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新型手术机器人系统自主置入胸椎椎弓根螺钉的准确性研究
引用本文:李宗泽,陈建庭,朱青安,朱永健,崔玉辉,侯崛东,孙东辉,陈嘉瑞. 新型手术机器人系统自主置入胸椎椎弓根螺钉的准确性研究[J]. 生物骨科材料与临床研究, 2022, 19(2): 5-10
作者姓名:李宗泽  陈建庭  朱青安  朱永健  崔玉辉  侯崛东  孙东辉  陈嘉瑞
作者单位:南方医科大学南方医院骨科-脊柱骨科,广东 广州,510515,南方医科大学南方医院骨科-脊柱骨科,广东 广州,510515,南方医科大学南方医院骨科-脊柱骨科,广东 广州,510515,南方医科大学南方医院骨科-脊柱骨科,广东 广州,510515,南方医科大学南方医院影像诊断科,广东 广州,510515,南方医科大学南方医院骨科-脊柱骨科,广东 广州,510515,深圳市鑫君特智能医疗器械有限公司,广东 深圳,518000,深圳市鑫君特智能医疗器械有限公司,广东 深圳,518000
基金项目:国家自然科学基金(81972110);广东省科技计划项目(2017B010110012)
摘    要:目的 评估新型手术机器人机器人系统用于置入胸椎椎弓根螺钉的准确性。方法 选取3具成人脊柱标本行CT扫描并三维重建。在术者监视下,机器人遵循术前规划,于各胸椎椎弓根经皮自主置入克氏针,完成开路扩孔、攻丝和经皮置钉。置钉后再行薄层CT扫描,测量螺钉破壁情况评估置钉准确性,螺钉位置准确性的评价基于Gertzbein-Robbins分级标准。比较上胸椎(T1-T4)、中胸椎(T5-T8)、下胸椎(T9-T12)螺钉置入准确性的差异。结果 共置入胸椎椎弓根螺钉72枚,螺钉位置临床可接受率(A级或B级)为84.7%。胸椎不同分段间螺钉位置临床可接受率的差异无统计学意义(P>0.05),但下胸椎置钉优秀率(A级)更高(P<0.05)。结论 携带自主动力装置的新型手术机器人系统可准确置入胸椎椎弓根螺钉,置钉准确率与胸椎分段无关。

关 键 词:手术机器人  椎弓根螺钉  胸椎  准确性
收稿时间:2022-01-11
修稿时间:2022-02-27

The accuracy of thoracic pedicle screw insertion by a novel surgical robotic system
Chen Jianting,and. The accuracy of thoracic pedicle screw insertion by a novel surgical robotic system[J]. Orthopaedic Biomechanics Materials and Clinical Study, 2022, 19(2): 5-10
Authors:Chen Jianting  and
Affiliation:Department of Spinal Surgery, Nanfang Hospital, Southern Medical University,,,,,,
Abstract:Objective To evaluate the accuracy of a novel surgical robotic system on thoracic pedicle screw insertion.Methods Three adult spinal specimens were selected for CT scan and 3-D reconstruction. Under the supervision of the surgeon, the robotic system percutaneously drilled the K-wire into each thoracic pedicle followed the preoperative planning and successively complete reaming, tapping and percutaneous screw insertion. Thin-slice CT scan was performed after the screw was inserted. The perforation of pedicle by each screw was measured to evaluate the accuracy of screw placement based on the Gertzbein and Robbins Scale. And the accuracy of screw placement in upper thoracic vertebrae (T1-T4), middle thoracic vertebrae (T5-T8) and lower thoracic vertebrae (T9-T12) were compared in the study.Results A total of 72 thoracic pedicle screws were inserted. The clinical acceptability of the screw placement (Grade A or B) was 84.7%. And no significant difference was found in the clinical acceptability of screw insertion in the different thoracic segments (P>0.05). But the excellent rate of lower thoracic screw placement (Grade A) was significantly higher than other thoracic segments (P<0.05).Conclusion The novel surgical robot system with autonomous power device can precisely insert thoracic pedicle screws, and no correlation was found between the accuracy of screw insertion and the different thoracic segments.
Keywords:Surgical robotic system  Pedicle screw  Thoracic vertebrae  Accuracy
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