Volume 19 Issue 1
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HE Liu, FANG Xuan-cheng, SHEN Cai-liang, LI Hao, LI Yu. Clinical study of robot-assisted placement of thoracolumbar pedicle screws[J]. Chinese Journal of General Practice, 2021, 19(1): 42-45. doi: 10.16766/j.cnki.issn.1674-4152.001725
Citation: HE Liu, FANG Xuan-cheng, SHEN Cai-liang, LI Hao, LI Yu. Clinical study of robot-assisted placement of thoracolumbar pedicle screws[J]. Chinese Journal of General Practice, 2021, 19(1): 42-45. doi: 10.16766/j.cnki.issn.1674-4152.001725
shu

Clinical study of robot-assisted placement of thoracolumbar pedicle screws

doi: 10.16766/j.cnki.issn.1674-4152.001725

  • Department of Spine Surgery, the First People's Hospital of Anqing, Anqing, Anhui 246003, China

Funds:

 2018YFC0114708

  • Received Date: 2020-07-10
    Available Online: 2022-02-19
    Abstract
  •   Objective  To explore the clinical effect of thoracic and lumbar pedicle screw placement with the assistance of a robotic system for orthopaedic surgery.  Methods  Total 40 patients underwent thoracolumbar pedicle screw internal fixation at the Department of Spine Surgery, Anqing First People's Hospital From August 2018 to May 2020 were divided into two groups: robot assisted operation group and "C" arm fluoroscopy group with 20 cases in each group according to the operation methods. The placement time of each pedicle screw and the number of intraoperative fluoroscopy were recorded, and the position (accuracy) of the two groups of screws was evaluated on the basis of postoperative X-ray and three-dimensional CT. Moreover, the accuracy and safety of screw placement were evaluated.  Results  In the robot-assisted surgery group, the average screw insertion time was (13.85±1.41) min, and in the "C" arm X-ray fluoroscopy, the screw insertion time was (14.03±1.84) min, and the difference between the two groups of data was not statistically significant (P>0.05). A total of 94 screws were placed in the robot-assisted surgery group (90 in Class Ⅰ screws, 4 in Class Ⅱ screws and 0 in Class Ⅲ screws), with an accuracy rate of 95.74% (90/94). Using the "C" arm X-ray fluoroscopy, a total of 96 screws (83 Grade Ⅰ screws, 10 Grade Ⅱ screws and 3 Grade Ⅲ screws) were placed in the nail placement group, with an accuracy rate of 86.46%(83/96). The difference between the two groups was significant (P < 0.05). The number of fluoroscopy in the robot-assisted surgery group was (8.15±1.53) times, and the number of fluoroscopy in the "C" arm X-ray fluoroscopy was (13.35±2.58) times. The difference between the two groups was statistically significant (P < 0.05).  Conclusion  The robot-assisted Tianji orthopaedic surgery can improve the accuracy and safety of pedicle screw placement and reduce intraoperative radiation, but it does not significantly increase the time of nail placement. Furthermore, it has a great application potential in spinal surgery.

     

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