Staartjes Victor E, Battilana Bianca, Schröder Marc L
Department of Neurosurgery, Bergman Clinics, Amsterdam, The Netherlands.
Department of Neurosurgery, University Hospital Zurich, Clinical Neuroscience Centre, University of Zurich, Zurich, Switzerland.
Neurospine. 2021 Mar;18(1):98-105. doi: 10.14245/ns.2040294.147. Epub 2020 Dec 14.
There have been no clinical studies comparing different robotic techniques. We compare minimally invasive, robot-guided transforaminal lumbar interbody fusion (RGTLIF) and mini-open robot-guided posterior lumbar interbody fusion (RG-PLIF).
Using data from a prospective institutional registry, we identified 38 patients who underwent RG-PLIF. Propensity score matching using a nearest-neighbor algorithm was implemented to select RG-TLIF controls. Twelve-month patient-reported outcome measures are presented. A reduction of ≥ 30% from baseline was defined as the minimum clinically important difference (MCID).
Among the 76 included patients, there was no difference between RG-TLIF and RG-PLIF in surgical time (132.3 ± 29.4 minutes vs. 156.5 ± 53.0 minutes, p = 0.162), length of stay (55.9 ± 20.0 hours vs. 57.2 ± 18.8 hours, p = 0.683), and radiation dose area product (310.6 ± 126.1 mGy × cm2 vs. 287.9 ± 90.3 mGy × cm2, p = 0.370). However, while there was no difference among the 2 groups in terms of raw postoperative patient-reported outcome measures scores (all p > 0.05), MCID in leg pain was greater for RG-PLIF (55.3% vs. 78.9%, p = 0.028), and MCID in Oswestry Disability Index was greater for RG-TLIF (92.1% vs. 68.4%, p = 0.009). There was no difference concerning back pain (81.6% vs. 68.4%, p = 0.185).
Our findings suggest that both RG-TLIF and RG-PLIF are viable and equally effective techniques in robotic spine surgery.
尚无比较不同机器人技术的临床研究。我们比较了微创机器人引导下经椎间孔腰椎椎间融合术（RGTLIF）和迷你开放机器人引导下腰椎后路椎间融合术（RG-PLIF）。
利用前瞻性机构登记处的数据，我们确定了38例行RG-PLIF的患者。采用最近邻算法进行倾向评分匹配，以选择RG-TLIF对照组。给出了患者报告的12个月结局指标。与基线相比降低≥30%被定义为最小临床重要差异（MCID）。
在纳入的76例患者中，RG-TLIF和RG-PLIF在手术时间（132.3±29.4分钟对156.5±53.0分钟，p = 0.162）、住院时间（55.9±20.0小时对57.2±18.8小时，p = 0.683）和辐射剂量面积乘积（310.6±126.1 mGy×cm²对287.9±90.3 mGy×cm²，p = 0.370）方面无差异。然而，虽然两组术后患者报告的原始结局指标评分无差异（所有p>0.05），但RG-PLIF的腿痛MCID更高（55.3%对78.9%，p = 0.028），RG-TLIF的Oswestry功能障碍指数MCID更高（92.1%对68.4%，p = 0.009）。背痛方面无差异（81.6%对68.4%，p = 0.185）。
我们的研究结果表明，RG-TLIF和RG-PLIF在机器人脊柱手术中都是可行且同样有效的技术。
