺损伤、获得满意的骨水泥弥散和降低骨水泥渗漏,也降低了术者放射暴露,获得了满意的临床疗效。BACKGROUND: Vertebroplasty can effectively treat spinal pathological fractures, but the side effects and bone cement leakage caused by this operation are often reported.OBJECTIVE: To investigate the clinical efficacy of robot-assisted percutaneous vertebroplasty in the treatment of pathological fractures of thoracic and lumbar vertebrae.METHODS: From June 2017 to December 2019, 25 patients with pathological fractures of thoracolumbar vertebrae in the Sichuan Provincial People’s Hospital were retrospectively analyzed, including 7 males and 18 females, aged from 57 to 80 years old. There were 10 cases of osteoporotic vertebral fracture, 15 cases of vertebral tumor, 16 cases of 3 diseased vertebrae, 6 cases of 4 diseased vertebrae, and 3 cases of more than 5 diseased vertebrae. There were 13 patients(50 vertebrae) with robot assisted vertebroplasty(robot group), and 12 patients(38 vertebrae) with freehand vertebroplasty(conventional group). The number of puncture, fluoroscopy, operation time, intraoperative blood loss, bone cement distribution, bone cement leakage and intraoperative radiation dose of the operator were recorded and compared between the two groups. Oswestry disability index and visual analogue scale scores of the patients were recorded and compared before and after operation. This study was approved by Ethics Committee of Sichuan Provincial People’s Hospital.RESULTS AND CONCLUSION:(1) The operation time, number of puncture, fluoroscopy, intraoperative blood loss, intraoperative radiation dose, and bone cement leakage in the robot group were all lower than those in the conventional group(P < 0.05). The bone cement distribution was better in the robot group than that in the conventional group(P < 0.05).(2) Oswestry disability index and visual analogue scale scores were significantly improved in the two groups at postoperative 2 days compared with those preoperatively(P < 0.05). Visual analogue scale score and Oswestry disability index of the robot group and the conventional group showed no statistic

关 键 词：骨 植入物 机器人 椎体成形术 胸腰椎 病理性骨折 骨水泥 放射暴露 

分 类 号：R459.9[医药卫生—治疗学] R319[医药卫生—临床医学]