Lin Shu, Hu Jiang, Wan Lun, Tang Liuyi, Wang Yue, Yu Yang, Zhang Wei
Department of Orthopedics, Sichuan Academy of Medical Science, People's Hospital of Sichuan Province, Chengdu Sichuan, 610072, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Sep 15;34(9):1136-1141. doi: 10.7507/1002-1892.202002131.
To evaluate the safety and effectiveness of robot-guided percutaneous kyphoplasty (PKP) in treatment of multi-segmental thoracolumbar osteoporotic vertebral compression fracture (OVCF).
A clinical data of 63 cases with multi-segmental thoracolumbar OVCF without neurologic deficit treated with PKP between October 2017 and February 2019 were analyzed retrospectively. The patients were divided into robot-guided group (33 cases) and traditional fluoroscopy group (30 cases). There was no significant difference in gender, age, fracture segment, bone mineral density, and preoperative visual analogue scale (VAS) score, midline vertebral height, and Cobb angle between the two groups ( >0.05). The time to establish the tunnel, the times of fluoroscopy, the dose of fluoroscopy, the deviation of puncture, the distribution of bone cement, the leakage of bone cement, the puncture angle, and the postoperative VAS score, midline vertebral height, and Cobb angle were recorded and compared.
The patients in two groups were followed up 11-13 months (mean, 12 months). Compared with traditional fluoroscopy group, the time to establish the tunnel, the times and dose of fluoroscopy in robot-guided group were significantly lower, the deviation of puncture was slighter, the distribution of bone cement was better, and the puncture angle was larger, the differences between the two groups were significant ( <0.05). There were 8 segments (9.3%, 8/86) of bone leakage in robot-guided group and 17 segments (22.6%, 17/75) in traditional fluoroscopy group, the difference between the two groups was significant ( =5.455, =0.020). There was no significant difference in VAS score, the midline vertebral height, and Cobb angle between the two groups at 2 days after operation and last follow-up ( >0.05).
Robot-guided PKP in treatment of multi-segmental thoracolumbar OVCF can shorten the operation time, improve the accuracy of puncture, reduce the times and dose of fluoroscopy, reduce the leakage of bone cement, and achieve better cement distribution.
评估机器人引导下经皮椎体后凸成形术（PKP）治疗多节段胸腰椎骨质疏松性椎体压缩骨折（OVCF）的安全性和有效性。
回顾性分析2017年10月至2019年2月期间采用PKP治疗的63例无神经功能缺损的多节段胸腰椎OVCF患者的临床资料。将患者分为机器人引导组（33例）和传统透视组（30例）。两组患者在性别、年龄、骨折节段数、骨密度、术前视觉模拟评分（VAS）、椎体中线高度及Cobb角等方面差异均无统计学意义（P>0.05）。记录并比较两组建立通道时间、透视次数、透视剂量、穿刺偏差、骨水泥分布、骨水泥渗漏、穿刺角度以及术后VAS评分、椎体中线高度和Cobb角。
两组患者随访11~13个月（平均12个月）。与传统透视组比较，机器人引导组建立通道时间、透视次数及剂量明显减少，穿刺偏差更小，骨水泥分布更佳，穿刺角度更大，差异均有统计学意义（P<0.05）。机器人引导组发生骨水泥渗漏8节段（9.3%，8/86），传统透视组发生17节段（22.6%，17/75），两组差异有统计学意义（χ²=5.455，P=0.020）。术后2天及末次随访时两组VAS评分、椎体中线高度及Cobb角差异均无统计学意义（P>0.05）。
机器人引导下PKP治疗多节段胸腰椎OVCF可缩短手术时间，提高穿刺准确性，减少透视次数及剂量，减少骨水泥渗漏，且骨水泥分布更佳。
