机器人辅助经皮伤椎置钉治疗胸腰椎爆裂骨折  

The robot-assisted percutaneous screwing of injured vertebra on thoracolumbar burst fractures

作　　者：雷龙跃 郑标 吴慕君 LEI Long-yue;ZHENG Biao;WU Mu-jun(Dept of Spine Surgery,Hangzhou Banger Orthopaedic Hospital,Hangzhou,Zhejiang 311100,China)

机构地区：[1]杭州邦尔骨科医院脊柱外科,浙江杭州311100

出　　处：《临床骨科杂志》2024年第4期466-470,共5页Journal of Clinical Orthopaedics

摘　　要：目的探讨机器人辅助经皮伤椎置钉治疗胸腰椎爆裂骨折的疗效。方法将56例胸腰椎爆裂骨折患者根据治疗方法不同分为观察组(采用机器人辅助经皮伤椎置钉治疗,28例)和对照组(采用经Wiltse入路伤椎置钉治疗,26例)。记录手术情况、疼痛VAS评分、伤椎前缘高度比、椎体Cobb角。根据Gertzbein Robbins标准评估椎弓根螺钉位置准确性。结果患者均获得随访,时间3~12个月。术中出血量、术中透视次数、切口长度、住院时间、骨痂形成时间观察组均少(短)于对照组(P<0.01),手术时间两组比较差异无统计学意义(P>0.05)。置钉优良率、精准率两组比较差异均无统计学意义(P>0.05)。疼痛VAS评分术后1、3 d观察组均低于对照组(P<0.05),术后1、3个月两组比较差异均无统计学意义(P>0.05)。伤椎前缘高度比和椎体Cobb角两组术后即刻、术后3个月比较差异均无统计学意义(P>0.05)。结论机器人辅助经皮伤椎置钉治疗胸腰椎爆裂骨折,可减少术中出血量、术中透视次数,缩短患者住院时间,减轻患者术后早期疼痛。Objective To investigate the effect of robot-assisted percutaneous screwing of injured vertebra for treatment of thoracolumbar burst fractures.Methods The 56 patients with thoracolumbar burst fractures were divided into the observation group(28 cases were treated with robot-assisted percutaneous screwing of injured vertebra)and control group(26 cases were treated with screwing of injured vertebra via Wiltse approch),according to different treatment methods.The surgical condition,pain VAS,anterior vertebral height ratio,Cobb angle of the injured vertebrae were recorded.The accuracy of pedicle screw position based on Gertzbein Robbins criteria was evaluated.Results All patients were followed up for 3~12 months.The observation group had fewer(shorter)intraoperative bleeding volume,intraoperative fluoroscopy frequency,incision length,hospital stay and callus formation time,compared to the control group(P<0.01),and there was no statistical difference in surgical time between the two groups(P>0.05).There were no statistical significance in the excellent-good rate and accuracy rate of screw placement between the two groups(P>0.05).The pain VAS:At 1,3 d after surgery,observation group was lower than that of the control group(P<0.05),and there was no statistical significance between the two groups at 1 and 3 months after surgery(P>0.05).There was no statistical significance in the anterior edge height ratio and Cobb angle of the injured vertebra between two groups immediately and 3 months after surgery(P>0.05).Conclusions Robot-assisted percutaneous screwing of injured vertebra for treatment of thoracolumbar burst fractures can reduce intraoperative bleeding,intraoperative fluoroscopy frequency,shorten patient hospitalization time,and relieve early postoperative pain.

关 键 词：胸腰椎骨折 经皮椎体置钉 骨科机器人 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学] R319[医药卫生—临床医学]