脊柱手术中机器人辅助与徒手椎弓根螺钉固定的前瞻性、随机、对照试验。

A prospective, randomized, controlled trial of robot-assisted vs freehand pedicle screw fixation in spine surgery.

作者信息

Kim Ho-Joong, Jung Whan-Ik, Chang Bong-Soon, Lee Choon-Ki, Kang Kyoung-Tak, Yeom Jin S

机构信息

Spine Center and Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Sungnam, Republic of Korea.

Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, Republic of Korea.

出版信息

Int J Med Robot. 2017 Sep;13(3). doi: 10.1002/rcs.1779. Epub 2016 Sep 27.

DOI:10.1002/rcs.1779

PMID:27672000

Abstract

BACKGROUND

The purpose of this study was to compare the accuracy and safety of an instrumented posterior lumbar interbody fusion (PLIF) using a robot-assisted minimally invasive (Robot-PLIF) or a conventional open approach (Freehand-PLIF).

METHODS

Patients undergoing an instrumented PLIF were randomly assigned to be treated using a Robot-PLIF (37 patients) and a Freehand-PLIF (41 patients).

RESULTS

For intrapedicular accuracy, there was no significant difference between the groups (P = 0.534). For proximal facet joint accuracy, none of the 74 screws in the Robot-PLIF group violated the proximal facet joint, while 13 of 82 in the Freehand-PLIF group violated the proximal facet joint (P < 0.001). The average distance of the screws from the facets was 5.2 ± 2.1 mm and 2.7 ± 1.6 mm in the Robot-PLIF and Freehand-PLIF groups, respectively (P < 0.001).

CONCLUSION

Robotic-assisted pedicle screw placement was associated with fewer proximal facet joint violations and better convergence orientations.

摘要

背景

本研究的目的是比较使用机器人辅助微创腰椎后路椎间融合术（Robot-PLIF）与传统开放手术（徒手PLIF）在腰椎后路椎间融合术（PLIF）中的准确性和安全性。

方法

接受器械辅助PLIF的患者被随机分配接受Robot-PLIF治疗（37例患者）和徒手PLIF治疗（41例患者）。

结果

在椎弓根内准确性方面，两组之间无显著差异（P = 0.534）。在近端小关节准确性方面，Robot-PLIF组的74枚螺钉均未侵犯近端小关节，而徒手PLIF组的82枚螺钉中有13枚侵犯了近端小关节（P < 0.001）。Robot-PLIF组和徒手PLIF组螺钉距小关节的平均距离分别为5.2±2.1mm和2.7±1.6mm（P < 0.001）。