Renaissance脊柱手术机器人在胸腰椎骨折中的临床应用

Clinical application of Renaissance spinal surgical robot in thoracolumbar fractures

目的评价Renaissance脊柱手术机器人应用于胸腰椎骨折的有效性和安全性。方法前瞻性纳入2017年1月—2019年1月收治的胸腰椎骨折患者82例,按随机数字表法分为机器人组(Renaissance脊柱手术机器人辅助置钉,40例)和对照组(透视下徒手置钉,42例)。比较机器人组和对照组置钉准确率、一次性置钉成功率、完成置钉时间、椎体前缘穿透率,评价机器人组螺钉置入角度与术前规划的一致性。结果所有手术顺利完成。机器人组骨折椎体40个,置入螺钉240枚;对照组骨折椎体42个,置入螺钉252枚。机器人组和对照组置钉准确率分别为96.67%(232/240)和89.68%(226/252),一次性置钉成功率分别为98.33%(236/240)和91.67%(231/252),完成置钉时间分别为(15.22±5.64)min和(20.01±7.12)min,椎体前缘穿透率分别为0.83%(2/240)和6.75%(17/252),上述指标2组间比较,差异均有统计学意义(P<0.05)。机器人组术前规划图像和术后横断面、矢状面CT扫描对比,椎弓根螺钉置入角度差异无统计学意义(P>0.05)。结论Renaissance脊柱手术机器人辅助椎弓根螺钉置入准确性高、置钉时间短、安全性高,置钉效果满意,是一种安全、有效、值得推广的新技术。

Objective To evaluate the clinical safety and effectiveness of Renaissance spinal surgery robot in the treatment of thoracolumbar fractures.Methods From January 2017 to January 2019,a total of 82 patients with thoracolumbar fractures were enrolled in the prospective randomized controlled trial.Among them,40 were randomized to robot group(Renaissance robot-assisted screw placement)and 42 to control group(unarmed screw placement under perspective).The accuracy of screw placement,one-time success rate of screw placement,completion time of screw placement and penetration rate of anterior vertebral margin were compared between the 2 groups.In the robot group,the consistency of actual screw placement angle was compared with that of preoperative planning.Results All the operations were successfully completed.In the robot group,40 fractured vertebral bodies and 240 screws were placed;in the control group,42 fractured vertebral bodies and 252 screws were placed.The accuracy rate of screw placement was 96.67%(232/240)and 89.68%(226/252),and the success rate of one-time screw placement was 98.33%(236/240)and 91.67%(231/252),and the time of screw placement was(15.22±5.64)min and(20.01±7.12)min,and the penetration rate of anterior vertebral body was 0.83%(2/240)and 6.75%(17/252)in the robot group and control group,respectively.There were significant differences between the 2 groups in the above items(P<0.05).There was no significant difference in the angle of pedicle screw placement between preoperative planning image and postoperative cross-sectional and sagittal CT scan in the robot group(P>0.05).Conclusions Renaissance spinal surgery robot assisted pedicle screw placement has the advantages of high accuracy,short screw placement time,high safety and satisfactory screw placement effect.It is a safe,effective and worthy of popularizing new technology.