Tang Xuebin, Zhou Chengqiang, Li Hua, Liao Yifeng, Qiao Liang, Zhang Junwei, Wang Yunqing, Xie Lin
Department of Orthopaedics, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, Jiangsu, China.
Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, 210028, Jiangsu, China.
J Robot Surg. 2025 Jan 3;19(1):39. doi: 10.1007/s11701-024-02169-1.
The rising incidence of osteoporotic vertebral compression fractures (OVCF) has increased the demand for precise treatments like robot-assisted percutaneous vertebroplasty (PVP), especially for conditions like Kümmell's disease that require high surgical accuracy. However, the traditional tracer fixation method has certain limitations. This study aimed to compare the safety and clinical efficacy of a modified tracer fixation technique with the traditional fixation method in robot-assisted percutaneous vertebroplasty (PVP) for Kümmell's disease. A retrospective analysis was conducted on 88 patients treated between April 2023 and January 2024. The patients were divided into two groups based on the tracer fixation method: the modified group (skin-fixed, 47 cases) and the traditional group (spinous process-fixed, 41 cases). Outcomes were measured by VAS, ODI, Cobb angle, working channel establishment time, surgical duration, intraoperative blood loss, intraoperative fluoroscopy dose, and complication rates. Both groups showed significant improvements in VAS, ODI, and Cobb angle at postoperative days 2 and 6 months (P < 0.05). The modified group had significantly lower VAS and ODI scores on postoperative days 2, shorter working channel establishment and surgical duration, and less intraoperative blood loss (P < 0.05). However, no significant differences were found in intraoperative fluoroscopy dose or complication rates (P > 0.05). In conclusion, while both techniques are safe and effective, the modified skin-fixed tracer technique offers advantages in reducing surgical trauma, significantly shortening the surgical duration, decreasing intraoperative blood loss, and promoting early recovery.
骨质疏松性椎体压缩骨折（OVCF）发病率的上升增加了对机器人辅助经皮椎体成形术（PVP）等精确治疗的需求，尤其是对于需要高手术精度的Kümmell病等病症。然而，传统的示踪剂固定方法存在一定局限性。本研究旨在比较改良示踪剂固定技术与传统固定方法在机器人辅助经皮椎体成形术（PVP）治疗Kümmell病中的安全性和临床疗效。对2023年4月至2024年1月期间接受治疗的88例患者进行回顾性分析。根据示踪剂固定方法将患者分为两组：改良组（皮肤固定，47例）和传统组（棘突固定，41例）。通过视觉模拟评分法（VAS）、Oswestry功能障碍指数（ODI）、Cobb角、工作通道建立时间、手术时长、术中出血量、术中透视剂量和并发症发生率来评估结果。两组在术后第2天和6个月时VAS、ODI和Cobb角均有显著改善（P＜0.05）。改良组术后第2天的VAS和ODI评分显著更低，工作通道建立时间和手术时长更短，术中出血量更少（P＜0.05）。然而，术中透视剂量或并发症发生率未见显著差异（P＞0.05）。总之，虽然两种技术都安全有效，但改良的皮肤固定示踪剂技术在减少手术创伤、显著缩短手术时长、减少术中出血量和促进早期恢复方面具有优势。
