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机器人技术对于经验较少的脊柱畸形外科医生很有用。

Robotics is useful for less-experienced surgeons in spinal deformity surgery.

机构信息

Department of Orthopaedic Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.

Spine Center, St. Marianna University Hospital, Kawasaki, Japan.

出版信息

Eur J Orthop Surg Traumatol. 2023 Jul;33(5):1805-1810. doi: 10.1007/s00590-022-03362-4. Epub 2022 Aug 17.

Abstract

PURPOSE

To verify whether robotics was useful for surgeons who had less experience with spinal deformity surgery.

METHODS

A retrospective review was conducted of 70 consecutive patients who underwent robotic-assisted pedicle screw placements with open procedures using a spine robotic system (Mazor X Stealth Edition) at a single institution from April 2021 to April 2022. Gertzbein-Robbins grades were used to assess the deviation of the 599 pedicle screws in the postoperative CT images. The rate of Grade A was considered the perfect accuracy rate, and the rate of Grades C, D, and E was calculated as the deviation rate. The perfect accuracy rate and deviation rate were compared between the spinal deformity and the non-deformity groups. The perfect accuracy rate, deviation rate, and screw insertion time were compared in the spinal deformity cases between the expert surgeon group and the less-experienced surgeon group.

RESULTS

The deviation rate of the spinal deformity group was higher than that of the non-deformity group even though there was no statistically significant difference (spinal deformity group: 2.3%, non-deformity group: 1.2%, p = 0.350). In the spinal deformity cases, there was no significant difference in the perfect accuracy rate between the expert surgeon group and the less-experienced surgeon group, but the deviation rate was significantly lower in the less-experienced surgeon group (expert surgeon group: 5.0%, less-experienced surgeon group: 0%, p = 0.008). The screw insertion time was significantly shorter in the less-experienced surgeon group.

CONCLUSION

Robotics is particularly useful for surgeons with less experience in spinal deformity surgery.

摘要

目的

验证机器人技术对于脊柱畸形手术经验较少的外科医生是否有用。

方法

对 2021 年 4 月至 2022 年 4 月在一家单机构使用脊柱机器人系统(Mazor X Stealth Edition)进行机器人辅助椎弓根螺钉置入的 70 例连续患者进行回顾性研究。使用 Gertzbein-Robbins 分级评估术后 CT 图像中 599 个椎弓根螺钉的偏差。A级被认为是完美的准确率,C、D 和 E 级的比例计算为偏差率。比较脊柱畸形组和非畸形组的完美准确率和偏差率。比较脊柱畸形病例中专家外科医生组和经验较少的外科医生组的完美准确率、偏差率和螺钉插入时间。

结果

尽管差异无统计学意义(脊柱畸形组:2.3%,非畸形组:1.2%,p=0.350),但脊柱畸形组的偏差率高于非畸形组。在脊柱畸形病例中,专家外科医生组和经验较少的外科医生组之间的完美准确率无显著差异,但经验较少的外科医生组的偏差率显著较低(专家外科医生组:5.0%,经验较少的外科医生组:0%,p=0.008)。经验较少的外科医生组的螺钉插入时间明显缩短。

结论

机器人技术对于脊柱畸形手术经验较少的外科医生特别有用。

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