单体位下斜外侧腰椎间融合术联合机器人辅助后路内固定治疗腰椎退行性疾病

目的:探讨单体位下斜外侧入路腰椎间融合术(oblique lumbar interbody fusion,OLIF)联合机器人辅助后路内固定治疗腰椎退行性病变的疗效.方法:对2019年9月至2020年12月收治的67例腰椎退行性病变患者进行回顾性分析,根据手术方式不同,分为传统OLIF联合后路透视经皮置钉内固定组(传统...

Single oblique lumbar interbody fusion with robot-assisted posterior internal fixation for lumbar degenerative diseases

Objective: To investigate the efficacy of single oblique lumbar interbody fusion(OLIF) with robot-assisted posterior internal fixation for the treatment of lumbar degenerative diseases.Methods: The clinical data of 67 patients with lumbar degenerative diseases treated from September 2019 to December 2020 was retrospectively analyzed. According to different surgical methods,the patients were divided into traditional group and robot group. The traditional group received traditional OLIF with posterior fluoroscopy percutaneous nail fixation,and the robot group received OLIF with robot-assisted posterior internal fixation. There were 33 patients in traditional group,including 13 males and 20 females,aged from 44 to 82 years old with an average of (59.7±9.1) years; and 34 cases in robot group,including 7 males and 27 females,aged from 45 to 81 years old with an average of(61.6±8.8) years. The operation time,fluoroscopy time,intraoperative blood loss,postoperative out of bed time and hospital stay were recorded. The visual analogue scale (VAS) of low back pain and Oswestry Disability Index(ODI) were compared before operation and 3 days,3 months after operation between two groups. The accuracy of nail placement was evaluated by postoperative CT scan.Results: Both groups of patients successfully completed the operation and were followed up for more than 3 months. The operation time,fluoroscopy time,intraoperative blood loss,postoperative out of bed time and hospital stay in traditional group were(299.85±15.79) min,(62.58±10.83) min,(118.33±10.80) ml,(2.5±0.7) d,(9.67±2.13) d;and robot group was(248.53±14.22) min,(19.47±3.51) min,(115.74±9.86) ml,(2.3±0.6) d,(9.44±1.93) d,respectively. The symptoms of postoperative low back pain,lower limb pain and numbness were significantly improved in all patients. The operation time and fluoroscopy time in robot group were significantly less than those of traditional group. There was no significant difference in intraoperative blood loss,postoperative out of bed time,hospital stay,VAS and ODI before and after operation (P>0.05). The accuracy of nail placement in robot group was 98.8% (2/160),which was higher than 89.9% (16/158) in traditional group.Conclusion: Treatment of lumbar degenerative diseases with single body position OLIF with robot-assisted posterior minimally invasive internal fixation has less operation time and fluoroscopy time,high nail placement accuracy and accurate surgical effect,which is worthy to be popularized in clinic.