脊柱外科手术机器人引导治疗胸腰椎骨折的疗效

The efficacy of spine robot-assisted surgery for treatment of thoracolumbar fracture

目的探讨Mazor Renaissance脊柱外科手术机器人引导治疗胸腰椎骨折的疗效。方法将32例胸腰椎骨折患者分别采用Mazor Renaissance脊柱外科机器人手术(机器人组,14例)和传统手术(传统组,18例)。比较两组患者的手术指标、术后疼痛VAS评分和ODI、影像学参数、术后并发症。采用Gertzbein et al标准评估置入椎弓根螺钉的准确性。结果患者均获得随访,时间6～18个月。手术时间、术中出血量、住院时间、疼痛缓解时间、自主翻身时间、自主下地活动时间、术后引流量、术后3 d及3个月VAS评分、术后并发症两组比较差异均无统计学意义(P>0.05)。机器人组术中透视次数明显少于传统组,置钉准确率显著高于传统组,差异均有统计学意义(P<0.05)。末次随访时,两组ODI和骨折椎体高度比较差异均无统计学意义(P>0.05)。结论与传统手术比较,Mazor Renaissance脊柱外科手术机器人引导下手术治疗胸腰椎骨折能显著提高置钉准确率、减少术中透视次数。

Objective To evaluate the effect of Mazor Renaissance spine robot-assisted surgery in the treatment of thoracolumbar fracture. Methods The 32 cases of thoracolumbar fractures who accepted surgery were retrospectively analyzed,including 14 cases of Mazor Renaissance spine robot-assisted surgery and 18 cases of traditional surgery.The two groups were compared in terms of perioperative index,postoperative VAS,ODI,radiologic parameters and complications. The accuracy of pedicle screw placement was evacuated by the Gertzbein et al criteria. Results All patients were followed up for 6 ～ 18 months. The operation time,intraoperative bleeding,hospitalization time,time for pain relief,turning over time by self,postoperative drainage volume,time for ambulatory recovery and VAS at 3 d and 3 months postoperation were similar between the two groups（ P 0. 05）. Compared with the traditional group,the Robot-assisted group had significantly more precise pedical screw placement and less intraoperative X-ray radiation（ P 0. 05）. There was no significant difference of ODI and fracture vertebral height between two groups at the last follow-up（ P 0. 05）. Conclusions Mazor Renaissance assisted surgery for the treatment of thoracolumbar fracture can significantly decrease intraoperative X-ray radiation,and have more precise pedical screw placement,compared with the traditional surgery.