机器人辅助手术对胸腰段骨折患者置钉准确性、创伤程度及预后的影响(附手术视频)  

Effect of robot-assisted surgery on screw placement accuracy,degree of trauma and prognosis in patients with thoracolumbar fractures(with surgical video)

作　　者：沈科 赵登[2] 尹立[3] SHEN Ke;ZHAO Deng;YIN Li(Department of Orthopaedics,Bayi Orthopedic Hospital,Chengdu 610000,China;Department of Orthopaedics,Chengdu Third People’s Hospital,Chengdu 610000,China;Department of Orthopaedics,Panzhihua Central Hospital,Panzhihua 617000,China)

机构地区：[1]成都市八一骨科医院骨科,四川成都610000 [2]成都市第三人民医院骨科,四川成都610000 [3]攀枝花市中心医院骨科,四川攀枝花617000

出　　处：《机器人外科学杂志（中英文）》2024年第5期765-770,共6页Chinese Journal of Robotic Surgery

基　　金：2019年度八一骨科医院院内科研立项课题(201934)。

摘　　要：目的:探讨机器人辅助手术治疗胸腰段骨折患者的应用效果。方法:前瞻性选取2021年2月至2023年2月医院收治的92例胸腰段骨折患者为研究对象,采用电脑随机法分为徒手组和机器人组,每组46例。徒手组行徒手置入椎弓根螺钉内固定术,机器人组行机器人辅助置入椎弓根螺钉内固定术。比较两组手术相关指标、手术前后创伤程度、腰椎功能及疼痛程度。结果:机器人组螺钉精准置入率优于徒手组,术中出血量、术中辐射剂量、卧床时间、住院时间均低于徒手组(P<0.05)。术后1 d机器人组hs-CRP、CK、IL-1β水平低于徒手组(P<0.05)。术后3个月、6个月机器人组ODI评分、VAS评分低于徒手组(P<0.05)。结论:机器人辅助手术治疗胸腰段骨折效果确切,螺钉精准置入率高,能减少术中出血量与术中辐射剂量,缩短卧床时间与住院时间,减少对机体的创伤,改善患者预后。Objective:To explore the application effect of robot-assisted surgery in the treatment of patients with thoracolumbar fractures.Methods:A total of 92 patients with thoracolumbar fractures admitted to Bayi Orthopedic Hospital from February 2021 to February 2023 were prospectively selected.They were randomly divided into the free-hand group and robotic group using computer generated numbers,with 46 cases in each group.The free-hand group was treated with free-hand pedicle screw placement,and the robotic group was treated with robot-assisted pedicle screw placement.The surgical indicators,the degree of trauma before and after operation,lumbar function and pain degree were compared between the two groups of patients.Results:The accurate screw placement rate of the robotic group was better than that of the free-hand group.The intraoperative blood loss,intraoperative radiation dose,bed rest time,and hospitalization time of the robotic group were lower than those of the free-hand group(P<0.05).1 day after surgery,the levels of hs-CRP,CK and IL-1βin the robotic group were lower than those in the free-hand group(P<0.05).The ODI and VAS scores in the robotic group were lower than those in the freehand group at 3 months and 6 months after surgery.Conclusion:Robot-assisted surgery is effective in treating thoracolumbar fractures with high precise placement rate of screws.It can reduce intraoperative blood loss and intraoperative radiation dose,shorten bedridden time and hospitalization time,reduce trauma to the body,and improve the prognosis of patients.

关 键 词：胸腰段骨折 机器人辅助手术 椎弓根螺钉 内固定 创伤程度 预后 

分 类 号：R683.2[医药卫生—骨科学]