脊柱手术机器人在胸腰椎骨折微创手术中的应用  

Application of spinal surgical robots in minimally invasive surgery for thoracolumbar fracture

作　　者：吴瑞[1] 周纪平[1] 杨凯[1] 杨永军[1] 李佳佳[1] 姚树强[1] WU Rui;ZHOU Ji-ping;YANG Kai;YANG Yong-jun;LI Jia-jia;YAO Shu-qiang(No.1 Ward of Spine,Shandong Wendeng Osteopathic Hospital,Wendeng264400,Shandong,China)

机构地区：[1]威海市文登整骨医院脊柱脊髓科一,山东文登264400

出　　处：《中国骨伤》2022年第2期118-122,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨Renaissance机器人导航系统在胸腰椎骨折微创手术中应用的安全性和准确性。方法:对2016年7月至2019年7月采用后路微创椎弓根钉内固定治疗的胸腰椎骨折患者进行回顾性分析,按置钉方式的不同分为机器人组及徒手组,机器人组采用机器人导航辅助置钉,徒手组采用传统徒手置钉法置钉。机器人组20例,男13例,女7例;年龄23~69(45.05±11.81)岁;T11骨折1例,T12骨折2例,L1骨折10例,L2骨折6例,L3骨折1例。徒手组20例,男11例,女9例;年龄26~65(43.40±11.22)岁;T11骨折2例,T12骨折7例,L1骨折10例,L3骨折1例。记录两组患者透视次数、手术时间、术中出血量。采用Neo法[1]评价螺钉分级。结果:机器人组置入螺钉126枚,徒手组置入螺钉124枚。手术时间、透视次数、术中出血量机器人组分别为(115.75±14.26)min、(7.95±0.89)次、(132.50±29.36)ml,徒手置钉组分别为(129.50±10.50)min、(14.40±2.56)次、(182.50±23.14)ml,组间比较差异有统计学意义(P<0.05)。根据Neo法评价螺钉分级:机器人组螺钉0级122枚,1级4枚;徒手组0级108枚,1级9枚,2级7枚;机器人组准确性优于徒手组(P<0.05)。结论:与徒手置钉相比,Renaissance机器人导航系统可有效提高椎弓根钉置入准确率,减少透视次数及术中出血,提高手术安全性。Objective:To evaluate the safety and accuracy of Renaissance robot navigation system in minimally invasive surgery for thoracolumbar fracture.Methods:The clinical data of patients with thoracolumbar fracture who underwent posterior minimally invasive pedicle screw internal fixation from July 2016 to July 2019 was retrospectively analyzed.And the patients were divided into robot group and artificial group.Robot navigation assisted screw placement was used in robot group,and traditional unarmed screw placement was used in artificial group.There were 20 patients in robot group,including 13 males and 7 females,aged from 23 to 69 years old with an average of(45.05±11.81)years old,one case was T11 fracture,2 cases were T12,10 cases were L1,6 cases were L2 and 1 case was L3.There were 20 patients in artificial group,including 11 males and 9 females,aged from 26 to 65 years old with an average of(43.40±11.22)years old,2 cases were T11 fractures,7 cases were T12,10 cases were L1,and 1 case was L3.The numbers of fluoroscopy,operation time and intraoperative blood loss were observed.The screw position was evaluated by Neo method.Results:A total of 126 screws were implanted in robot group and 124 screws were implanted in artificial group.The operation time,fluoroscopy times,intraoperative blood loss were(115.75±14.26)min,(7.95±0.89)times and(132.50±29.36)ml in robot group and(129.50±10.50)min,(14.40±2.56)times and(182.50±23.14)ml in artificial group,respectively,there was significant difference between the groups(P<0.05).According to Neo classification method,there were 122 screws at grade 0,4 screws at grade 1 in robot group,and there were 108 screws at grade 0,9 screws at grade 1 and 7 screws at grade 2 in artificial group.The accuracy of the robot group was better than that of artificial group(P<0.05).Conclusion:Compared with free hand screw placement,Renaissance robot navigation system can effectively improve the accuracy of pedicle screw placement,reduce the number of fluoroscopy times and intraoperative blood l

关 键 词：脊柱骨折 计算机辅助外科手术 机器人 

分 类 号：R683.2[医药卫生—骨科学]