Clinical study of robot-assisted placement of thoracolumbar pedicle screws

HE Liu; FANG Xuan-cheng; SHEN Cai-liang; LI Hao; LI Yu

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

Volume 19 Issue 1

Jan. 2021

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Article Navigation > Chinese Journal of General Practice > 2021 > 19(1): 42-45

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

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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

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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

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.
- Pedicle screw,
- Internal fixation,
- Robotics,
- Surgical procedures

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References

[1]	朱如森, 冯世庆, 刘岩. 脊柱内固定椎弓根螺钉置入后生物力学的稳定性[J]. 中国组织工程研究, 2013, 17(17): 3156-3163. https://www.cnki.com.cn/Article/CJFDTOTAL-XDKF201317025.htm
[2]	LEE G W, SON J H, AHN M W, et al. The comparison of pedicle screw and cortical screw in posterior lumbar interbody fusion: a prospective randomized noninferiority trial[J]. Spine J, 2015, 15(7): 1519-1526. doi: 10.1016/j.spinee.2015.02.038
[3]	李彦明, 李明, 张国友, 等. 3D打印在脊柱侧凸矫形中的应用初探[J]. 第二军医大学学报, 2016, 37(02): 231-235. https://www.cnki.com.cn/Article/CJFDTOTAL-DEJD201602017.htm
[4]	BERTELSEN A, MELO J, SÁNCHEZ E, et al. A review of surgical robots for spinal interventions[J]. Int J Med Robot, 2013, 9(4): 407-422. doi: 10.1002/rcs.1469
[5]	FOLEY K T, SIMON D A, RAMPERSAUD Y R. Virtual fluoroscopy: computer-assisted fluoroscopic navigation[J]. Spine, 2001, 26(4): 347-351. doi: 10.1097/00007632-200102150-00009
[6]	赵燕鹏, 唐佩福. 骨科机器人及导航技术研究进展[J]. 中国矫形外科杂志, 2016, 24(3): 242-246. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJXS201603015.htm
[7]	BARZILAY Y, LIEBERGALL M, FRIDLANDER A, et al. The international journal of medical robotics and computer assisted surgery[J]. Int J Med Robot, 2006, 2(2): 146-153. doi: 10.1002/rcs.90
[8]	MOLLIQAJ G, SCHATLO B, ALAID A, et al. Accuracy of robot-guided versus freehand fluoroscopy-assisted pedicle screw insertion in thoracolumbar spinal surgery[J]. Neurosurgical Focus, 2017, 42(5): E14. doi: 10.3171/2017.3.FOCUS179
[9]	翟骁, 陈自强, 杨明园, 等. 国内首次机器人辅助椎弓根螺钉置入脊柱侧凸矫形手术(附14例报告)[J]. 第二军医大学学报, 2015, 36(11): 1161-1166. https://www.cnki.com.cn/Article/CJFDTOTAL-DEJD201511002.htm
[10]	刘华水, 段升军, 贾逢爽, 等. TiRobot机器人辅助经皮空心螺钉内固定治疗不稳定型骨盆骨折[J]. 山东大学学报(医学版), 2017, 55(7): 103-109. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYB201707019.htm
[11]	田伟, 王晋超, 刘亚军, 等, 上颈椎手术方式回顾及应用机器人辅助上颈椎手术的体会[J]. 中国医疗器械信息, 2017, 23(7): 9-13. doi: 10.3969/j.issn.1006-6586.2017.07.002
[12]	艾克帕尔·吾不利, 买买艾力·玉山. 微创脊柱内固定系统治疗无神经损伤胸腰椎骨折的临床疗效分析[J]. 中国临床研究, 2017, 30(5): 649-651. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCK201705020.htm
[13]	田伟, 范明星, 韩晓光, 等. 机器人辅助与传统透视辅助脊柱椎弓根螺钉内固定的临床对比研究[J]. 骨科临床与研究杂志, 2016, 1(1): 4-10. https://www.cnki.com.cn/Article/CJFDTOTAL-GKLC201601004.htm
[14]	范明星, 刘亚军, 段芳芳, 等. 机器人辅助胸腰椎椎弓根螺钉内固定术的学习曲线和临床意义[J]. 骨科临床与研究杂志, 2018, 3(4): 213-217. https://www.cnki.com.cn/Article/CJFDTOTAL-GKLC201804007.htm
[15]	刘亚军, 曾成, 范明星, 等. 俯卧位机器人辅助脊柱外科手术中呼吸运动导致体椎位移评估与测量[J]. 临床军医杂志, 2016, 44(10): 1015-1018. https://www.cnki.com.cn/Article/CJFDTOTAL-JYGZ201610007.htm
[16]	章仁杰, 申才良, 张华庆, 等. 骨科机器人辅助胸腰椎椎弓根螺钉内固定位置不良原因分析[J]. 颈腰痛杂志, 2019, 40(5): 577-582. doi: 10.3969/j.issn.1005-7234.2019.05.001

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Clinical study of robot-assisted placement of thoracolumbar pedicle screws

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