机器人外科学杂志（中英文）2025，Vol.6Issue(2)：210-216,7.DOI:10.12180/j.issn.2096-7721.2025.02.004
不同模式下骨科手术机器人微创经椎间孔入路腰椎椎间融合术的置钉准确性与手术效率比较
Comparison of nail placement accuracy and surgical efficiency of orthopedic robot-assisted minimally invasive transforaminal lumbar interbody fusion under different modes
摘要
Abstract
Objective:To compare the nail placement accuracy and surgical efficiency of orthopedic robot-assisted minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)with intraoperative X-ray and CT alignment.Methods:57 patients who underwent robotic-assisted MIS-TLIF from June 2020 to June 2023 in Qilu Hospital of Shandong University were selected.They were divided into the X-ray alignment group(n=19),the CT alignment group(n=19)and the freehand group(n=19).Patients in the above three groups underwent intraoperative X-ray alignment-assisted pedicle screw placement,intraoperative CT alignment-assisted pedicle screw placement and freehand pedicle screw placement,respectively.Screw placement accuracy,rate of superior level facet joint violations,number of intraoperative fluoroscopies,bleeding,radiation exposure level,postoperative length of hospital stay,and clinical outcomes among the three groups were compared.Meanwhile,operative time were compared between the X-ray-aligned group and CT-aligned group.Results:There was no statistically significant difference in bleeding,postoperative length of hospital stay,and lumbar spondylolisthesis segments among the three groups(P＞0.05).Postoperative VAS and ODI scores of the three groups were significantly improved compared with those before surgery(P＜0.05).Intraoperative radiation exposure in the X-ray alignment group was lower than that in the CT alignment group,and they were both lower than that in the freehand group(P＜0.05).There was no statistically significant difference in the clinically acceptable screw placement and rate of superior level facet joint violations among the three groups of patients(P＞0.05).The X-ray alignment group has lower alignment and planning time(P＜0.05),and higher robot equipping and nail placement time than the CT alignment group(P＜0.05),but the difference in the total operative time between the two groups was not statistically significant(P＞0.05).The total operative times of the X-ray-aligned group and CT-aligned group were higher than that of the freehand group(P＜0.05).Conclusion:Robot-assisted MIS-TLIF with X-ray and CT alignment intraoperatively has high nail placement accuracy and safety,low radiation exposure,which can be used as an effective adjunct to MIS-TLIF.关键词
骨科手术机器人/微创经椎间孔入路腰椎椎间融合术/X线配准/CT配准/置钉准确性/手术效率Key words
Orthopaedic Surgical Robot/Minimally Invasive Transforaminal Lumbar Interbody Fusion/X-ray Alignment/CT Alignment/Nail Placement Accuracy/Surgical Efficiency分类
医药卫生引用本文复制引用
王辉,孙小刚,田永昊,原所茂,王连雷,刘新宇..不同模式下骨科手术机器人微创经椎间孔入路腰椎椎间融合术的置钉准确性与手术效率比较[J].机器人外科学杂志（中英文）,2025,6(2):210-216,7.基金项目
国家自然科学基金(81874022,82172483,82102522) （81874022,82172483,82102522）
山东省重点研发计划(2022CXGC01050) （2022CXGC01050）
山东省自然科学基金(ZR202102210113) （ZR202102210113）
山东省泰山学者项目(tsqn202211317) （tsqn202211317）
中央高水平医院临床研究基金(2022-PUMCH-D-004) National Natural Science Foundation of China(81874022,82172483,82102522) （2022-PUMCH-D-004）
Key R&D Plan Project of Shandong Province(2022CXGC01050) （2022CXGC01050）
Natural Science Foundation of Shandong Province(ZR202102210113) （ZR202102210113）
Shandong Taishan Scholars Project(tsqn202211317) （tsqn202211317）
Clinical Research Fund of the Central High-level Hospital(2022-PUMCH-D-004) （2022-PUMCH-D-004）
