Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Friendship East Road, Xi'an City, 710054, Shaanxi Province, China.
Eur Spine J. 2021 Jan;30(1):142-150. doi: 10.1007/s00586-020-06641-y. Epub 2020 Oct 20.
To study radiological and clinical differences between robotic-assisted pedicle screw fixation with and without real-time optical tracking.
Patients who underwent lumbar internal fixation in our hospital from June 2017 to February 2020 were divided into Tinavi group (with optical tracking) and Renaissance group (without optical tracking) according to assisted technology. The imaging data of the patients were collected, and the accuracy of screw implantation was measured according to Rampersaud A-D grade. Clinical outcomes such as operative time, fluoroscopic time and radiations dose were also collected.
A total of 376 patients were included, including 201 patients in the Tinavi group with 968 screws implanted and 175 patients in the Renaissance group with 822 screws implanted. The accuracy of "perfect" and "clinically acceptable" pedicle screw implantation in the Tinavi group was 94.9%-98.7%, respectively, while in the Renaissance group was 91.2%-94.5%, respectively. There was significant difference between the two groups (P < 0.05). The operative time and operative time per screw in the Tinavi group were lower than those in the Renaissance group. However, fluoroscopic time per screw and radiations dose of the Tinavi group were significantly higher than those of the Renaissance group.
Optical tracking in robotic system appears to increase accuracy because of the ability to detect the real-time position of the patient. Although there are still many problems to be solved, robot with optical tracking system shows its great potential in clinical application.
研究具有和不具有实时光学跟踪的机器人辅助椎弓根螺钉固定的影像学和临床差异。
根据辅助技术将 2017 年 6 月至 2020 年 2 月在我院接受腰椎内固定的患者分为 Tinavi 组（具有光学跟踪）和 Renaissance 组（无光学跟踪）。收集患者的影像学资料，根据 Rampersaud A-D 分级测量螺钉植入的准确性。还收集了手术时间、透视时间和放射剂量等临床结果。
共纳入 376 例患者，其中 Tinavi 组 201 例，共植入 968 枚螺钉；Renaissance 组 175 例，共植入 822 枚螺钉。Tinavi 组“完美”和“临床可接受”椎弓根螺钉植入的准确性分别为 94.9%-98.7%，而 Renaissance 组分别为 91.2%-94.5%。两组之间存在显著差异（P < 0.05）。Tinavi 组的手术时间和每枚螺钉的手术时间均低于 Renaissance 组。然而，Tinavi 组的每枚螺钉透视时间和放射剂量明显高于 Renaissance 组。
机器人系统中的光学跟踪似乎可以通过检测患者的实时位置来提高准确性。尽管仍有许多问题需要解决，但具有光学跟踪系统的机器人在临床应用中显示出巨大的潜力。
