机器人辅助椎弓根外穿刺经皮后凸成形术  

Robot-assisted extrapedicular percutaneous kyphoplasty

作　　者：高鑫峰 夏韶襁 赵志刚[1] 夏平 GAO Xin-feng;XIA Shao-qiang;ZHAO Zhi-gang;XIA Ping(Department of Orthopedics,The Fourth Hospital of Wuhan City,Wuhan 430033,China)

机构地区：[1]武汉市第四医院骨科,湖北武汉430033

出　　处：《中国矫形外科杂志》2024年第6期487-492,共6页Orthopedic Journal of China

摘　　要：[目的]探讨骨科机器人辅助下经椎弓根外入路穿刺后凸成形术(percutaneous kyphoplasty, PKP)治疗骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fracture, OVCF)的疗效。[方法]回顾性分析2019年3月—2022年3月单侧椎弓根外入路穿刺PKP治疗OVCF的43例患者的临床资料。根据医患沟通结果,18例采用机器人辅助导航穿刺(机器人组),25例采用传统透视引导穿刺(透视组)。对比分析两组围手术期、随访及影像学资料。[结果]机器人组手术时间显著长于透视组[(43.5±5.2) min vs (26.2±4.9) min, P<0.001],但是,机器人组术中透视次数显著少于透视组[(3.3±0.8)次vs (8.8±3.3)次, P<0.001]。两组穿刺成功率、骨水泥渗漏率、下地行走时间、住院天数的差异均无统计学意义(P>0.05)。术后平均随访时间(19.8±5.7)个月,两组恢复完全负重活动时间的差异无统计学意义(P>0.05)。术后随时间推移,两组患者VAS、ODI评分均显著减少(P<0.05),相应时间点,两组间VAS、ODI评分的差异均无统计学意义(P>0.05)。影像方面,两组骨水泥分布优秀率比较差异无统计学意义(P>0.05),两组术后局部后凸Cobb角、椎体前缘相对高度均显著改善(P<0.05)。相应时间点,两组间的上述影像指标的差异均无统计学意义(P>0.05)。[结论]机器人导航可以减少透视次数,但是增加了手术时间,可以作为目前手术方法的一种有益补充。[Objective]To investigate the clinical outcomes of robot-assisted extrapedicular percutaneous kyphoplasty(PKP)for the treatment of osteoporotic vertebral compression fracture(OVCF).[Methods]A retrospective study was conducted on 43 patients who re⁃ceived extrapedicular PKP for OVCF from March 2019 to March 2022.According to the preoperative doctor-patient communication,18 cases underwent robot-assisted puncture(robot group),while other 25 cases underwent traditional fluoroscopy guided puncture(fluoroscopy group).The perioperative,follow-up and imaging data of the two groups were compared and analyzed.[Results]Although the robot group consumed significantly longer operative time than the fluoroscopy group[(43.5±5.2)min vs(26.2±4.9)min,P<0.001],the former was signifi⁃cantly less than the latter in term of intraoperative fluoroscopy number[(3.3±0.8)times vs(8.8±3.3)times,P<0.001].There were no signifi⁃cant differences in first puncture success rate,bone cement leakage rate,walking time and hospitalization days between the two groups(P>0.05).The mean follow-up time was(19.8±5.7)months,and there was no significant difference between the two groups in the time to return to full weight-bearing activities(P>0.05).The VAS and ODI scores were significantly decreased in both groups over time(P<0.05),which were not significantly different between the two groups at any corresponding time points(P>0.05).As for imaging,there was no significant difference in the excellence rate of bone cement distribution between the two group(P>0.05).The local kyphotic Cobb angle and the rela⁃tive anterior vertebral height significantly improved postoperatively compared with those preoperatively in both groups(P<0.05),whereas which proved not statistically significant between the two groups at any time points accordingly(P>0.05).[Conclusion]Robotic navigation can reduce the number of fluoroscopy,but increase the operation time,and can be a useful supplement to current surgical methods.

关 键 词：骨质疏松性椎体压缩骨折 椎弓根外后凸成形术 骨科机器人 临床结果 

分 类 号：R687[医药卫生—骨科学]