BÄcker Henrik C, Freibott Christina E, Perka Carsten, Weidenbaum Mark
Department of Orthopaedic Surgery, Columbia University Medical Center-Presbyterian Hospital, The Spine Hospital at New York Presbyterian, New York, New York.
Center for Muskuloskeletal Surgery, Charité Berlin, University Hospital Berlin, Berlin, Germany.
Int J Spine Surg. 2020 Oct;14(5):818-823. doi: 10.14444/7116. Epub 2020 Oct 23.
A few articles on robot-assisted pedicle screw placement described the learning curve but failed to report on the overall operative time, including cases in which the robotic system malfunctioned. The purpose of this study was to identify a single surgeon's learning curve including estimated blood loss, surgery time, anesthesia time, robot time, and complications.
A retrospective study was performed between January 2016 and August 2018 for patients who underwent posterior spinal fusion using the Mazor robot. Based on the charts, the robot time, time of anesthesia, and surgery time were recorded, as were the complications, misplacement of screws, and blood loss.
Of 62 robot-assisted surgeries scheduled, only 46 were performed (74.2%) upon patients with a mean age of 63.3 ± 13.0 years. The mean follow-up time was 13.2 ± 8.0 months and most commonly a fusion from L4 to S1 was performed (20/46, 43.5%). A high improvement in estimated intraoperative blood loss was observed of 755.7 ± 344.7 mL (slope = -9.89). A decrease in time in anesthesia, surgery, and robotic usage was identified with a slope factor of -3.64 ( = .22, SE = 85.4, < .005), -3.97 ( = 0.30, SE 75.8, < .005), -0.69 ( = .07, SE = 27.8, < .09), respectively. Furthermore, a decrease in pedicle screw insertion time and operative time was found (slope = -0.05, = .02, SE = 3.4, = .37). In total, 5 major complications (cases 8, 19, 21, 35, 43) and 6 minor complications (cases 4, 14, 15, 20, 29), were identified (21.7%) without any learning curve.
Robot pedicle screw insertion shows no major learning curve; however, the blood loss and the installation process of the system improved with experience.
几篇关于机器人辅助椎弓根螺钉置入的文章描述了学习曲线，但未报告总体手术时间，包括机器人系统发生故障的病例。本研究的目的是确定单一外科医生的学习曲线，包括估计失血量、手术时间、麻醉时间、机器人使用时间和并发症。
对2016年1月至2018年8月间使用Mazor机器人进行后路脊柱融合术的患者进行回顾性研究。根据病历记录机器人使用时间、麻醉时间和手术时间，以及并发症、螺钉误置和失血量。
在计划的62例机器人辅助手术中，仅对46例患者进行了手术（74.2%），患者平均年龄为63.3±13.0岁。平均随访时间为13.2±8.0个月，最常见的是进行L4至S1融合（20/46，43.5%）。观察到估计术中失血量有显著改善，为755.7±344.7 mL（斜率=-9.89）。麻醉时间、手术时间和机器人使用时间均有所减少，斜率因子分别为-3.64（R² = 0.22，SE = 8
