机器人辅助椎弓根外穿刺经皮后凸成形术
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高鑫峰,副主任医师,研究方向:脊柱外科,(电话)13871166769,(电子信箱)wuhangaoxinfeng@163.com

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R687

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Robot-assisted extrapedicular percutaneous kyphoplasty
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    摘要:

    [目的] 探讨骨科机器人辅助下经椎弓根外入路穿刺后凸成形术(percutaneous kyphoplasty, PKP) 治疗骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fracture, OVCF) 的疗效。[方法] 回顾性分析2019 年3 月—2022 年3 月单侧椎弓根外入路穿刺PKP 治疗OVCF 的43 例患者的临床资料。根据医患沟通结果,18 例采用机器人辅助导航穿刺(机器人组),25 例采用传统透视引导穿刺(透视组)。对比分析两组围手术期、随访及影像学资料。[结果] 机器人组手术时间显著长于透视组[(43.5±5.2) min vs (26.2±4.9) min, P<0.001],但是,机器人组术中透视次数显著少于透视组[(3.3±0.8) 次vs (8.8±3.3) 次, P<0.001]。两组穿刺成功率、骨水泥渗漏率、下地行走时间、住院天数的差异均无统计学意义(P>0.05)。术后平均随访时间(19.8±5.7) 个月,两组恢复完全负重活动时间的差异无统计学意义(P>0.05)。术后随时间推移,两组患者VAS、ODI 评分均显著减少(P<0.05),相应时间点,两组间VAS、ODI 评分的差异均无统计学意义(P>0.05)。影像方面,两组骨水泥分布优秀率比较差异无统计学意义(P>0.05),两组术后局部后凸Cobb 角、椎体前缘相对高度均显著改善(P<0.05)。相应时间点,两组间的上述影像指标的差异均无统计学意义(P>0.05)。[结论] 机器人导航可以减少透视次数,但是增加了手术时间,可以作为目前手术方法的一种有益补充。

    Abstract:

    [Objective] To investigate the clinical outcomes of robot-assisted extrapedicular percutaneous kyphoplasty (PKP) for thetreatment of osteoporotic vertebral compression fracture (OVCF). [Methods] A retrospective study was conducted on 43 patients who re-ceived extrapedicular PKP for OVCF from March 2019 to March 2022. According to the preoperative doctor-patient communication, 18cases underwent robot-assisted puncture (robot group), while other 25 cases underwent traditional fluoroscopy guided puncture (fluoroscopygroup). The perioperative, follow-up and imaging data of the two groups were compared and analyzed. [Results] Although the robot groupconsumed significantly longer operative time than the fluoroscopy group [(43.5±5.2) min vs (26.2±4.9) min, P<0.001], the former was signifi-cantly less than the latter in term of intraoperative fluoroscopy number [(3.3±0.8) times vs (8.8±3.3) times, P<0.001]. There were no signifi-cant differences in first puncture success rate, bone cement leakage rate, walking time and hospitalization days between the two groups (P>0.05). The mean follow-up time was (19.8±5.7) months, and there was no significant difference between the two groups in the time to returnto full weight-bearing activities (P>0.05). The VAS and ODI scores were significantly decreased in both groups over time (P<0.05), whichwere not significantly different between the two groups at any corresponding time points (P>0.05). As for imaging, there was no significantdifference in the excellence rate of bone cement distribution between the two group (P>0.05). The local kyphotic Cobb angle and the rela-tive anterior vertebral height significantly improved postoperatively compared with those preoperatively in both groups (P<0.05), whereaswhich proved not statistically significant between the two groups at any time points accordingly (P>0.05). [Conclusion] Robotic navigationcan reduce the number of fluoroscopy, but increase the operation time, and can be a useful supplement to current surgical methods.

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高鑫峰,夏韶襁,赵志刚,等. 机器人辅助椎弓根外穿刺经皮后凸成形术[J]. 中国矫形外科杂志, 2024, (6): 487-492. DOI:10.3977/j. issn.1005-8478.2024.06.02.
GAO Xin-feng, XIA Shao-qiang, ZHAO Zhi-gang, et al. Robot-assisted extrapedicular percutaneous kyphoplasty[J]. ORTHOPEDIC JOURNAL OF CHINA , 2024, (6): 487-492. DOI:10.3977/j. issn.1005-8478.2024.06.02.

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  • 收稿日期:2023-12-22
  • 最后修改日期:2024-03-05
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  • 在线发布日期: 2024-03-26
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