机器人辅助穿刺经皮椎体成形术治疗GenantⅢ型骨质疏松性椎体压缩骨折的疗效分析

Efficacy of robot-assisted percutaneous vertebroplasty in treating GenantⅢosteoporotic vertebral compression fracture

目的比较机器人辅助穿刺和徒手穿刺经皮椎体成形术(PVP)治疗GenantⅢ型骨质疏松性椎体压缩骨折(OVCF)的疗效。方法回顾性分析2020年1月至2022年6月23例接受PVP治疗的GenantⅢ型OVCF患者临床资料,机器人辅助穿刺PVP 12例(A组),徒手穿刺PVP 11例(B组)。比较两组患者穿刺次数、透视次数、手术时间、骨水泥渗漏情况,比较手术前、术后1 d、末次随访时疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)。结果A组手术时间为(37.25±2.60)min,B组手术时间为(39.55±6.85)min,两组差异无统计学意义(P>0.05)。A组穿刺次数、透视次数、骨水泥渗漏发生率均少于或低于B组,差异有统计学意义(P<0.05)。两组术后1 d、末次随访时VAS、ODI评分均较术前明显降低,差异有统计学意义(P<0.05);两组VAS、ODI评分组间比较,差异无统计学意义(P>0.05)。结论与徒手穿刺PVP相比,机器人辅助穿刺PVP治疗GenantⅢ型OVCF准确性高、术中透视次数减少、骨水泥渗漏率降低。

Objective To compare the clinical efficacy between robot-assisted puncture versus freehand puncture for percutaneous vertebroplasty(PVP)to treat GenantⅢosteoporotic vertebral compression fracture(OVCF).Methods A retrospective study on 23 patients with GenantⅢOVCF who underwent PVP surgery was performed in our hospital using data collected between Jan 2020 and June 2022.Twelve patients were treated by robot-assisted PVP(group A)and another 11 patients were treated by freehand PVP(group B).The two groups were compared with regard to number of punctures,operation time,number of fluoroscopies,cement leakage,and visual analogue scale(VAS),as well as Oswestry disability index(ODI)evaluated before operation,on post-operative day 1 and at the last follow-up after surgery.Results The mean operation time of group A was 37.25±2.60 minutes,which was not significantly shorter than that of group B(39.55±6.85 minutes)(P>0.05).However the number of punctures and fluoroscopies and rate of cement leakage in group A were all significantly less and lower,respectively,than those in group B(both P<0.05).The VAS and ODI scores on post-operative day 1 and at the last follow-up after surgery were both significantly lower than those before surgery(P<0.05),however,were no significant differences in these parameters between the two groups(P>0.05).Conclusion Robot-assisted puncture PVP to treat GenantⅢOVCF improves puncture accuracy,reduces the number of fluoroscopies required,and reduces bone cement leakage.