Torii Yoshiaki, Ueno Jun, Iinuma Masahiro, Yoshida Atsuhiro, Niki Hisateru, Akazawa Tsutomu
Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan; Spine Center, St. Marianna University Hospital, Kawasaki, Japan.
Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan.
J Orthop Sci. 2023 Sep;28(5):961-965. doi: 10.1016/j.jos.2022.06.012. Epub 2022 Jul 19.
BACKGROUND: The purpose of this study was to verify whether a spine robotic system was useful for junior surgeons. METHODS: Twenty-seven patients underwent posterior spinal fusion with open surgery using a spine robotic system (Mazor X Stealth Edition, Medtronic Inc., Dublin, Ireland) from April to August 2021. Pedicle screw insertions were performed by five surgeons. The surgeon and insertion time were recorded for each pedicle screw. Two surgeons who are board-certified spine surgeons by the Japanese Society for Spine Surgery and Related Research (JSSR) were defined as the expert surgeon group. Three surgeons who were training to acquire qualifications as JSSR board certified spine surgeons were defined as the junior surgeon group. In postoperative CT images, the deviation of 255 pedicle screws was evaluated using the Gertzbein-Robbins (GR) grades. RESULTS: In the expert surgeon group, the GR grades were Grade A for 79 screws (90.8%), Grade B for 6 (6.9%), Grade C for 2 (2.3%), and 0 (0%) for Grades D and E. I In the junior surgeon group, the GR grades were Grade A for 162 screws (96.4%), Grade B for 6 (3.6%), and 0 (0%) for Grades C, D, and E. There was no significant difference in the deviation rate between surgeon groups (p = 0.08). The mean insertion times were 174.5 ± 83.0 s in the expert surgeon group and 191.0 ± 111.0 s in the junior surgeon group. There was no significant difference in the insertion time between surgeon groups (p = 0.22). CONCLUSIONS: There were no significant differences in the deviation rate and the insertion time of robotic-assisted pedicle screw placement between expert surgeons and junior surgeons who were training to acquire qualifications as JSSR board certified spine surgeons. Robotic-assisted pedicle screw placement can be effectively employed by junior surgeons.
背景:本研究的目的是验证脊柱机器人系统对初级外科医生是否有用。 方法:2021年4月至8月,27例患者使用脊柱机器人系统(Mazor X Stealth Edition,美敦力公司,爱尔兰都柏林)接受了开放性后路脊柱融合手术。椎弓根螺钉植入由5名外科医生完成。记录每枚椎弓根螺钉的手术医生及植入时间。两名通过日本脊柱外科学会及相关研究(JSSR)认证的脊柱外科医生被定义为专家外科医生组。三名正在接受培训以获取JSSR认证脊柱外科医生资格的外科医生被定义为初级外科医生组。在术后CT图像中,使用Gertzbein-Robbins(GR)分级评估255枚椎弓根螺钉的偏差。 结果:在专家外科医生组中,79枚螺钉(90.8%)的GR分级为A级,6枚(6.9%)为B级,2枚(2.3%)为C级,D级和E级为0枚(0%)。在初级外科医生组中,162枚螺钉(96.4%)的GR分级为A级,6枚(3.6%)为B级,C级、D级和E级为0枚(0%)。外科医生组之间的偏差率无显著差异(p = 0.08)。专家外科医生组的平均植入时间为174.5 ± 83.0秒,初级外科医生组为191.0 ± 111.0秒。外科医生组之间的植入时间无显著差异(p = 0.22)。 结论:在接受培训以获取JSSR认证脊柱外科医生资格的专家外科医生和初级外科医生之间,机器人辅助椎弓根螺钉置入的偏差率和植入时间没有显著差异。初级外科医生可以有效地使用机器人辅助椎弓根螺钉置入技术。
Eur J Orthop Surg Traumatol. 2023-7
Bone Joint J. 2023-5-1
J Robot Surg. 2024-3-30
Neurospine. 2023-12
Eur J Orthop Surg Traumatol. 2023-7