Department of Spine Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
J Comp Eff Res. 2021 Jul;10(10):845-856. doi: 10.2217/cer-2021-0078. Epub 2021 Apr 28.
To compare the screw accuracy and clinical outcomes between robot-assisted minimally invasive transforaminal lumbar interbody fusion (RA MIS-TLIF) and open TLIF in the treatment of one-level lumbar degenerative disease. From May 2018 to December 2019, a consecutive series of patients undergoing robot-assisted minimally invasive one-level lumbar fusion procedures were retrospectively compared with matched controls who underwent one-level open TLIF procedures for clinical and quality-of-life outcomes. A total of 52 patients underwent RA MIS-TLIF procedures (robot-assisted [RA] group) and 52 matched controls received freehand open TLIF procedures (open [OP] group). The RA group had more grade A screws with 96.2% one-time success rate of screw placement (p < 0.05). Besides, the RA group experienced less intraoperative blood loss and shorter length of hospital stay, while the OP group had shorter operative duration and cumulative radiation time (p < 0.001). What is more, the average VAS score for low back pain and ODI score in the RA group were lower than that in the OP group 1 month after operation (p < 0.05). The use of real-time, image-guided robot system may further expand the advantages of MIS-TLIF technique in terms of accuracy and safety.
比较机器人辅助微创经椎间孔腰椎间融合术(RA MIS-TLIF)与开放 TLIF 治疗单节段腰椎退行性疾病的螺钉准确性和临床疗效。 2018 年 5 月至 2019 年 12 月,回顾性比较了连续系列接受机器人辅助微创单节段腰椎融合术的患者与接受单节段开放 TLIF 术的匹配对照者的临床和生活质量结果。共有 52 例患者接受了 RA MIS-TLIF 手术(机器人辅助 [RA] 组),52 例匹配对照者接受了徒手开放 TLIF 手术(开放 [OP] 组)。RA 组有更多的 A 级螺钉,螺钉放置一次性成功率为 96.2%(p < 0.05)。此外,RA 组术中出血量较少,住院时间较短,而 OP 组手术时间和累积辐射时间较短(p < 0.001)。更重要的是,RA 组术后 1 个月的腰痛视觉模拟评分(VAS)和 ODI 评分均低于 OP 组(p < 0.05)。实时、图像引导机器人系统的使用可能会进一步扩大 MIS-TLIF 技术在准确性和安全性方面的优势。