机器人辅助与徒手经皮椎体成形术治疗椎体压缩骨折的疗效比较

doi:10.3969/j.issn.1006-7795.2025.05.002

首都医科大学学报 ›› 2025, Vol. 46 ›› Issue (5): 770-776.doi: 10.3969/j.issn.1006-7795.2025.05.002

• 智慧骨科及手术机器人临床应用 • 上一篇下一篇

机器人辅助与徒手经皮椎体成形术治疗椎体压缩骨折的疗效比较

姜双鹏^#,韩雨洋^#,王嘉熙,张刚,董超,宋红星,姚琦^*

首都医科大学附属北京世纪坛医院关节外科骨肿瘤科，北京 100038

收稿日期:2025-07-01 修回日期:2025-08-01 出版日期:2025-10-21 发布日期:2025-10-22
通讯作者: 姚琦 E-mail:yqjh2010@163.com
基金资助:
北京市医院管理中心“登峰”计划项目（DFL20240702），2024年北京市属医院科研培育计划项目（PX20240701）。

Efficacy comparison of robotic-assisted versus manual percutaneous vertebroplasty for vertebral compression fractures

Jiang Shuangpeng^#, Han Yuyang^#, Wang Jiaxi, Zhang Gang, Dong Chao, Song Hongxing, Yao Qi^*

Department of Joint Surgery and Bone Tumor, Beijing Shijitan Hospital,Capital Medical University, Beijing 100038, China

Received:2025-07-01 Revised:2025-08-01 Online:2025-10-21 Published:2025-10-22
Supported by:
This study was supported by Beijing Hospitals Authority “Dengfeng” Talent Training Program (DFL20240702)， 2024 Research Cultivation Program of Beijing Municipal Hospitals (PX20240701).

摘要/Abstract

摘要： 目的评估骨科手术机器人辅助经皮椎体成形术（percutaneous vertebroplasty, PVP）和徒手PVP术治疗骨质疏松性椎体压缩骨折（osteoporotic vertebral compression fractures, OVCF）的临床效果，探讨机器人辅助手术的优势，指导临床决策。方法选取2021年4月至2025年4月因单节段OVCF于首都医科大学附属北京世纪坛医院关节外科骨肿瘤科行PVP术治疗的患者为研究对象，其中机器人辅助手术组患者（机器人组）29例，徒手手术组患者（对照组）88例，随访1个月。对比两组患者的总住院日、手术时长、骨水泥注入量、骨水泥渗漏率、神经损伤率、术中透视次数、穿刺一次性成功率、术后和术前的椎体前缘高度差值、术前、术后1d和术后1个月的视觉模拟评分（Visual Analogue Scale, VAS）以及Oswestry功能障碍指数（Oswestry Disability Index, ODI）等资料。结果两组患者性别、年龄、骨折至手术时间和骨折节段分布等一般资料比较差异无统计学意义，具有可比性。机器人组术中透视次数和术后第1天ODI指数显著低于对照组（P<0.05），穿刺一次性成功率显著高于对照组（P<0.05），其余各项参数与对照组相比差异无统计学意义（P>0.05）。结论机器人辅助PVP术和徒手PVP术治疗OVCF均有良好的临床疗效。机器人辅助PVP术可以减少术中透视次数，可能在提高穿刺一次性成功率及改善术后早期腰部功能方面更有优势，但需要大样本随机对照研究通过多因素分析进一步验证其可靠性。

关键词: 骨质疏松性椎体压缩骨折（OVCF）, 经皮椎体成形术（PVP）, 手术机器人, 穿刺, 透视, 视觉模拟评分（VAS）, Oswestry功能障碍指数（ODI）

Abstract: Objective To evaluate the clinical outcomes of robot-assisted percutaneous vertebroplasty (PVP) versus manual PVP in treating osteoporotic vertebral compression fractures (OVCF), and explore the advantages of robotic assistance for clinical decision-making. Methods Patients who underwent single-level PVP for OVCF at the Department of Joint Surgery and Bone Tumor, Beijing Shijitan Hospital, Capital Medical University, between April 2021 and April 2025 were enrolled. The robot group (n=29) and manual PVP group (control, n=88) were followed-up for 1 month. Parameters compared included: total hospital stay, operative time, cement volume, cement leakage rate, nerve injury rate, intraoperative fluoroscopy number, first-attempt success rate of puncture, postoperative versus preoperative anterior vertebral height difference, Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores preoperatively, at 1-day and 1-month postoperatively. Results No statistically significant differences existed in baseline characteristics (gender, age, fracture-to-surgery interval, and fracture distribution) between groups (P>0.05). The number of intraoperative fluoroscopy times and the ODI index on the first day after surgery in the robot group were significantly lower than those in the control group (P<0.05), and the first-attempt success rate of puncture was significantly higher than that in the control group (P<0.05). There were no statistically significant differences in the other parameters between the two groups (P>0.05). Conclusion Both robot-assisted PVP and manual PVP have good clinical efficacy in the treatment of OVCF. Robot-assisted PVP can reduce the number of intraoperative fluoroscopy times and may have more advantages in improving the first-attempt success rate of puncture and early postoperative lumbar function. However, its reliability needs to be further verified through large-sample randomized controlled studies with multivariate analysis.

Key words: osteoporotic vertebral compression fractures, percutaneous vertebroplasty, surgical robot, needle puncture, fluoroscopy, Visual Analogue Scale, Oswestry Disability Index

中图分类号:

R683.2

姜双鹏, 韩雨洋, 王嘉熙, 张刚, 董超, 宋红星, 姚琦. 机器人辅助与徒手经皮椎体成形术治疗椎体压缩骨折的疗效比较[J]. 首都医科大学学报, 2025, 46(5): 770-776.

