| 付松,邵诗泽,王龙强,侯海涛,王亚楠,刘海军,王欢,黄相鹏,吕仁花.机器人经皮置钉Quadrant通道下减压、椎间融合治疗腰椎滑脱症[J].脊柱外科杂志,2017,15(1):7-12. |
机器人经皮置钉Quadrant通道下减压、椎间融合治疗腰椎滑脱症  点此下载全文 (Fulltext) |
| 付松1 邵诗泽1 王龙强1 侯海涛1 王亚楠1 刘海军1 王欢1 黄相鹏1 吕仁花2 |
1. 山东省文登整骨医院脊柱脊髓科, 山东 264400;
2. 山东省威海市文登中心医院骨科, 山东 264423 |
| 基金项目： |
| DOI：10.3969/j.issn.1672-2957.2017.01.002 |
| 摘要点击次数: 1146 |
| 全文下载次数: 566 |
| 摘要： |
| 目的 总结机器人经皮置入椎弓根螺钉辅助Quadrant通道下减压、椎间融合治疗腰椎滑脱症的手术技巧并分析其短期疗效。方法 2014年6月-2015年3月，山东省文登整骨医院脊柱脊髓科手术治疗腰椎滑脱症患者39例。利用机器人进行术前规划，安放机器人机械臂，按照术前规划经皮置入椎弓根螺钉，在Mast Quadrant通道辅助下行减压、椎间融合术。记录手术时间、置钉时间、术中出血量、术后引流量，统计螺钉置入准确率及术中、术后的并发症发生情况。术后2周及1、6、12个月进行随访，随访指标包括Oswestry功能障碍指数（ODI）、疼痛视觉模拟量表（VAS）评分、反映滑脱程度的Taillard指数、滑脱间隙的椎间隙高度以及椎间融合情况。结果 39例患者手术均顺利完成，其中36例获得随访。术中出血量为（266.8±61.6）mL，手术时间为（115.3±32.8）min，机器人经皮置入单枚螺钉时间为（1.4±0.6）min，术后引流量为（196.4±69.5）mL。术后随访，各个时间点VAS评分、ODI、Taillard指数较术前降低，滑脱间隙的椎间隙高度较术前增高，差异均有统计学意义（P<0.05）。术后12个月随访时CT显示椎间均达到骨性愈合，未见椎间融合器移位、内固定断裂等并发症。结论 机器人经皮置钉辅助Quadrant通道下减压、椎间融合术操作安全、简单，置钉准确率高，容易掌握，对于腰椎滑脱症具有较好的临床疗效。 |
| 关键词：腰椎 脊椎滑脱 机器人 脊柱融合术 减压术,外科 |
| Treatment of lumbar spondylolisthesis with Quadrant-assisted decompression and interbody fusion by using a robot percutaneous insertion of pedicle screws Fulltext |
| FU Song1 SHAO Shi-ze1 WANG Long-qiang1 HOU Hai-tao1 WANG Ya-nan1 LIU Hai-jun1 WANG Huan1 HUANG Xiang-peng1 LÜ Ren-hua2 |
1. Department of Spinal and Spinal Cord, Shandong Wendeng Osteopath Hospital, Weihai 264400, Shandong, China;
2. Department of Orthopaedics, Weihai Wendeng Central Hospital, Weihai 264423, Shandong, China |
| Fund Project: |
| Abstract: |
| Objective To summarize the surgical technique and short term curative effect of Quadrant-assisted decompression and interbody fusion by using a robot percutaneous insertion of pedicle screws for lumbar spondylolisthesis. Methods From June 2014 to March 2015, 39 patients with lumbar spondylolisthesis were treated using robot to make preoperative planning and in stall robot manipulator in Shandong Wendeng Osteopath Hospital. According to preoperative planning, pedicle screws were placed percutaneously. Mast Quadrant-assisted decompression and interbody fusion were performed for the treatment of lumbar spondylolisthesis. The operation time, time of screws insertion, amount of bleeding during operation, volume of drainage, accuracy of screw insertion and complications after operation and during operation were observed and recorded. Oswestry dysfunction index (ODI), pain Visual Analogue Scale (VAS) score, Taillard index, the intervertebral height and the fusion of the intervertebral space were observed during the follow-up periods at 2 weeks and 1, 6 and 12 months. Results All the 39 patients were successfully operated and 36 were followed up. Intraoperative blood loss was (266.8±61.6) mL, operation time(115.3±32.8) min, time of screws insertion by robot (1.4±0.6) min, and the average volume of drainage (196.4±69.5) mL. The VAS score, ODI and Taillard index were decreased, and the intervertebral height were increased compared with pre-operation, all showing statistically significant difference (P<0.05). At 12 months follow-up, CT showed bone healing, no interbody fusion cage shift and no internal fixation fracture. Conclusion The robot percutaneous insertion of pedicle screws with Quadrant-assisted decompression and interbody fusion is safe, simple, of high accuracy and easy to grasp, and has a good clinical efficacy for treating lumbar spondylolisthesis. |
| Keywords:Lumbar vertebrae Spondylolysis Robotics Spinal fusion Decompression, surgical |
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