机器人辅助脊柱手术的历史、前沿与未来趋势

History and trends of robot-assisted spine surgery

脊柱手术机器人自第1代发展至今已有20年历史,目前关键技术已日趋完善,出现了以器械内植物可视化导航、无导丝植钉为特征的第4代机型。机器人辅助脊柱手术(robot-assisted spine surgery,RSS)技术基础原理包括手术计划、追踪、图像注册以及机械臂控制技术。目前,该技术已成熟应用于胸腰椎手术中,在颈椎手术、脊柱肿瘤手术以及经皮脊柱手术等脊柱外科领域尚处于初期阶段,在精确定位、减少手术创伤,从而改善患者预后方面具有优势。RSS技术前沿研究同时关注临床成本效益分析以及机器人特异性并发症。随着人工智能技术实现与机器人手术计划的结合,RSS技术将进一步整合其他新兴技术,应用于更广泛的临床场景中。

Spanning two decades since the 1st generation spinal robotics inception,the robot-assisted spine surgery(RSS)technology has evolved through generations,culminating in the 4th generation characterized by real-time visual navigation and wire-free screw placement.The fundamental principles of RSS technology include surgical planning,tracking,image registration,and robotic arm control technologies.Currently,RSS technology is maturely employed in thoracolumbar procedures and is progressively being applied in cervical surgeries,spinal tumor resections,and percutaneous operations,offering advantages in reducing tissue trauma and exposure to radiation,thereby improving patient outcomes.Emerging research also focuses on the cost-effectiveness of clinical applications and robot-specific complications.With the integration of artificial intelligence into surgical planning,RSS technology is poised to further incorporate emerging technologies and expand its application across a broader clinical spectrum.