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天玑机器人辅助腰椎椎间融合术治疗退行性腰椎疾病的Meta分析:螺钉置入准确性及临床安全性的综合评估

Meta-analysis of TiRobot-assisted lumbar interbody fusion for degenerative lumbar disease: a comprehensive evaluation of screw placement accuracy and clinical safety.

作者信息

Zhou Yue, Dai Yupei, Shen Guohang, Si Lijing, Wang Kaiyong, Chen Yang, Wang Ruoyan

机构信息

North Sichuan Medical College, No. 234 Fu Jiang Road, Shunqing, Nanchong, 637000, Sichuan, People's Republic of China.

Department of Clinical Medicine, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan, 750004, People's Republic of China.

出版信息

J Robot Surg. 2025 Jul 3;19(1):346. doi: 10.1007/s11701-025-02536-6.

Abstract

This study focuses on the clinical management of lumbar degenerative diseases and employs meta-analysis methods to comprehensively investigate and compare the safety and pedicle screw placement accuracy of TiRobot-assisted technology versus freehand techniques in lumbar interbody fusion surgery. Although TiRobot-assisted lumbar interbody fusion has shown promise, existing studies report inconsistent findings. A systematic search was undertaken across four major databases-PubMed, Embase, the Cochrane Library, and Web of Science. The primary outcomes analyzed included operative time, intraoperative blood loss, pedicle screw placement accuracy, facet joint violation (FJV) grading, radiation exposure time and dose, and postoperative hospital stay. The meta-analysis demonstrated that the TiRobot group had considerable advantages over the freehand group with respect to reduced intraoperative blood loss, improved screw placement accuracy, lower FJV grade, decreased radiation dose, shorter hospital stay, and lower ODI scores (WMD < 0, p < 0.05). However, no significant advantage was noted in operative time (WMD > 0, p < 0.05). In summary, this study presents preliminary evidence supporting the superior safety and accuracy of TiRobot-assisted approaches in the management of lumbar degenerative diseases, suggesting its potential as a viable and safe alternative in clinical practice and offering valuable insights for future research.

摘要

本研究聚焦于腰椎退行性疾病的临床管理,并采用荟萃分析方法,全面调查和比较在腰椎椎间融合手术中,TiRobot辅助技术与徒手技术在安全性和椎弓根螺钉置入准确性方面的差异。尽管TiRobot辅助腰椎椎间融合术已展现出前景,但现有研究报告的结果并不一致。我们对四个主要数据库——PubMed、Embase、Cochrane图书馆和Web of Science进行了系统检索。分析的主要结局包括手术时间、术中失血量、椎弓根螺钉置入准确性、小关节侵犯(FJV)分级、辐射暴露时间和剂量以及术后住院时间。荟萃分析表明,TiRobot组在减少术中失血量、提高螺钉置入准确性、降低FJV分级、减少辐射剂量、缩短住院时间以及降低ODI评分方面(加权均数差<0,p<0.05)比徒手组具有显著优势。然而,在手术时间方面未发现显著优势(加权均数差>0,p<0.05)。总之,本研究提供了初步证据,支持TiRobot辅助方法在腰椎退行性疾病管理中具有更高的安全性和准确性,表明其在临床实践中作为一种可行且安全的替代方法的潜力,并为未来研究提供了有价值的见解。

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