机器人辅助椎弓钉固定强直性脊柱炎胸腰椎骨折

Robot-assisted pedicle screw fixation of thoracolumbar fracture in ankylosing spondylitis

[目的]分析机器人辅助椎弓钉固定治疗强直性脊柱炎胸腰椎骨折的临床效果。[方法]回顾性分析2016年1月—2021年6月收治的15例强直性脊柱炎胸腰椎骨折患者资料,根据医患沟通结果,8例采用机器人辅助置钉,7例采用徒手置钉。比较两组围手术期情况和随访结果。[结果]两组患者均顺利完成手术。机器人组置钉准确性、住院费用明显高于徒手组(P<0.05),而术中透视次数和透视剂量明显低于徒手组(P<0.05)。两组患者恢复完全负重活动时间的差异无统计学意义(P>0.05)。随时间推移,两组患者VAS、ODI评分均显著减少(P<0.05),而JOA评分显著增加(P<0.05)。相应时间点,两组VAS、ODI、JOA评分的比较差异均无统计学意义(P>0.05)。[结论]机器人辅助椎弓钉固定治疗AS胸腰椎骨折可提高置钉准确性高,降低辐射伤害,提高手术安全性。

[Objective]To evaluate the clinical results of robot-assisted pedicle screw fixation of thoracolumbar fracture of ankylosing spondylitis(AS).[Methods]A retrospective study was conducted on 15 patients who received surgical treatment for thoracolumbar fracture complicated with ankylosing spondylitis from January 2016 to June 2021.According to the doctor-patient communication,8 patients re⁃ceived robot-assisted screw placement,while the remaining 7 patients were treated with freehand secrew placement.The perioperative con⁃ditions and follow-up results were compared between the two groups.[Results]All the patients in both groups had operation completed suc⁃cessfully.The robot group proved significantly superior to the freehand group in term of accuracy of screw placement,whereas the former had significantly less intraoperative fluoroscopy and fluoroscopy dose,and significant greater hospitalization cost than the latter(P<0.05).There was no significant difference between two groups in the time to resume full weight-bearing activity(P>0.05).The VAS and ODI scores significantly decreased(P<0.05),while JOA scores significantly increased in both groups over time(P<0.05),which were not statisti⁃cally significant between the two groups at any corresponding time points(P>0.05).[Conclusion]Robot-assisted pedicle screw fixation of AS thoracolumbar fractures does improve the accuracy of screw insertion,reduce radiation injury,and improve the safety of surgery.