脊柱手术机器人在胸腰椎骨折微创手术中的应用

目的:探讨Renaissance机器人导航系统在胸腰椎骨折微创手术中应用的安全性和准确性.方法:对2016年7月至2019年7月采用后路微创椎弓根钉内固定治疗的胸腰椎骨折患者进行回顾性分析,按置钉方式的不同分为机器人组及徒手组,机器人组采用机器人导航辅助置钉,徒手组采用传统徒手置钉法置钉.机器人组20例,男13例,女7...

Application of spinal surgical robots in minimally invasive surgery for thoracolumbar fracture

Objective: To evaluate the safety and accuracy of Renaissance robot navigation system in minimally invasive surgery for thoracolumbar fracture.Methods: The clinical data of patients with thoracolumbar fracture who underwent posterior minimally invasive pedicle screw internal fixation from July 2016 to July 2019 was retrospectively analyzed. And the patients were divided into robot group and artificial group. Robot navigation assisted screw placement was used in robot group,and traditional unarmed screw placement was used in artificial group. There were 20 patients in robot group,including 13 males and 7 females,aged from 23 to 69 years old with an average of(45.05±11.81)years old,one case was T₁₁ fracture,2 cases were T₁₂,10 cases were L₁,6 cases were L₂ and 1 case was L₃. There were 20 patients in artificial group,including 11 males and 9 females,aged from 26 to 65 years old with an average of(43.40±11.22)years old,2 cases were T₁₁ fractures,7 cases were T₁₂,10 cases were L₁,and 1 case was L₃. The numbers of fluoroscopy,operation time and intraoperative blood loss were observed. The screw position was evaluated by Neo method.Results: A total of 126 screws were implanted in robot group and 124 screws were implanted in artificial group. The operation time,fluoroscopy times,intraoperative blood loss were(115.75±14.26) min,(7.95±0.89) times and (132.50±29.36) ml in robot group and (129.50±10.50) min,(14.40±2.56) times and(182.50±23.14) ml in artificial group,respectively,there was significant difference between the groups(P<0.05). According to Neo classification method,there were 122 screws at grade 0,4 screws at grade 1 in robot group,and there were 108 screws at grade 0,9 screws at grade 1 and 7 screws at grade 2 in artificial group. The accuracy of the robot group was better than that of artificial group(P<0.05).Conclusion: Compared with free hand screw placement,Renaissance robot navigation system can effectively improve the accuracy of pedicle screw placement,reduce the number of fluoroscopy times and intraoperative blood loss,thereby improving the safety of operation.