Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Shaanxi, 710016, PR China.
Xi'an Medical University, Xi'an, Shaanxi, China.
BMC Geriatr. 2024 Nov 6;24(1):916. doi: 10.1186/s12877-024-05447-7.
Manual placement of cervical pedicle screws is risky, and robot-assisted placement of atlantoaxial pedicle screws has not been reported.
We describe a 74-year-old female patient with atlantoaxial fracture and dislocation combined with spinal cord injury caused by a car accident. The left lower limb muscle strength was grade 0, the right upper limb muscle strength was grade 1, and the right lower limb muscle strength was grade 2. Loss of sensation below the clavicle level, decreased superficial sensation in the extremities, loss of deep sensation in the left lower extremity, and incontinence were observed. We successfully placed atlas pedicle screws with the assistance of the Mazor X robot. One week after the operation, radiological imaging revealed that the reduction effect was good, the placement of the pedicle screws was satisfactory, the left upper limb and left lower limb muscle strength was level 2, the right upper limb and the muscle strength of the right lower limb were grade 3, and the sensory function was partially restored. No complications related to screw placement were found at the 3-month postoperative follow-up.
Mazor X robot-assisted descending pedicle screw fixation of the atlas is feasible and safe.
手动放置颈椎椎弓根螺钉风险较大，而机器人辅助寰枢椎椎弓根螺钉的放置尚未见报道。
我们描述了一例 74 岁女性患者，因车祸导致寰枢椎骨折脱位合并脊髓损伤。左侧下肢肌力为 0 级，右侧上肢肌力为 1 级，右侧下肢肌力为 2 级。观察到锁骨平面以下感觉丧失，四肢浅感觉减退，左下肢深感觉丧失，以及尿失禁。我们成功地在 Mazor X 机器人的辅助下放置了寰椎椎弓根螺钉。术后 1 周，影像学检查显示复位效果良好，椎弓根螺钉位置满意，左侧上肢和左下肢肌力为 2 级，右侧上肢和右下肢肌力为 3 级，感觉功能部分恢复。术后 3 个月随访时未发现与螺钉放置相关的并发症。
Mazor X 机器人辅助下寰椎下椎弓根螺钉固定是可行和安全的。
