Department of Neurologic Surgery, Mayo Clinic, Rochester, MN; Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic, Rochester, MN.
Department of Neurologic Surgery, Mayo Clinic, Jacksonville, FL.
Mayo Clin Proc. 2021 May;96(5):1193-1202. doi: 10.1016/j.mayocp.2020.07.034. Epub 2020 Dec 28.
OBJECTIVE: To highlight the early experience of implementing a robotic spine surgery program at a three-site medical center, evaluating the impact of increasing experience on the operative time and number of procedures performed. PATIENTS AND METHODS: A retrospective chart review of patients undergoing robotic screw placement between September 4, 2018, and October 16, 2019, was conducted. Baseline characteristics as well as intraoperative and post-operative outcomes were obtained. RESULTS: For a total of 77 patients, the mean age (SD) was 55.7 years (11.5) and 49.4% (n=38) were female. A total of 402 screws were placed (384 pedicle screws, 18 cortical screws) using robotic guidance with a median of two operative levels (interquartile range [IQR], 1 to 2). Median (IQR) estimated blood loss was 100 mL (50 to 200 mL) and the median (IQR) operative time was 224 minutes (193 to 307 minutes). With accrual of surgical experience, operative time declined significantly (R=-0.39; P<.001) whereas the number of procedures performed per week increased (R=0.30; P=.05) throughout the study period. Median (IQR) length of hospital stay following surgery was 2 days (IQR, 2 to 3 days). There were two screws requiring revision intraoperatively. No postoperative revisions were required, and no complications were encountered related to screw placement. CONCLUSION: Early experience at our institution using a spinal robot has demonstrated no requirement for postoperative screw revisions and no complications related to screw malposition. The increased operative times were reduced as the frequency of procedures increased. Moreover, procedural times diminished over a short period with a weekly increasing number of procedures.
目的:强调在一个三站点医疗中心实施机器人脊柱手术项目的早期经验,评估经验增加对手术时间和手术次数的影响。
患者和方法:对 2018 年 9 月 4 日至 2019 年 10 月 16 日期间接受机器人螺钉放置的患者进行了回顾性图表审查。获得了基线特征以及术中及术后结果。
结果:共 77 例患者,平均年龄(SD)为 55.7 岁(11.5),49.4%(n=38)为女性。共使用机器人导航放置了 402 枚螺钉(384 枚椎弓根螺钉,18 枚皮质螺钉),中位数为 2 个手术节段(四分位距[IQR],1 至 2)。中位数(IQR)估计失血量为 100 毫升(50 至 200 毫升),中位数(IQR)手术时间为 224 分钟(193 至 307 分钟)。随着手术经验的积累,手术时间显著下降(R=-0.39;P<.001),而每周手术次数增加(R=0.30;P=.05)。术后中位数(IQR)住院时间为 2 天(IQR,2 至 3 天)。有 2 枚螺钉术中需要修正。无术后螺钉修正,无螺钉位置不良相关并发症。
结论:本机构使用脊柱机器人的早期经验表明,不需要术后螺钉修正,也没有螺钉位置不当的并发症。随着手术频率的增加,手术时间增加。此外,随着每周手术次数的增加,手术时间在短时间内减少。
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