骨科手术机器人辅助Wiltse入路椎弓根螺钉固定术对脊柱骨折合并脊髓损伤的近远期疗效分析  

Analysis of short-term and long-term efficacy orthopedic surgical robotassisted pedicle screw fixation via Wiltse approach in spinal fractures with spinal cord injury

作　　者：徐子彧[1] 刘俊鹏 黎萌 XU Ziyu;LIU Junpeng;LI Meng(Department of Orthopedics,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院骨科,北京100020

出　　处：《机器人外科学杂志(中英文)》2025年第4期552-557,共6页Chinese Journal of Robotic Surgery

基　　金：国家自然科学基金(81071515)。

摘　　要：目的:探讨天玑^(®)骨科手术机器人辅助Wiltse入路椎弓根螺钉固定术对脊柱骨折合并脊髓损伤的近远期疗效。方法:选取2020—2023年首都医科大学附属北京朝阳医院收治的120例脊柱骨折合并脊髓损伤患者,应用抽签法分为传统术式组与机器人辅助组,各60例。传统术式组实施传统后正中入路椎弓根螺钉固定术治疗,机器人辅助组实施天玑^(®)骨科手术机器人辅助Wiltse入路椎弓根螺钉固定术治疗。对比两组围手术期指标,置钉准确率,术后并发症发生率,术后3 d及术后3个月椎体后凸角、椎体后凸角矫正率、椎体高度恢复率,日本骨科协会评分(JOA)及脊柱功能指数量表(SFI)评分。结果:机器人辅助组围手术期指标低于传统术式组(P<0.05);机器人辅助组置钉准确率高于传统术式组(P<0.05);机器人辅助组术后并发症发生率低于传统术式组(P<0.05);术后3 d及术后3个月机器人辅助组椎体后凸角低于传统术式组,椎体后凸角矫正率、椎体高度恢复率高于传统术式组(P<0.05);术后3 d及术后3个月机器人辅助组JOA评分、SFI评分高于传统术式组(P<0.05)。结论:天玑^(®)骨科手术机器人辅助Wiltse入路椎弓根螺钉固定术治疗脊柱骨折合并脊髓损伤近远期效果显著,可减少患者手术时间,减轻手术损伤,提升置钉准确率,降低术后早期并发症发生率,同时可提升近远期固定效果,提升患者腰椎功能。Objective:To investigate the short-term and long-term efficacy of TiRobot^(®)orthopedic surgical robot-assisted pedicle screw fixation via Wiltse approach in spinal fractures with spinal cord injury.Methods:120 patients with spinal fractures and spinal cord injury who were admitted to Beijing Chaoyang Hospital,Capital Medical University from 2020 to 2023 were selected and divided into the traditional surgery group and the robot-assisted group using the lottery method,with 60 cases in each group.The traditional surgery group underwent conventional pedicle screw fixation via posterior midline approach,while the robot-assisted group received orthopedic surgical robot-assisted pedicle screw fixation via Wiltse approach.The perioperative indicators,screw placement accuracy,incidence of postoperative complications,vertebral kyphosis angle,vertebral kyphosis correction rate,vertebral height recovery rate at 3 days and 3 months after surgery,as well as JOA and SFI scores were compared between the two groups.Results:The robot-assisted group showed lower perioperative indicators compared to the traditional surgery group(P<0.05).The screw placement accuracy was higher in the robotassisted group(P<0.05),and the incidence of postoperative complications was lower(P<0.05).At 3 days and 3 months postoperatively,the vertebral kyphosis angle in the robot-assisted group was lower than that in the traditional surgery group,while the vertebral kyphosis correction rate and vertebral height recovery rate were higher(P<0.05).The JOA and SFI scores in the robot-assisted group were also higher than those in the traditional surgery group at 3 days and 3 months after surgery(P<0.05).Conclusion:TiRobot^(®)orthopedic surgical robot-assisted pedicle screw fixation via Wiltse approach has significant short-term and long-term efficacy in treating spinal fractures with spinal cord injury.It can reduce operative time,minimize surgical trauma,improve screw placement accuracy,lower early postoperative complications,enhance short-term and long-term

关 键 词：骨科手术机器人 Wiltse入路 椎弓根螺钉固定术 脊柱骨折 脊髓损伤 

分 类 号：R683.2[医药卫生—骨科学]