机器人辅助与徒手单侧穿刺椎体成形术治疗骨质疏松性椎体压缩骨折疗效的比较

Comparison of outcomes of robot assisted and conventional percutaneous vertebroplasty on osteoporotic vertebral compression fracture

目的比较机器人辅助与徒手单侧穿刺椎体成形术治疗骨质疏松性椎体压缩骨折患者的临床疗效。方法选取2016年12月至2017年4月怀化市中医医院收治的80例骨质疏松性椎体压缩骨折患者,按照手术方式的不同分为机器人辅助组和传统徒手组2组,每组40例。比较2组患者的疼痛视觉模拟评分(VAS)、日本骨科学会(JOA)评分、椎体后凸角度(Cobb角)、手术时间、骨水泥用量、X线透视次数、术后并发症以及住院时间等。结果机器人辅助组和传统徒手组术后VAS评分较术前均降低,术后JOA评分较术前均升高,术后Cobb角较术前均减小,组内差异均有统计学意义(P均<0.05),组间差异均无统计学意义(P均>0.05)。2组间手术时间、骨水泥用量及X线透视次数比较,差异均有统计学意义(P均<0.05)。机器人辅助组术后骨水泥渗漏2例,传统徒手组术后骨水泥渗漏5例,未发生其他并发症,2组术后并发症发生率差异无统计学意义(P>0.05)。机器人辅助组和传统徒手组患者住院时间比较[(4.9±1.9)d vs.(6.1±1.2)d],差异有统计学意义(P<0.05)。结论机器人辅助单侧椎体成形术治疗骨质疏松性椎体压缩骨折安全有效,可在临床应用推广。

Objective To compare the clinical effect of robot assisted and freehand unilateral puncture vertebroplasty in the treatment of osteoporotic vertebral compression fracture. Methods A total of 80 patients with osteoporotic vertebral compression fracture from December 2016 to April 2017 in Huaihua Traditional Chinese Medicine Hospital were enrolled in this study. All cases were divided into 2 groups according to different surgical methods： robot assisted group and traditional freehand group. There were 40 cases in each group. The VAS score,JOA score,Cobb angle,operative time,amount of bone cement,number of X-ray fluoroscopy,postoperative complications and hospitalization time were compared between the 2 groups. Results In both of robot assisted group and traditional freehand group, the postoperative VAS scores were lower than that preoperative,postoperative JOA scores were higher than that preoperative,postoperative Cobb angles were smaller than that preoperative,the differences within the group were statistically significant（ all P 〈 0. 05）.The differences between the 2 group were not statistically significant（ all P 〉 0. 05）. The time of surgery,the dosage of bone cement and the times of X-ray fluoroscopy in the 2 group were significantly different（ all P 〈0. 05）. There were 2 cases with bone cement leakage in robot assisted group postoperative and 5 cases with bone cement leakage in traditional freehand group postoperative. No other complications occurred in the 2 groups. There was no significant difference in the incidence of postoperative complications between the 2 groups（ P 〉 0. 05）. The hospitalization time of patients in the robot assisted group [（ 4. 9 ± 1. 9） d] was compared with the traditional freehand group [（ 6. 1 ± 1. 2） d]and the difference was statistically significant（ P 〈 0. 05）.Conclusion Robot assisted unilateral percutancous vertebroplasty is a safe and effective treatment of osteoporotic vertebral compression fractures.