骨科机器人辅助技术在骨肿瘤手术中的应用现状  

Analysis of the application of orthopedic robot assisted technology in bone tumor surgery

作　　者：杨勇昆[1] 刘巍峰[1] Yang Yongkun;Liu Weifeng(Deptartment of Orthopaedic Oncology Surgery,Beijing Jishuitan Hospital,Peking University,Beijing 100035,China)

机构地区：[1]北京积水潭医院骨肿瘤科,北京100035

出　　处：《中华骨科杂志》2023年第5期337-342,共6页Chinese Journal of Orthopaedics

基　　金：北京市自然科学基金(L212042);北京市属医院科研培育计划(PX2021015);北京市医管局"青苗"计划(QML20200403);北京积水潭医院"学科骨干"计划专项经费资助(XKGG202105);北京积水潭医院自然基金培育计划(ZR-202104)。

摘　　要：智能化和精准化是当前骨科手术发展的重要方向和研究热点。骨科机器人辅助技术逐渐应用于骨科各专业的手术中,但在骨肿瘤手术中的应用相对起步较晚,目前适合于临床应用的场景较为有限。通过检索PubMed、Embase、ScienceDirect、中国知网及万方数据库中有关骨科机器人辅助技术在骨肿瘤手术领域中的应用情况,分析其智能化和精准化需求,并对骨科机器人在骨肿瘤手术中的临床应用情况加以整理和分析。机器人辅助下骨肿瘤穿刺活检术,尤其是对体积较小、位置较深、局部解剖结构较为复杂的肿瘤,可提高穿刺活检的精确性和阳性率。机器人辅助骨肿瘤精确截骨,较手动截骨和机器人辅助下截骨的精确性更高、误差更小。机器人辅助技术具有提高解剖结构复杂部位如骶骨和骨盆肿瘤切除的精确性的应用潜力;机器人辅助技术在脊柱肿瘤手术中的应用可提高置入椎弓根钉的精准性和微创椎体成形术的安全性,并可用于脊柱肿瘤的微创精准手术切除。分析机器人辅助骨肿瘤手术目前存在的问题及发展方向,如成本效益、配准精度、软组织识别和反馈、误差叠加和纠错等问题,为深入开展相关临床应用和研究提供参考依据。Intellectualization and precision are important directions of development and research highlights of orthopaedic surgery at present.The orthopaedic robot-assisted technology is gradually applied to various orthopaedic specialties.However the application of robot-assisted technology in bone tumor surgery started relatively late and the scenarios suitable for clinical application are relatively limited.By searching PubMed,Embase,ScienceDirect,CNKI and Wanfang database about the application of orthopaedic robot-assisted technology in the field of bone tumor surgery,we analyzed its intelligence and precision requirements,sorted and analyzed the current clinical application of orthopaedic robot in bone tumor surgery.The robot-assisted puncture biopsy of bone tumor could improve the accuracy and positive rate,especially for tumors with small size,deep location and complex local anatomical structure.For robot-assisted precise osteotomy for bone tumors,the accuracy and error analysis of manual osteotomy and robot-assisted osteotomy in the literatures were compared.The robot-assisted technology has the potential to improve the accuracy of tumor resection at complex anatomical structures such as sacrum and pelvic tumors.For the application of robot-assisted technology in spinal tumor surgery,literature reports suggested that it can improve the accuracy of pedicle screw placement and the safety of minimally invasive vertebroplasty,and can be used for minimally invasive precise surgical resection of spinal tumors.At the same time,the existing problems and development directions were analyzed,such as cost-effectiveness,accuracy of registration,soft tissue recognition and feedback,error superposition and error correction,so as to provide reference basis for further clinical application and study.

关 键 词：机器人手术 骨肿瘤 人工智能 精准医学 

分 类 号：R738.1[医药卫生—肿瘤]