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李金健,李晓军,于建林,段修杨,王哲,林海朋,姜传杰,杨永军,张卫,谭远超,席焱海,王伟恒.机器人辅助置钉与椎弓根边界法置钉治疗胸腰椎骨折的疗效比较[J].脊柱外科杂志,2024,22(3):152-157.
机器人辅助置钉与椎弓根边界法置钉治疗胸腰椎骨折的疗效比较     点此下载全文 (Fulltext)
李金健1  李晓军1  于建林1*  段修杨1  王哲1  林海朋1  姜传杰1  杨永军1  张卫1  谭远超1  席焱海2  王伟恒2
1. 山东省文登整骨医院脊柱脊髓二科, 威海 264400;
2. 海军军医大学长征医院骨科, 上海 200003
基金项目:山东省中医药科技项目(Z-2022028)
DOI:10.3969/j.issn.1672-2957.2024.03.002
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摘要:
      目的 比较机器人辅助置钉与椎弓根边界法置钉治疗单纯胸腰椎骨折的疗效。 方法 2021年1月—2021年10月,山东省文登整骨医院采用椎弓根钉棒内固定治疗无神经损伤的单纯胸腰椎骨折患者60例,其中30例采用椎弓根边界法置钉(边界组),30例采用机器人辅助置钉(机器人组)。记录手术时间、术中出血量、住院时间,记录术前、术后1周及术后1年的Oswestry功能障碍指数(ODI)和疼痛视觉模拟量表(VAS)评分,计算术前及术后1年伤椎前缘高度压缩比。在术后CT上评估螺钉位置准确率及有无近端关节侵扰。 结果 所有手术均顺利完成,所有患者随访12个月以上。机器人组手术时间长于边界组,差异有统计学意义(P<0.05);2组术中出血量、住院时间差异无统计学意义(P>0.05)。2组术后伤椎前缘高度压缩比、VAS评分及ODI差异均无统计学意义(P>0.05)。在螺钉位置准确率和近端关节侵扰方面,机器人组优于边界组,但差异无统计学意义(P>0.05)。 结论 边界法置钉可以提供与机器人辅助置钉相近的置钉准确率及临床疗效。
关键词:胸椎  腰椎  脊柱骨折  内固定器  机器人
Comparison of therapeutic effects between robot-assisted and pedicle boundary method screw placement for thoracolumbar fractures    Fulltext
Li Jinjian1  Li Xiaojun1  Yu Jianlin1*  Duan Xiuyang1  Wang Zhe1  Lin Haipeng1  Jiang Chuanjie1  Yang Yongjun1  Zhang Wei1  Tan Yuanchao1  Xi Yanhai2  Wang Weiheng2
1. Second Department of Spinal and Spinal Cord, Shandong Wengdeng Osteopathic Hospital, Weihai 264400, Shandong, China;
2. Department of Orthopaedics, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
Fund Project:
Abstract:
      Objective To compare the efficacy of robot-assisted screw placement and pedicle boundary method screw placement in the treatment of simple thoracolumbar fracture.Methods From January 2021 to October 2021,60 patients with simple thoracolumbar fracture without nerve injury were treated with pedicle screw fixation in Shandong Wengdeng Osteopathic Hospital. Among them,30 cases of screw placement with pedicle boundary method(boundary group) and 30 with robot-assisted(robot group). The operation time,intraoperative blood loss and hospital stay were recorded. The Oswestry disability index(ODI) and pain visual analogue scale(VAS) score were recorded at pre-operation,postoperative 1 week and postoperative 1 year. The compression ratio of the anterior edge height of the injured vertebra at pre-operation and postoperative 1 year were calculated. The accuracy of screw position and the presence of proximal joint invasion were evaluated on postoperative CT. Results All the operations were successfully completed. The patients were followed up for more than 12 months. The operation time of the robot group was significantly longer than that of the boundary group,with a statistical significance(P<0.05). There was no significant difference in intraoperative blood loss and hospital stay between the 2 groups(P>0.05). There were no significant differences in compression ratio of the anterior edge height of the injured vertebra,VAS score and ODI between the 2 groups at post-operation(P>0.05). In terms of screw placement accuracy and proximal joint intrusion,the robot group was better than the boundary group,but the difference was not statistically significant(P>0.05). Conclusion The pedicle boundary method can provide the screw placement accuracy and clinical efficacy similar to the robot-assisted screw placement.
Keywords:Thoracic vertebrae  Lumbar vertebrae  Spinal fracture  Internal fixators  Robotics
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