天玑Ⅱ机器人辅助胸腰椎椎弓根螺钉内固定术的临床应用

Clinical application of 2^(nd) generation TiRobot-assisted thoracolumbar pedicle screw fixation

目的分析天玑Ⅱ机器人辅助胸腰椎椎弓根螺钉内固定术的临床效果,为天玑Ⅱ机器人在脊柱外科手术的临床应用提供依据。方法天玑Ⅱ骨科手术机器人优化了主控触屏、机械臂末端和机械臂示踪器。本研究分析2020年12月至2021年5月期间在北京积水潭医院实施天玑Ⅱ机器人辅助胸腰椎椎弓根螺钉内固定术20例患者的病例资料,使用图像融合法测量导针偏差,使用术后影像测量螺钉准确性,同时记录手术时间、术中出血量、术后平均住院时间和并发症情况,评估天玑Ⅱ机器人系统的临床应用效果。结果20例机器人辅助手术均顺利完成,共置入了92枚椎弓根螺钉。导针的入点偏差为1.44(0.93,1.93)mm,止点偏差为1.47(1.02,2.22)mm,综合偏差为1.55(0.96,1.99)mm。轴位角度偏差为1.90°(1.40°,2.20°),矢状位角度偏差为1.00°(0.60°,1.20°)。螺钉位置优秀率为90.2%,螺钉位置优良率为100%。手术时间为(206±60)min,术中出血量为200(113,200)mL,术后住院时间为5(4,6)d,未出现围手术期并发症。结论天玑Ⅱ机器人系统较前一代手术机器人进行了多项升级,有助于更加准确、高效地完成胸腰椎椎弓根螺钉内固定术。

Objective To investigate the clinical outcome of 2^(nd) generation TiRobot-assisted thoracolumbar pedicle screw fixation.,and to provide evidence for the clinical application of 2^(nd) generation TiRobot in spine surgery.Methods The 2^(nd) generation TiRobot optimizes the main control touch screen,the remote end and the tracker of the robotic arm.A total of 20 patients undergone 2^(nd) generation TiRobot-assisted thoracolumbar pedicle screw fixation at Beijing Jishuitan Hospital from December 2020 to May 2021 were analyzed.By measuring the guide-wire deviation(based on image fusion),screw accuracy(based on postoperative image),and perioperative data(operation time,intraoperative blood loss,postoperative hospital stay and complications),the clinical application of the 2^(nd) generation TiRobot system was evaluated.Results All 20 robot-assisted surgeries were completed successfully with a total of 92 pedicle screws inserted.The entry point deviation of the guide-wire was 1.44(0.93,1.93)mm,the end point deviation was 1.47(1.02,2.22)mm,and the mean deviation for each screw was 1.55(0.96,1.99)mm.The axial angular deviation was 1.90(1.40,2.20)°,and the sagittal angular deviation was 1.00(0.60,1.20)°.The perfect rate of screw position was 90.2%,and the clinically acceptable rate was 100%.The operation time was 206±60 minutes,the intraoperative blood loss was 200(113,200)mL,and the postoperative hospital stay was 5(4,6)days.There were no perioperative complications.Conclusions The 2^(nd) generation TiRobot system,undergone numerous upgrades compared with its previous generation,helps to complete the thoracolumbar pedicle screw internal fixation more accurately and efficiently.