机器人辅助经皮微创椎弓钉内固定术治疗单节段胸腰椎压缩性骨折的临床疗效分析  

Clinical effect of robot-assisted percutaneous pedicle screw fixation in the treatment of patients with single segmental thoracolumbar compression fracture

作　　者：郑冲 柴俊 卢伟杰[2] ZHENG Chong;CHAI Jun;LU Weijie(Department of Orthopedics,Xiangyang Central Hospital,Xiangyang 441138,China;Department of Orthopedics,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China)

机构地区：[1]襄阳市中心医院骨外科,湖北襄阳441138 [2]广州医科大学附属第一医院骨外科,广东广州510120

出　　处：《机器人外科学杂志（中英文）》2024年第5期818-824,830,共8页Chinese Journal of Robotic Surgery

基　　金：“科普+乡村振兴”服务工程项目(K2022010103)。

摘　　要：目的:探讨应用机器人辅助经皮椎弓根螺钉内固定术治疗的单节段胸腰椎压缩性骨折患者的临床效果。方法:回顾性分析2018年1月—2023年1月襄阳市中心医院收治的73例单节段胸腰椎压缩性骨折患者的临床资料,其中43例采用常规经皮微创椎弓钉内固定术(常规微创组),30例采用手术机器人辅助下经皮椎弓根螺钉内固定术(机器人微创组),术后随访至2024年1月。比较两组患者围手术期相关手术指标、植钉准确率及安全率、手术前后病椎前缘高度百分比和矢状面Cobb角的改变、疼痛、生活质量及功能障碍评分的差异。结果:机器人微创组的手术时间、术中出血量、术中透视次数和住院时间均明显低于常规微创组(P<0.05),植钉准确率高于常规微创组(P<0.05)。与手术前相比,两组患者术后病椎前缘高度百分比逐渐增加、Cobb角逐渐降低、视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)评分逐渐降低、巴塞尔指数评分量表(Barthel)评分逐渐增加(P<0.05),但两组患者间的差异无统计学意义(P>0.05)。结论:机器人辅助下治疗胸腰椎骨折植钉准确率更高,术中出血量及透视次数均明显减少,极大程度缩短了患者住院时间,且效果确切,值得在临床上推广。Objective:To investigate the clinical effect of robot-assisted percutaneous pedicle screw fixation in the treatment of patients with single segmental thoracolumbar compression fracture.Methods:Clinical data of 73 patients with single segmental thoracolumbar fracture who were admitted to Xiangyang Central Hospital from January 2018 to January 2023 were retrospectively analyzed,of which 43 cases who were treated with conventional percutaneous pedicle screw fixation were divided into the conventional minimally invasive group,and 30 cases who were treated with robot-assisted percutaneous pedicle screw fixation(robotic minimally invasive group).Patients were followed up until January 2024.The perioperative indicators,the accuracy and safety rate of implants,the percentage of affected anterior vertebral height and the changes of sagittal Cobb angle before and after surgery,pain level,quality of life,and dysfunction were compared between the two groups.Results:The operative time,intraoperative blood loss,intraoperative fluoroscopy times and length of hospital stay in the robotic minimally invasive group were significantly lower than those in the conventional minimally invasive group(P<0.05).The accuracy of implant in robotic minimally invasive group was higher than that in the conventional minimally invasive group(P<0.05).Compared with that before operation,the percentage of affected anterior vertebral height in the two groups were both increased,the angle of Cobb decreased,visual analogue scale(VAS)and Oswestry disability index(ODI)scores decreased,and Barthel index scores increased(P<0.05),but there was no statistically significant difference between the two groups(P>0.05).Conclusion:Orthopedic robotassisted treatment of thoracolumbar fracture has higher accuracy,less intraoperative blood loss and radiation times,and shorter length of hospital stay,which is worthy of clinical promotion.

关 键 词：内固定术 压缩性骨折 胸椎 腰椎 机器人辅助手术 

分 类 号：R683.2[医药卫生—骨科学]