机器人辅助经皮椎体成形术对治疗胸腰椎压缩性骨折的临床疗效分析

Clinical efficacy analysis of robot-assisted percutaneous vertebroplasty in the treatment of thoracolumbar compression fracture

目的分析机器人辅助经皮椎体成形术(PVP)对治疗骨质疏松性椎体压缩性骨折(OVCF)的临床疗效与安全性。方法2023年9月至2024年1月新疆医科大学第六附属医院脊柱外科行机器人辅助PVP的患者41例;其中男4例,女37例;BMI(23.8±4.0)kg/m^(2);年龄(70.5±9.3)岁;病椎包括T10椎体3例、T11椎体5例、T12椎体6例、L1椎体13例、L2椎体7例、L3椎体3例、L4椎体4例。观察其骨水泥灌注量、透视次数、骨水泥渗漏率、手术时间、术后住院时间及其他并发症发生情况;同时对比机器人辅助组术前、术后椎体中线高度、Cobb角、ODI评分及疼痛视觉模拟评分(VAS)。结果机器人辅助PVP骨水泥渗漏率为7.3%(3/41),手术(穿刺及骨水泥推注)(31.9±4.7)min,透视(12.1±1.3)次,术后住院(3.2±0.8)d;41例患者均未发生术后感染及并发症。术后1 d VAS(2.0±0.8)分,Cobb角(8.9°±5.2°),均低于术前[(5.0±0.9)分、(12.6°±6.2°)]。术后1 d椎体中线高度(19.8±5.2)mm高于术前(16.6±5.3)mm,差异均有统计学意义(均P<0.05)。结论机器人辅助PVP治疗胸腰椎压缩性骨折是一种可行、有效、安全的方法,可获得满意的临床疗效。

Objective To analyse the clinical efficacy and safety of robot-assisted percutaneous vertebroplasty(PVP)for the treatment of osteoporotic vertebral body compression fracture(OVCF).Methods From September 2023 to January 2024,41 patients who underwent robot-assisted PVP in the Department of Spine Surgery of the Sixth Affiliated Hospital of Xinjiang Medical University.There were 4 males and 37 females,BMI(23.8±4.0)kg/m^(2),age(70.5±9.3)years.Distribution of diseased vertebrae included T10 vertebrae in 3 cases,T11 vertebrae in 5 cases,T12 vertebrae in 6 cases,L1 vertebrae in 13 cases,L2 vertebrae in 7 cases,L3 vertebrae in 3 cases,L4 vertebrae in 4 cases.The amount of bone cement instilled,the number of fluoroscopes,the rate of cement leakage,and the duration of the procedure were observed.The time of postoperative hospitalisation and the occurrence of other complications,preoperative,postoperative vertebral midline heights,Cobb angles,Oswestry disability index(ODI)and visual analogue scale(VAS)were also compared in the robot-assisted group.Results Robot-assisted PVP bone cement leakage rate was 7.3%(3/41),operative time(puncture and cement injection)(31.9±4.7)min,the number of fluoroscopies(12.1±1.3),and the time of postoperative hospitalisation(3.2±0.8)d.No postoperative infections or complications occurred in any of the 41 patients.Postoperative 1 day VAS was(2.0±0.8)and Cobb angle(8.9°±5.2°)were lower than preoperative[(5.0±0.9)and(12.6°±6.2°)].The postoperative 1 day vertebral midline height(19.8±5.2)mm was higher than the preoperative height(16.6±5.3)mm,and the differences were statistically significant(P<0.05).Conclusion Robot-assisted PVP for the treatment of thoracolumbar compression fractures is a feasible,effective,safe method,and can achieve satisfactory clinical outcomes.