摘要
目的比较骨科机器人辅助与传统透视辅助下经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fractures,OVCF)的临床疗效和安全性。方法将符合要求的180例OVCF患者随机分为两组,观察组应用天玑骨科机器人系统行PVP治疗,对照组采用C型臂透视辅助下行PVP治疗。记录并比较两组患者的手术时间、住院时间、穿刺内倾角度、骨水泥灌注量以及并发症发生情况,并分别于术前、术后1 d、术后1周、术后1月记录两组患者的腰背部疼痛视觉模拟量表(visual analogue scale,VAS)评分、Oswestry功能障碍指数(Oswestry disability index,ODI)及手术椎体Cobb角。结果两组患者的住院时间及骨水泥灌注量差异无统计学意义(P>0.05);观察组手术时间较对照组均明显减少(P<0.05),穿刺内倾角度较对照组明显增大(P<0.05);手术后第1天、术后1周、术后1个月VAS评分以及ODI评分较术前明显降低,差异有统计学意义(P<0.05),两组间比较差异无统计学意义(P>0.05)。术后复查伤椎Cobb角较术前无明显变化(P>0.05)。对照组有15例患者出现骨水泥渗漏入椎管,观察组骨水泥渗漏4例,组间差异有统计学意义(P<0.05)。结论骨科机器人辅助与传统透视辅助PVP治疗OVCF均能获得良好的临床疗效,前者能减少手术时间,降低骨水泥渗漏率,应用前景良好。
Objective To compare the clinical efficacy and safety of percutaneous vertebroplasty(PVP)with robotic orthopedic assistance versus conventional fluoroscopy assistance for treatment of osteoporotic vertebral compression fractures(OVCF).Methods A total of 180 patients with OVCF were randomly divided into experiment group,in which patients were treated with robot-assisted unilateral puncture vertebroplasty;and control group,in which patients were treated with manual unilateral puncture vertebroplasty.The operative time,hospital stay,the injection amount of bone cement,penetration angles,and complications were compared between the 2 groups.The low back pain visual analogue scale(VAS),Oswestry disability index(ODI)and Cobb angle were compared between the 2 groups before the operation and 1 day,1 week and 1 month after the operation.Results There was no significant difference in hospital stay and the injection amount of bone cement between the 2 groups.In the robot-assisted group,the operative time was significantly shorter than that of the conventional fluoroscopy group,but the penetration angle of the robot-assisted group was significantly larger(P<0.05).The VAS score and ODI index 1 day,1 week and 1 month after operation were significantly improved(P<0.05),but there was no significant difference between the two groups(P>0.05).There was no significant difference in the Cobb angle between the two groups before and after operation(P>0.05).Among the 180 vertebrae,bone cement leakage into spinal canal was reported in 15 cases control group,and 4 case in experience group.There was significant difference between the two groups(P<0.05).Conclusion The clinical effect and of PVP with robot-assisted are similar to that of the conventional fluoroscopy,but the former can reduce operation time,and the leakage of bone cement.
作者
谢海清
李贤坤
孙进
张云帆
武明鑫
XIE Hai-qing;LI Xian-kun;SUN Jin;ZHANG Yun-fan;WU Ming-xin(Department of Spinal Surgery,Huizhou Third People's Hos-poital,Huizhou 516000,Guangdong,China)
出处
《广东医学》
CAS
2021年第9期1102-1106,共5页
Guangdong Medical Journal