单体位下斜外侧腰椎间融合术联合机器人辅助后路内固定治疗腰椎退行性疾病  

Single oblique lumbar interbody fusion with robot-assisted posterior internal fixation for lumbar degenerative diseases

作　　者：潘群龙 俞海明[1] 张荣谋 PAN Qun-long;YU Hai-ming;ZHANG Rong-mou(The Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,Fujian,China)

机构地区：[1]福建医科大学附属第二医院,福建泉州362000

出　　处：《中国骨伤》2022年第2期128-131,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨单体位下斜外侧入路腰椎间融合术(oblique lumbar interbody fusion,OLIF)联合机器人辅助后路内固定治疗腰椎退行性病变的疗效。方法:对2019年9月至2020年12月收治的67例腰椎退行性病变患者进行回顾性分析,根据手术方式不同,分为传统OLIF联合后路透视经皮置钉内固定组(传统组)和OLIF联合机器人辅助后路内固定组(机器人组)。传统组33例,其中男13例,女20例,年龄44~82(59.7±9.1)岁;机器人组34例,其中男7例,女27例,年龄45~81(61.6±8.8)岁。分别记录两组患者的手术时间、透视时间、术中出血量、术后下床时间及住院时间;比较术前及术后3 d,3个月时患者的腰背痛视觉模拟评分(visual analogue scale,VAS)和Oswestry功能障碍指数(Oswestry Disability Index,ODI);术后CT扫描评估两组患者的置钉准确率。结果:两组患者均顺利完成手术,并获得3个月以上的随访。传统组的手术时间、透视时间、术中出血量、术后下床时间及住院时间分别为(299.85±15.79)min,(62.58±10.83)min,(118.33±10.80)ml,(2.5±0.7)d,(9.67±2.13)d;机器人组为(248.53±14.22)min,(19.47±3.51)min,(115.74±9.86)ml,(2.3±0.6)d,(9.44±1.93)d。所有患者术后腰痛及下肢疼痛麻木等症状明显改善,机器人组的手术时间、透视时间明显少于传统组,术中出血量、术后下床时间、住院时间以及手术前后VAS、ODI两组间比较差异无统计学意义(P>0.05);机器人组置钉准确率为98.8%(2/160),高于传统组的89.9%(16/158)。结论:采用单体位下OLIF联合机器人辅助后路内固定治疗腰椎退行性疾病比传统OLIF联合后路透视经皮置钉手术时间、透视时间少,置钉准确率高,手术效果确切,值得在临床中推广。Objective:To investigate the efficacy of single oblique lumbar interbody fusion(OLIF)with robot-assisted posterior internal fixation for the treatment of lumbar degenerative diseases.Methods:The clinical data of 67 patients with lumbar degenerative diseases treated from September 2019 to December 2020 was retrospectively analyzed.According to different surgical methods,the patients were divided into traditional group and robot group.The traditional group received traditional OLIF with posterior fluoroscopy percutaneous nail fixation,and the robot group received OLIF with robot-assisted posterior internal fixation.There were 33 patients in traditional group,including 13 males and 20 females,aged from 44 to 82 years old with an average of(59.7±9.1)years;and 34 cases in robot group,including 7 males and 27 females,aged from 45 to 81 years old with an average of(61.6±8.8)years.The operation time,fluoroscopy time,intraoperative blood loss,postoperative out of bed time and hospital stay were recorded.The visual analogue scale(VAS)of low back pain and Oswestry Disability Index(ODI)were compared before operation and 3 days,3 months after operation between two groups.The accuracy of nail placement was evaluated by postoperative CT scan.Results:Both groups of patients successfully completed the operation and were followed up for more than 3 months.The operation time,fluoroscopy time,intraoperative blood loss,postoperative out of bed time and hospital stay in traditional group were(299.85±15.79)min,(62.58±10.83)min,(118.33±10.80)ml,(2.5±0.7)d,(9.67±2.13)d;and robot group was(248.53±14.22)min,(19.47±3.51)min,(115.74±9.86)ml,(2.3±0.6)d,(9.44±1.93)d,respectively.The symptoms of postoperative low back pain,lower limb pain and numbness were significantly improved in all patients.The operation time and fluoroscopy time in robot group were significantly less than those of traditional group.There was no significant difference in intraoperative blood loss,postoperative out of bed time,hospital stay,VAS and ODI before and

关 键 词：椎间盘退行性变 脊柱融合术 机器人 外科手术 计算机辅助 

分 类 号：R681.5[医药卫生—骨科学]