Luo Kaihang, Zou Xuenong, Chen Wei, Cui Shangbin, Liu Shaoyu, Chen Liuyun, Zhou Lin
Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China.
Department of Ophthalmology, The University of Hong Kong Sheznhen Hospital, Shenzhen, Guangdong, China.
Eur Spine J. 2025 Jan;34(1):105-117. doi: 10.1007/s00586-024-08510-4. Epub 2024 Nov 1.
This study aims to evaluate the accuracy and safety of C1 lateral mass and upper cervical pedicle screw placement assisted by the TiRobot II system.
Ten patients who underwent cervical spine surgery assisted by the TiRobot II system were included. Screw accuracy was assessed using the Gertzbein-Robbins scale and by comparing the final screw positions with pre-planned trajectories. Deviations in screw tip, tail, and angle were recorded. Clinical data, including symptoms, surgical outcomes, and postoperative follow-up, were collected. Neurological improvement was evaluated using pre- and post-operative mJOA scores, with recovery rates calculated by Hirabayashi's method to assess outcomes 3 months after surgery.
A total of 30 screws were placed in 10 patients. All screws (30/30) were within the clinically acceptable range, with 93.33% (28 screws) classified as Grade A and 6.67% (2 screws) as Grade B. In the sagittal plane, the average tip deviation was 1.82 ± 0.79 mm, tail deviation 1.64 ± 0.60 mm, and angular deviation 1.92 ± 1.39°. In the axial plane, tip deviation was 1.96 ± 0.87 mm, tail deviation 1.92 ± 0.65 mm, and angular deviation 2.01 ± 1.07°. The average surgery time was 318.80 ± 66.07 min, with a mean EBL of 205.00 ± 55.03 mL. Postoperative mJOA scores significantly improved from 8.10 ± 1.97 to 12.60 ± 1.78 (p < 0.05), with a 52 ± 14% recovery rate. All patients showed significant symptom improvement.
The TiRobot II system demonstrates the capability to precisely execute pre-planned trajectories and improves the accuracy and safety of C1 lateral mass and upper cervical screw placement.
本研究旨在评估TiRobot II系统辅助下C1侧块和上颈椎椎弓根螺钉置入的准确性和安全性。
纳入10例接受TiRobot II系统辅助颈椎手术的患者。使用Gertzbein-Robbins量表并通过将最终螺钉位置与术前规划轨迹进行比较来评估螺钉准确性。记录螺钉尖端、尾部和角度的偏差。收集临床数据，包括症状、手术结果和术后随访情况。使用术前和术后的改良日本骨科协会（mJOA）评分评估神经功能改善情况，并采用平林法计算恢复率以评估术后3个月的结果。
10例患者共置入30枚螺钉。所有螺钉（30/30）均在临床可接受范围内，其中93.33%（28枚螺钉）为A级，6.67%（2枚螺钉）为B级。在矢状面，平均尖端偏差为1.82±0.79mm，尾部偏差为1.64±0.60mm，角度偏差为1.92±1.39°。在轴位面，尖端偏差为1.96±0.87mm，尾部偏差为1.92±0.65mm，角度偏差为2.01±1.07°。平均手术时间为318.80±66.07分钟，平均估计失血量（EBL）为205.00±55.03毫升。术后mJOA评分从8.10±1.97显著提高至12.60±1.78（p<0.05），恢复率为52±14%。所有患者症状均有显著改善。
TiRobot II系统显示出精确执行术前规划轨迹的能力，并提高了C1侧块和上颈椎螺钉置入的准确性和安全性。
