Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan.
Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Clin Interv Aging. 2022 Apr 22;17:589-599. doi: 10.2147/CIA.S359538. eCollection 2022.
Severe complications, including screw loosening events and low fusion rates, in spinal fusion surgery using the traditional open method are problematic. This retrospective study aimed to evaluate the rate of screw loosening and the clinical outcomes of bone-mounted miniature robot-assisted pedicle screw placement in patients treated for degenerative spinal disease.
Data were collected from the medical records of 118 patients (mean age, 69 years). Differences in clinical outcomes, including the Oswestry disability index, visual analog scale score, screw loosening rate, cage fusion rate, and complications, were evaluated among different bone mineral densities.
The screw loosening and cage fusion rates for all patients, normal bone mineral density, osteopenia, and osteoporosis groups were 12%, 8.6%, 13.1%, and 14%, respectively, and 85.3%, 93%, 82.5%, and 81.4%, respectively. There was a higher screw loosening rate and a lower cage fusion rate in the osteopenia and osteoporosis groups than in the normal bone density group. The accuracy of the screw placement was 97.3%. There were no statistically significant differences in the Oswestry disability index and visual analog scale scores, and no major complications for dural tear or vascular or visceral injury.
Our study demonstrated an acceptable screw loosening rate in patients with osteoporosis compared to that in patients with normal bone mineral density. The robotic system resulted in accurate screw placement in patients with osteoporosis.
传统开放式脊柱融合手术存在严重并发症，包括螺钉松动和融合率低等问题。本回顾性研究旨在评估骨载微型机器人辅助经皮螺钉置入术治疗退行性脊柱疾病患者的螺钉松动率和临床结果。
从 118 例患者（平均年龄 69 岁）的病历中收集数据。评估不同骨密度患者的临床结果（包括 Oswestry 残疾指数、视觉模拟评分、螺钉松动率、 cage 融合率和并发症）的差异。
所有患者、正常骨密度、骨质疏松和骨质减少组的螺钉松动和 cage 融合率分别为 12%、8.6%、13.1%和 14%，85.3%、93%、82.5%和 81.4%。骨质疏松和骨质减少组的螺钉松动率较高， cage 融合率较低，与正常骨密度组相比。螺钉放置的准确性为 97.3%。Oswestry 残疾指数和视觉模拟评分无统计学差异，无硬脑膜撕裂、血管或内脏损伤等重大并发症。
与正常骨密度患者相比，我们的研究显示骨质疏松患者的螺钉松动率可接受。机器人系统可实现骨质疏松患者螺钉的准确放置。
