超声引导下经皮关节突关节穿刺机器人辅助系统的实验研究  

An ultrasound-guided robot assisted system for percutaneous facet joint puncture: an experimental study

作　　者：高丽[1] 张元智[2] 王少白[3] 胡旭锋 米婧 刘亚欧[2] Gao Li;Zhang Yuanzhi;Wang Shaobai;Hu Xufeng;Mi Jing;Liu Yaou(Department of Anesthesiology,The Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China;Department of Orthopaedics,The Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China;Shanghai University of Sports,Shanghai 200438,China)

机构地区：[1]内蒙古医科大学附属医院麻醉科,呼和浩特010050 [2]内蒙古医科大学附属医院骨科,呼和浩特010050 [3]上海体育学院,上海200438

出　　处：《中华创伤骨科杂志》2022年第10期869-873,共5页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金项目(81760412);内蒙古自治区科技成果转化项目(CGZH2018148);内蒙古自治区科技计划项目(201802157,2019GG113);内蒙古自治区自然科学基金项目(2019MS08151);内蒙古医科大学"致远"人才基金项目(ZY0120011)。

摘　　要：目的通过超声图像和二维X线荧光图像配准,评估超声引导机器人辅助关节突关节穿刺术动物实验的准确性。方法取成年绵羊腰椎新鲜标本6个,浸泡于明胶溶液,分为左右侧关节突关节各24个,共计48个关节突关节,依据穿刺方式分为机器人组和徒手组(n=24),机器人组和徒手组均穿刺左右侧关节突关节各12个,机器人组采用随机数字表法选取穿刺关节,徒手组穿刺对侧关节;机器人组左侧关节突关节左侧L_(1)3个,L_(2)3个,L_(3)3个,L43个,右侧关节突关节L_(1)2个,L_(2)3个,L_(3)5个,L42个;机器人组和徒手组均在同一标本上进行,采用自身对照实验,记录和比较两组定位误差、方向误差、扫描时间、路径规划、总穿刺时间、总操作时间。结果机器人辅助穿刺的定位误差[(2.21±1.12)mm]、方向误差(1.51°±0.47°)显著小于徒手组[(3.26±1.44)mm、2.24°±0.89°],差异均有统计学意义(P<0.05);机器人组所有模型均在首次成功实现关节突关节穿刺,徒手组则需要多次校正;机器人组总操作时间[(463.84±34.93)s]显著长于徒手组[(298.40±27.48)s],但总穿刺时间[(37.97±6.87)s]显著短于徒手组[(261.61±33.15)s],差异均有统计学意义(P<0.05)。结论机器人辅助下的关节突穿刺术可以在较少的针头调整次数下实现精准穿刺。Objective To evaluate the accuracy of an ultrasound-guided robot-assisted system for percutaneous facet joint puncture in an animal experiment by registration of ultrasound images and two-dimensional X-ray fluorescence images.Methods Six specimens of fresh adult sheep lumbar spine were prepared and soaked in gelatin solution.The specimens contained a total of 48 facet joints with 24 ones respectively on the left and right sides.Half of the joints were assigned by the random number table method into a robot-assisted group which were subjected to percutaneous facet joint puncture assisted by the ultrasound-guided robot-assisted system while the contralateral ones into a freehand group which were subjected to percutaneous facet joint puncture by freehand.In the robot-assisted group,the left facet joints were 3 L_(1),3 L_(2),3 L_(3) and 3 L4 ones while the right facet joints were 2 L_(1),3 L_(2),5 L_(3) and 2 L4 ones.In this self-control animal experiment,both the robot-assisted punctures and the freehand punctures were carried out in the same specimen.The puncture success rate,puncture needle adjustment,positioning deviation,orientation deviation and operation time were recorded.Results The positioning deviation and orientation deviation in the robot-assisted group[(2.21±1.12)mm and 1.51°±0.47°]were significantly lower than those in the freehand group[(3.26±1.44)mm and 2.24°±0.89°](P<0.05).All the articular facet joint punctures were successfully accomplished for the first time in the robot-assisted group while those required multiple adjustments in the freehand group.In the robot-assisted group,the total operation time[(463.84±34.93)s]was significantly longer than that in the freehand group[(298.40±27.48)s],but the puncture time[(37.97±6.87)s]was significantly shorter than that in the freehand group[(261.61±33.15)s](P<0.05).Conclusion The ultrasound-guided robot-assisted system for percutaneous facet joint puncture can lead to accurate puncture with limited needle adjustments.

关 键 词：腰椎 椎关节突关节 超声处理 机器人 

分 类 号：R687.4[医药卫生—骨科学]