机器人辅助下椎体后凸成形术改良示踪器固定方式治疗Kümmell’s病的安全性及临床疗效分析  

Analysis of the safety and clinical efficacy of robot-assisted PKP modified tracer fixation in the treatment of Kümmell′s disease

作　　者：陶晖[1] 黄志伟 夏暑阳 杨昆[1] 张银顺[1] 李伟[1] 董福龙[1] 钱军[1] 申才良[1] TAO Hui;HUANG Zhi-wei;XIA Shu-yang;YANG Kun;ZHANG Yin-shun;LI Wei;DONG Fu-long;QIAN Jun;SHEN Cai-liang(Department of Orthopedics,The First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院骨科,安徽合肥230022

出　　处：《颈腰痛杂志》2024年第3期397-403,407,共8页The Journal of Cervicodynia and Lumbodynia

基　　金：国家重点研发计划(编号:2022YFC2407504);安徽省高校优秀青年项目(编号:2022AH030117)。

摘　　要：目的 比较天玑机器人辅助下经皮椎体后凸成形术(percutaneous kyphoplasty, PKP)中,棘突夹固定与贴皮固定示踪器治疗Kümmell’s病的安全性和临床疗效。方法 回顾性分析2020年1月至2022年7月安徽医科大学第一附属医院收治的113例单发椎体Kümmell’s病患者临床资料,根据示踪器固定方式,分为传统组(棘突夹固定,52例)和改良组(贴皮固定,61例)。比较两组患者工作通道建立时间、手术时间、术中出血量、术中辐射剂量、骨水泥注入量、分布及渗漏情况,以及术前、术后的椎体后凸Cobb角度、椎体高度、目测类比评分及Oswestry功能障碍指数。结果 两组病例均未出现机器人辅助下穿刺失败患者,患者均获随访12~24个月、平均(16.1±5.1)个月;两组患者术后椎体后凸Cobb角、椎体高度、目测类比评分、Oswestry功能障碍指数均较术前明显改善(P<0.05);改良组的工作通道建立时间、手术时间、术中出血量及术后第1天的目测类比评分、Oswestry功能障碍指数均显著优于传统组(P<0.05);两组患者在术中辐射剂量、术后椎体后凸Cobb角度、椎体高度、末次随访目测类比评分、Oswestry功能障碍指数、骨水泥注入量、分布及渗漏方面,无显著性差异(P>0.05)。结论 机器人辅助下PKP治疗Kümmell’s病过程中安装棘突夹与贴皮固定示踪器均能安全、有效地完成手术,并取得良好的临床疗效,其中改良贴皮固定示踪器可减少创伤、有效缩短手术时间,更有利于患者早期康复。Objective To compare the safety and clinical efficacy of robot-assisted percutaneous kyphoplasty(PKP)with spinoclip fixation and percutaneous fixation tracer in the treatment of Kümmell’s disease.Methods The clinical data of 113 patients with single vertebral Kümmell’s disease admitted to the First Affiliated Hospital of Anhui Medical University from January 2020 to July 2022 were retrospectively analyzed.According to the tracer fixation method,the patients were divided into traditional group(spine clip fixation,52 cases)and modified group(percutaneous fixation,61 cases).The establishment time of working channel,operation time,intraoperative blood loss,intraoperative radiation dose,bone cement injection volume,distribution and leakage were compared between the two groups,as well as the Cobb Angle of kyphosis,vertebral height,visual analog score and Oswestry disability index before and after operation.Results There was no failure of robot-assisted puncture in the two groups.All patients were followed up for 12-24 months,with an average of 16.1±5.1 months.The Cobb Angle of kyphosis,vertebral height,visual analogue scale and Oswestry disability index of the two groups were significantly improved after post-operation(P<0.05).The working channel establishment time,operation time,intraoperative blood loss,visual analog scale and Oswestry disability index on the first day after post-operation in the modified group were significantly better than those in the traditional group(P<0.05).There were no significant differences between the two groups in intraoperative radiation dose,postoperative kyphosis Cobb Angle,vertebral height,visual analogue scale,Oswestry disability index,bone cement injection volume,distribution and leakage(P>0.05).Conclusions Robot-assisted PKP can safely and effectively complete the operation and achieve good clinical efficacy.The modified percutaneous fixation tracer can reduce trauma,effectively shorten the operation time,and is more conducive to the early rehabilitation of patients.

关 键 词：Kümmell病 天玑骨科机器人 PKP 贴皮固定 示踪器 

分 类 号：R687.3[医药卫生—骨科学]