机器人辅助与徒手经皮椎体成形术比较  

Robot-assisted percutaneous vertebroplasty versus conventional manual counterpart

作　　者：罗世科 王传恩[1] 熊小明 钟睿[1] 李井泉 胡彬[1] 王卓琳 向军伟 LUO Shi-ke;WANG Chuan-en;XIONG Xiao-ming;ZHONG Rui;LI Jing-quan;HU Bin;WANG Zhuo-lin;XIANG Jun-wei(Affiliated Sport Hospital of Chengdu University of Physical Education,Chengdu,Sichuan 610041,China)

机构地区：[1]成都体育学院附属体育医院,四川成都610041

出　　处：《中国矫形外科杂志》2025年第2期118-123,共6页Orthopedic Journal of China

基　　金：四川省科技厅重点研发项目(编号:2023YFS0452);四川省中医药管理局科学技术专项课题面上项目(编号:2023MS529)。

摘　　要：[目的]比较机器人辅助与传统徒手穿刺下经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fracture,OVCF)的临床疗效。[方法]回顾性分析2021年1月—2022年11月在本院行PVP治疗的119例单节段OVCF患者的临床资料。根据入院时间,将患者分为两组,后期的75例采用机器人辅助下PVP,早期的44例采用传统徒手椎弓根外入路PVP。比较两组围手术期、随访及影像结果。[结果]所有患者均顺利完成手术。机器人组在手术时间[(19.5±5.3)min vs(28.0±7.4)min,P<0.001]、穿刺时间[(7.7±4.5)min vs(14.3±6.8)min,P<0.001]、骨水泥注入时间[(7.3±1.6)min vs(8.7±1.6)min,P<0.001]、术中透视次数[(24.2±4.1)次vs(28.2±5.5)次,P<0.001]、住院天数[(8.2±2.9)d vs(12.3±4.4)d,P<0.001]、一次性穿刺成功率[例(%),67(89.3)vs 27(61.4),P<0.001]、骨水泥注入量[(6.6±1.1)ml vs(5.4±1.4)ml,P<0.001]均显著优于徒手组。两组恢复完全负重活动时间的差异无统计学意义(P>0.05)。随时间推移,两组VAS评分、ODI指数均显著减少(P<0.05),相应时间点,两组间上述指标的差异均无统计学意义(P>0.05)。影像方面,与术前相比,末次随访时两组术后局部Cobb角、椎体前缘高度均显著改善(P<0.05);相应时间点,两组间上述影像指标的差异均无统计学意义(P>0.05)。[结论]机器人辅助下PVP治疗OVCF更为安全,能缩短手术时间、减少术中透视、增加骨水泥注入量,可有效强化椎体。[Objective]To compare the clinical outcomes of robot-assisted percutaneous vertebroplasty(PVP)versus conventional manual PVP in the treatment of osteoporotic vertebral compression fracture(OVCF).[Methods]A retrospective analysis was performed on 119 patients who received PVP for single-segment OVCF in our hospital from January 2021 to November 2022.According to the time se⁃quence of admission,the patients were divided into two groups,75 patients in the late stage received robot-assisted PVP,while 44 patients in the early stage received conventional manual PVP through the extrapedicular approach.The data of perioperative period,follow-up and imaging were compared between the two groups.[Results]All patients in both groups had PVP completed successfully.The robot group proved significantly superior to the manual group in terms of operation time[(19.5±5.3)min vs(28.0±7.4)min,P<0.001],puncture time[(7.7±4.5)min vs(14.3±6.8)min,P<0.001],bone cement injection time[(7.3±1.6)min vs(8.7±1.6)min,P<0.001],intraoperative fluorosco⁃py times[(24.2±4.1)times vs(28.2±5.5)times,P<0.001],hospitalization day[(8.2±2.9)days vs(12.3±4.4)days,P<0.001],one-time suc⁃cess rate of puncture[cases(%),67(89.3)vs 27(61.4),P<0.001]and bone cement injection volume[(6.6±1.1)ml vs(5.4±1.4)ml,P<0.001].There was no significant difference in the time to resume full weight-bearing activities between the two groups(P>0.05).With the passage of time,the VAS and ODI scores in both groups significantly decreased(P<0.05),whereas which were not statistically significant between the two groups at any corresponding time points(P>0.05).As for imaging,the local Cobb angle and anterior vertebral body margin height significantly improved in both groups at the last follow-up compared with those preoperatively(P<0.05),however,there were no sig⁃nificant differences in the above image indicators between the two groups at any time points accordingly(P>0.05).[Conclusion]The robotassisted PVP for OVCF is safer,with advantages of shortening operative t

关 键 词：骨质疏松椎体压缩性骨折 经皮椎体成形术 单侧椎弓根外入路 机器人辅助 

分 类 号：R683.2[医药卫生—骨科学]