机器人辅助经皮穿刺椎体成形术治疗老年骨质疏松性椎体压缩骨折的疗效分析

Effectiveness of robot-assisted percutaneous vertebroplasty for osteoporotic vertebral compression fracture in the elderly

目的 探讨机器人辅助经皮穿刺椎体成形术(percutaneous vertebroplasty,PVP)治疗老年骨质疏松性椎体压缩骨折的疗效。方法 回顾性分析2019年6月-2021年3月四川省科学城医院收治的90例老年骨质疏松性椎体压缩骨折患者的临床资料,其中机器人辅助PVP患者40例(观察组),C臂透视辅助PVP患者50例(对照组);记录并比较两组患者手术前后疼痛视觉模拟评分法(Visual Analogue Scale,VAS)评分、手术前后Oswestry功能障碍指数(Oswestry Disability Index,ODI)评分、术中骨水泥渗漏情况、术中C臂透视次数、手术时间、手术前后血红蛋白浓度的差异。结果 观察组术中骨水泥渗漏发生率(5%vs. 20%)、术中C臂透视次数[(18.3±3.2)vs.(41.3±7.8)次]、手术时间[(28.3±4.6)vs.(43.2±7.3) min]、血红蛋白丢失量[(7.2±2.0)vs.(15.2±4.4)g/L]均少于对照组(P<0.05),观察组与对照组手术后VAS评分、ODI评分改善值的差异均无统计学意义[(3.63±1.64)vs.(3.40±1.65)分,P>0.05;(50.70±4.95)vs.(52.10±6.69)分,P>0.05]。结论 机器人辅助PVP治疗老年骨质疏松性椎体压缩骨折可显著降低骨水泥渗漏风险,缩短手术时间,减少术中C臂透视次数,降低手术隐性失血量,可于临床推广和应用。

Objective To evaluate the effectiveness of robot-assisted percutaneous vertebroplasty(PVP) in the treatment of osteoporotic vertebral compression fracture(OVCF) in the elderly. Methods The clinical data of 90 elderly patients with OVCF treated in Sichuan Science City Hospital between June 2019 and March 2021 were retrospectively analyzed. The patients were divided into robot-assisted group(40 cases) and C-arm-assisted group(50 cases). The preand post-operative Visual Analogue Scale(VAS) score, pre-and post-operative Oswestry Disability Index(ODI) score,intraoperative cement leakage, intraoperative fluoroscopy frequency, operation time, and the loss of hemoglobin were recorded and compared between the two groups. Results The incidence of intraoperative cement leakage(5% vs. 20%),intraoperative fluoroscopy frequency [(18.3±3.2) vs.(41.3±7.8) times], operation time [(28.3±4.6) vs.(43.2±7.3) min] and the loss of hemoglobin [(7.2±2.0) vs.(15.2±4.4) g/L] of the robot-assisted group were less than those of the C-arm-assisted group(P<0.05). There was no statistically significant difference between the two groups in the decrease of VAS score or ODI score(3.63±1.64 vs. 3.40±1.65, P>0.05;50.70±4.95 vs. 52.10±6.69, P>0.05). Conclusions Robot-assisted PVP for elderly patients with OVCF can significantly reduce the risk of cement leakage, shorten the operation time, reduce the intraoperative fluoroscopy frequency, and reduce the surgical hidden blood loss. It can be used for clinical promotion and application.