Lai Juyi, Tan Huangsheng, Deng Pengwei, Wang Yinbo, Huang Yong, Feng Hualong, Lan Zhiming, Sun Zhitao, Wang Jian, Fu Yuanfei, He Shenghua
The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China.
Shenzhen Traditional Chinese Medicine Hospital, No.1, Fuhua Road, Futian District, Shenzhen, Guangdong Province, China.
BMC Surg. 2025 Aug 26;25(1):395. doi: 10.1186/s12893-025-03049-7.
This study aimed to evaluate the clinical efficacy and safety of TiRobot-assisted PVP surgery in the treatment of middle and upper thoracic OVCF. We also aimed to determine (1) changes in Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) before and after treatment, (2) imaging changes of the fractured vertebra, (3) operation time and intraoperative blood loss, (4) frequency of puncture and fluoroscopy, hospital stay, radiation exposure of patient and surgeon, and (5) bone cement leakage and distribution and operation-related complications.
A retrospective analysis was performed on 62 patients with OVCF of the middle and upper thoracic vertebrae (T1-T8) who underwent PVP surgery in Shenzhen Traditional Chinese Medicine Hospital from January 2017 to January 2023. Of them, 30 and 32 patients underwent TiRobot-assisted PVP surgery (robot group) and conventional C-arm-assisted PVP surgery (conventional group), respectively. VAS and ODI scores and the anterior height and local kyphotic angle of the fractured vertebra were compared before surgery and 3 days, 1 month, and 1 year after surgery. Simultaneously, the operation time, intraoperative blood loss, puncture frequency, fluoroscopy frequency, hospital stay, surgeon radiation exposure, patient radiation exposure, bone cement leakage, cement distribution, and complication were compared between the two groups.
VAS score and ODI score at 3 days, 1 month, and 1 year after surgery were significantly improved in both groups compared with those before surgery (p < 0.05). The VAS score of the robot group was lower than that of the conventional group 3 days after surgery (p < 0.05), with no significant difference observed before and after surgery (p > 0.05). No significant difference was observed in anterior height and local kyphotic angle of fractured vertebra between the two groups before and after the surgery (p > 0.05). The operation time, intraoperative blood loss, puncture frequency, fluoroscopy frequency, hospital stay, surgeon radiation exposure, patient radiation exposure, bone cement leakage, and cement distribution of the robot group were all better than those of the conventional group (p < 0.05). Simultaneously, the incidence of complications in the robot group was 3.33% (1/30) lower than that of the conventional group (15.62%) (5/32) (p < 0.05).
Compared with traditional PVP surgery, the use of TiRobot-assisted PVP in the treatment of middle and upper thoracic OVCF has the advantages of accuracy, safety, and low-radiation exposure, which can further improve surgical safety, reduce bone cement leakage, and achieve satisfactory clinical efficacy.
本研究旨在评估天玑机器人辅助经皮椎体后凸成形术（PVP）治疗中上位胸椎骨质疏松性椎体压缩骨折（OVCF）的临床疗效和安全性。我们还旨在确定：（1）治疗前后视觉模拟评分法（VAS）和奥斯维辛残疾指数（ODI）的变化；（2）骨折椎体的影像学变化；（3）手术时间和术中出血量；（4）穿刺和透视频率、住院时间、患者和术者的辐射暴露；（5）骨水泥渗漏及分布情况以及与手术相关的并发症。
对2017年1月至2023年1月在深圳市中医院接受PVP手术的62例中上位胸椎（T1-T8）OVCF患者进行回顾性分析。其中，30例和32例患者分别接受了天玑机器人辅助PVP手术（机器人组）和传统C型臂辅助PVP手术（传统组）。比较手术前及术后3天、1个月和1年时的VAS和ODI评分以及骨折椎体的前缘高度和局部后凸角。同时，比较两组的手术时间、术中出血量、穿刺频率、透视频率、住院时间、术者辐射暴露、患者辐射暴露、骨水泥渗漏、骨水泥分布及并发症情况。
与术前相比，两组术后3天、1个月和1年时的VAS评分和ODI评分均显著改善（p＜0.05）。机器人组术后3天的VAS评分低于传统组（p＜0.05），术前和术后比较差异无统计学意义（p＞0.05）。两组手术前后骨折椎体的前缘高度和局部后凸角比较差异无统计学意义（p＞0.05）。机器人组的手术时间、术中出血量、穿刺频率、透视频率、住院时间、术者辐射暴露、患者辐射暴露、骨水泥渗漏及骨水泥分布均优于传统组（p＜0.05）。同时，机器人组的并发症发生率比传统组低3.33%（1/30比15.62%（5/32））（p＜0.05）。
与传统PVP手术相比，天玑机器人辅助PVP治疗中上位胸椎OVCF具有精准、安全、低辐射暴露的优点，可进一步提高手术安全性，减少骨水泥渗漏，取得满意的临床疗效。
