Li Haibo, Zou Juan, Yu Jianlin
Department of Orthopedics, Tianjin Hospital, Tianjin University, Tianjin, China.
Department of General Surgery, Shandong Wendeng Orthopedic Hospital, Weihai, China.
Clin Orthop Surg. 2024 Dec;16(6):948-961. doi: 10.4055/cios24086. Epub 2024 Nov 15.
The objective of this study was to investigate the impact of robot-assisted surgery (RA) on the risk of new vertebral compression fracture (NVCF) and bone cement leakage in patients with osteoporotic vertebral compression fractures (OVCF) after percutaneous vertebral augmentation (PVA), including percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP).
A meta-analysis was performed to evaluate the clinical outcomes and adverse effects of RA-PVA versus fluoroscopy-assisted (FA)-PVA in patients with OVCF. A validation cohort of 385 patients who underwent PVP or PKP was retrospectively analyzed. In addition, we attempted to create well-calibrated nomograms to estimate the risk of NVCF and bone cement leakage.
The meta-analysis revealed that the incidence of NVCF and bone cement leakage was significantly lower in RA-PVA than in FA-PVA. The validation cohort confirmed that RA-PVA provided better results than FA-PVA in terms of NVCF and bone cement leakage.
The meta-analysis and the validation cohort suggest that RA reduced the risk of NVCF and bone cement leakage in patients with OVCF after PVA. The nomograms are accurate and easy-to-implement methods for clinicians to estimate the risk of NVCF and bone cement leakage after PVA.
本研究的目的是调查机器人辅助手术（RA）对骨质疏松性椎体压缩骨折（OVCF）患者经皮椎体强化术（PVA，包括经皮椎体后凸成形术（PKP）和经皮椎体成形术（PVP））后新发椎体压缩骨折（NVCF）风险和骨水泥渗漏的影响。
进行一项荟萃分析，以评估RA-PVA与透视辅助（FA）-PVA治疗OVCF患者的临床结局和不良反应。对385例行PVP或PKP的患者组成的验证队列进行回顾性分析。此外，我们试图创建校准良好的列线图，以估计NVCF和骨水泥渗漏的风险。
荟萃分析显示，RA-PVA组的NVCF和骨水泥渗漏发生率显著低于FA-PVA组。验证队列证实，在NVCF和骨水泥渗漏方面，RA-PVA比FA-PVA效果更好。
荟萃分析和验证队列表明，RA降低了PVA后OVCF患者的NVCF和骨水泥渗漏风险。列线图是临床医生评估PVA后NVCF和骨水泥渗漏风险的准确且易于实施的方法。
