Yang Chengzhi, Liu Gang, Tang Jingli, Li Gaorong, Qin Xi, Hu Juzheng
Trauma Center, Fourth Affiliated Hospital of Guangxi Medical University/Liuzhou Workers' Hospital, Liuzhou Guangxi, 545005, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2022 Aug 15;36(8):940-945. doi: 10.7507/1002-1892.202204043.
To investigate the effectiveness of TiRobot-assisted percutaneous sacroiliac cannulated screw fixation in the treatment of posterior pelvic ring injuries with sacral variations, and to evaluate its feasibility and safety.
The clinical data of 7 patients with Tile type C pelvic fractures and sacral variations treated with TiRobot-assisted percutaneous sacroiliac cannulated screw fixation between January 2020 and June 2021 were retrospectively analyzed. There were 5 males and 2 females with an average age of 36 years (range, 17-56 years). The causes of injury were traffic accident in 4 cases and falling from height in 3 cases. According to Tile classification of pelvic fractures, there were 1 case of type C1.1, 1 case of type C1.2, and 5 cases of type C1.3; according to Denis classification of sacral fractures, there were 3 cases of zone Ⅰ and 4 cases of zone Ⅱ; sacral deformities included 3 cases of lumbar sacralization, 2 cases of sacral lumbarization, and 2 cases of accessory auricular surface of the sacrum. The time from injury to operation ranged from 2 to 7 days, with an average of 4.6 days. The implantation time of each screw, the fluoroscopy times of each guide pin, the quality of fracture reduction (according to Matta score), the excellent and good rate of screw position, the healing time of fracture, and the incidence of complications were recorded, and the effectiveness was evaluated by Majeed score.
A total of 13 screws were implanted during the operation, the implantation time of each screw was 10-23 minutes, with an average of 18.2 minutes; the position of the guide pin was good, and no guide pin was adjusted, the fluoroscopy times of each guide pin were 3-7 times, with a median of 4 times. Postoperative imaging data at 3 days showed that the position of sacroiliac screw implantation was evaluated as excellent. No complication such as incision infection or vascular nerve injury occurred, and no adverse events related to robotic devices occurred. At 3 days after operation, according to Matta score, the quality of fracture reduction was excellent in 6 cases and good in 1 case, and the excellent and good rate was 100%. All the 7 patients were followed up 6-15 months, with an average of 12.4 months. Bone union was achieved in all patients, and the healing time ranged from 18 to 24 weeks, with an average of 21.2 weeks. Majeed score at last follow-up was 81-95, with an average of 91.5; 5 cases were excellent, 2 cases were good, and the excellent and good rate was 100%.
TiRobot-assisted percutaneous sacroiliac cannulated screw fixation for posterior pelvic ring injury with sacral variation is accurate, safe, minimally invasive, and intelligent, and the effectiveness is satisfactory.
探讨天玑机器人辅助下经皮骶髂关节空心螺钉固定术治疗伴有骶骨变异的骨盆后环损伤的有效性，并评估其可行性和安全性。
回顾性分析2020年1月至2021年6月间7例采用天玑机器人辅助下经皮骶髂关节空心螺钉固定术治疗的Tile C型骨盆骨折伴骶骨变异患者的临床资料。其中男性5例，女性2例，平均年龄36岁（17 - 56岁）。致伤原因：交通事故4例，高处坠落3例。根据Tile骨盆骨折分类，C1.1型1例，C1.2型1例，C1.3型5例；根据Denis骶骨骨折分类，Ⅰ区3例，Ⅱ区4例；骶骨畸形包括腰骶化3例，骶椎腰化2例，骶骨副耳状面2例。受伤至手术时间为2 - 7天，平均4.6天。记录每枚螺钉的植入时间、各导针透视次数、骨折复位质量（根据Matta评分）、螺钉位置优良率、骨折愈合时间及并发症发生率，并采用Majeed评分评估疗效。
术中共植入螺钉13枚，每枚螺钉植入时间为10 - 23分钟，平均18.2分钟；导针位置良好，无需调整，各导针透视次数为3 - 7次，中位数为4次。术后3天影像学资料显示骶髂关节螺钉植入位置评估为优。未发生切口感染、血管神经损伤等并发症，未发生与机器人设备相关的不良事件。术后3天，根据Matta评分，骨折复位质量优6例，良1例，优良率为100%。7例患者均获随访，随访时间6 - 15个月，平均12.4个月。所有患者均达到骨性愈合，愈合时间为18 - 24周，平均21.2周。末次随访时Majeed评分为81 - 95分，平均91.5分；优5例，良2例，优良率为100%。
天玑机器人辅助下经皮骶髂关节空心螺钉固定术治疗伴有骶骨变异的骨盆后环损伤准确、安全、微创、智能，疗效满意。
