机器人辅助经皮螺钉治疗胸腰椎骨折的疗效分析

Analysis of therapeutic effect of robot-assisted percutaneous screw in the treatment of thoracolumbar fractur

目的探究PSIS-A机器人辅助经皮螺钉治疗胸腰椎骨折的临床效果。方法选择2022年8月—2024年1月因胸腰椎骨折于绵阳市骨科医院住院需行经皮椎弓根螺钉内固定术的患者。通过随机数字表分组法将纳入患者分为机器人组与徒手组。比较两组患者手术时间、术中出血、术中辐射剂量及时间、植钉准确率、小关节侵犯率、疼痛视觉模拟评分法评分等指标。结果共纳入患者60例。其中,机器组28例,徒手组32例。机器人组术后第3天疼痛视觉模拟评分法评分优于徒手组(P=0.003)。除术中出血量、术中辐射次数外(P>0.05),机器人组的手术时间、平均植钉时间、术中辐射剂量均低于徒手组(P<0.05)。机器人组植钉准确优秀率高于徒手组(94.6%vs.84.9%;χ^(2)=7.806,P=0.005);机器人组和徒手组的植钉准确可接受率(96.4%vs.91.1%;χ^(2)=3.240,P=0.072)、螺钉小关节侵犯率(7.2%vs.14.1%;χ^(2)=3.608,P=0.058)比较,差异均无统计学意义。结论PSIS-A型机器人辅助经皮微创椎弓根螺钉内固定术治疗胸腰椎骨折应用前景巨大。

Objective To explore the clinical effect of PSIS-A robot-assisted percutaneous screw in the treatment of thoracolumbar fracture.Methods Patients with thoracolumbar fracture who were hospitalized in Mianyang Orthopedic Hospital between August 2022 and January 2024 and required percutaneous pedicle screw f ixation were selected.Patients were divided into robot group and free hand group by random number table.Operative time,intraoperative bleeding,intraoperative radiation dose and time,implant accuracy rate,small joint invasion rate,Visual Analogue Scale score for pain and other indexes were compared between the two groups.Results A total of 60 patients were included.Among them,there were 28 cases in the robot group and 32 cases in the free hand group.On the third day after surgery,the Visual Analogue Scale score of the robot group was better than that of the free hand group(P=0.003).Except for intraoperative bleeding and radiation frequency(P>0.05),the surgical time,average nail implantation time,and intraoperative radiation dose in the robot group were all lower than those in the free hand group(P<0.05).The accuracy and excellence rate of nail planting in the robot group were higher than those in the free hand group(94.6%vs.84.9%;χ^(2)=7.806,P=0.005).There was no statistically significant difference in the acceptable accuracy rate(96.4%vs.91.1%;χ^(2)=3.240,P=0.072)and the incidence of screw facet joint invasion(7.2%vs.14.1%;χ^(2)=3.608,P=0.058)between the two groups.Conclusion The application of PSIS-A type robot assisted percutaneous minimally invasive pedicle screw fixation in the treatment of thoracolumbar fr actures is promising.