机器人辅助置钉在成人退变性脊柱侧弯矫形术中的应用

Application of robot assisted nail placement in adult degenerative scoliosis surgery

目的探讨机器人辅助置钉在成人退变性脊柱侧弯(adult degenerative scoliosis,ADS)矫形术中的准确性和安全性。方法选取2021年1月~2021年12月因ADS就诊、行后路短节段矫形植骨融合内固定术的患者32例,其中机器人置钉15例,徒手置钉17例。分析比较两组术中出血量、平均置钉时间、术后并发症发生率及置钉准确率。结果两组手术均顺利结束,均未出现椎弓根螺钉相关的神经、血管损伤及深部感染。与徒手组相比,机器人组术中出血量、平均置钉时间减少,差异有统计学意义(P<0.05);术后复查影像学,机器人组置钉准确率明显高于徒手组,差异有统计学意义(P<0.05)。结论机器人辅助置钉在ADS手术中能够更加精准地置入椎弓根螺钉,而且缩短置钉时间、减少出血量。

Objective To investigate the accuracy and safety of robot-assisted pedicle screw implantation in adult degenerative scoliosis(ADS)surgery.Methods A total of 32 patients with ADS who received posterior short-segment instrumented fusion were selected from January 2021 to December 2021.Among them,15 cases were treated with robot-assisted pedicle screw implantation(robot group),and 17 cases with free-hand pedicle screw implantation(free-hand group).The amount of intraoperative blood loss,the average screw placement time,the incidence of postoperative complications and the accuracy of screw placement were analyzed and compared between the two groups.Results The operation was successfully completed in both two groups,and there was no injury of nerve and blood vessel related to pedicle screw and deep infection.Compared with the free-hand group,intraoperative blood loss and average screw placement time in the robot group were decreased,with statistically significant differences(P<0.05).Postoperative imaging showed that the accuracy of screw placement in the robot group was significantly higher than that in the free-hand group,with statistically significance difference(P<0.05).Conclusion Robot-assisted screw placement can be more accurate in ADS surgery,shorten the screw placement time and reduce the amount of blood loss.