Jiang Shuangpeng, Han Yuyang, Wang Jiaxi, Zhang Gang, Dong Chao, Song Hongxing, Yao Qi. Efficacy comparison of robotic-assisted versus manual percutaneous vertebroplasty for vertebral compression fractures[J]. Journal of Capital Medical University, 2025, 46(5): 770-776.

参考文献

［1］ Zileli M, Fornari M, Costa F, et al. Epidemiology, natural course, and preventive measures of osteoporotic vertebral fractures: WFNS spine committee recommendations［J］. J Neurosurg Sci, 2022, 66(4): 282－290.
［2］ Son H J, Park S J, Kim J K, et al. Mortality risk after the first occurrence of osteoporotic vertebral compression fractures in the general population: a nationwide cohort study［J］. PLoS One, 2023, 18(9): e0291561.
［3］ Chen Z F, Xu L, Shi L, et al. Long-term outcome of percutaneous vertebroplasty versus conservative treatment for osteoporotic vertebral compression fractures: a retrospective cohort study with three-year follow-up［J］. Front Med, 2024, 11: 1391243.
［4］ Martin C T, Niewoehner C B, Burmeister L A. Significant loss of areal bone mineral density following prolonged bed rest during treatment with teriparatide［J］. J Endocr Soc, 2017, 1(6): 609-614.
［5］ Litin Y, Rastogi S, Agarwal A, et al. A prospective evaluation of percutaneous vertebroplasty in osteoporotic vertebral compression fracture patients［J］. Cureus, 2023, 15(6): e40255.
［6］ Hou J G, Zhang N, Chen G D. Factors affecting cement leakage in percutaneous vertebroplasty: a retrospective cohort study of 309 patients［J］. Eur Rev Med Pharmacol Sci, 2023, 27(9): 3877-3886.
［7］ Onen M R, Simsek M, Naderi S. Robotic spine surgery: a preliminary report［J］. Turk Neurosurg, 2014, 24(4): 512-518.
［8］ D'Souza M, Gendreau J, Feng A, et al. Robotic-Assisted spine surgery: history, efficacy, cost, and future trends［J］. Robot Surg, 2019, 6: 9-23.
［9］ Wu J Y, Fan M X, He D, et al. Accuracy and clinical characteristics of robot-assisted cervical spine surgery: a systematic review and meta-analysis［J］. Int Orthop, 2024, 48(7): 1903-1914.
［10］ Fu X Y, She Y M, Jin G W, et al. Comparison of robotic-assisted total knee arthroplasty: an updated systematic review and meta-analysis［J］. J Robot Surg, 2024, 18(1): 292.
［11］ Kou W, Zhou P Q, Lin J H, et al. Technologies evolution in robot-assisted fracture reduction systems: a comprehensive review［J］. Front Robot AI, 2023, 10: 1315250.
［12］ Yang G, Liu D G, Zhou G J, et al. Robot-assisted anterior cruciate ligament reconstruction based on three-dimensional images［J］. J Orthop Surg Res, 2024, 19(1): 246.
［13］ Shen H, Zhou J L, Yu L P. Cervical pedicle screw fixation with the Tianji orthopedic surgical robot［J］. J Orthop Surg Res, 2025, 20(1): 131.
［14］ Wang X, Zhu Y H, Zhu Q S. Efficacy and safety of robot-assisted versus fluoroscopy-assisted PKP or PVP for osteoporotic vertebral compression fractures: a systematic review and meta-analysis［J］. J Robot Surg, 2023, 17(6): 2597-2610.
［15］ Tan L, Wen B T, Guo Z Q, et al. Robot-assisted percutaneous vertebroplasty for osteoporotic vertebral compression fractures: a retrospective matched-cohort study［J］. Int Orthop, 2023, 47(2): 595-604.
［16］ Shi B, Hu L, Du H L, et al. Robot-assisted percutaneous vertebroplasty under local anaesthesia for osteoporotic vertebral compression fractures: a retrospective, clinical, non-randomized, controlled study［J］. Int J Med Robot, 2021, 17(3): e2216.
［17］罗世科, 王传恩, 熊小明, 等. 机器人辅助与徒手经皮椎体成形术比较［J］. 中国矫形外科杂志, 2025, 33(2): 118-123.
［18］袁伟, 孟小童, 刘欣春, 等. 机器人辅助经皮椎体后凸成形术治疗单/双节段骨质疏松性椎体压缩骨折临床疗效［J］. 中国修复重建外科杂志, 2021, 35(8): 1000-1006.
［19］ Lee N J, Lombardi J M, Qureshi S, et al. Robot-assisted spine surgery: the pearls and pitfalls［J］. J Am Acad Orthop Surg, 2025, 33(2): e81-e92.［20］ Yuan W, Cao W H, Meng X T, et al. Learning curve of robot-assisted percutaneous kyphoplasty for osteoporotic vertebral compression fractures［J］. World Neurosurg, 2020, 138: e323-e329.
［21］ Yang F G, Chen K, Luo Y C, et al. Comparison of near-and midterm outcomes of two unilateral percutaneous translaminar vertebral kyphoplasty procedures for the treatment of single-segment OVCF: a single-center randomized controlled study［J］.Eur J Orthop Surg Traumatol,2025,35(1):142.

机器人辅助与徒手经皮椎体成形术治疗椎体压缩骨折的疗效比较

Efficacy comparison of robotic-assisted versus manual percutaneous vertebroplasty for vertebral compression fractures

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 1

编辑推荐

Metrics

本文评价