linical comparative study of robot-assisted and fluoroscopy-assisted free-hand cortical bone trajectory screw placement in the treatment of single-level degenerative lumbar diseases

doi:10.3969/j.issn.1006-7795.2023.05.019

Abstract

Abstract: Objective To compare the safety and accuracy of robotic-assisted and free-hand cortical screw placement in spinal internal fixation. Methods A total of 71 patients who underwent cortical bone trajectory screw (CBT) for single-level degenerative lumbar spine disease at our center from December 2019 to June 2021 were retrospectively analyzed. Patients receiving fluoroscopy-assisted free-hand CBT screw placement were assigned to the free-hand group (FG, n=35) and robot-assisted CBT screw placement was assigned to the robot-assisted group (RG, n=36). Screw placement accuracy and facet violation were assessed by three-dimensional reconstruction of postoperative computed tomography(CT). The average screw placement time, intraoperative blood loss, and intraoperative radiation exposure of medical staff were compared between the two groups.Results A total of 284 CBT screws were implanted in 71 patients, 140 of which were completed by the FG and 144 screws by the RG. Robot-assisted nailing was significantly more accurate than free-hand nailing (92.36% vs 82.86%, P=0.015). The incidence of facet joint violation was significantly lower in the RG than in the FG (22.22% vs 40.00%, P=0.022). However, the single screw placement time was significantly longer in the RG than in the FG ［(501.92±70.08) s vs (382.54±63.21) s, P=0.000］. The radiation exposure time of medical staff during surgery was significantly lower in the RG than in the FG ［(56.81±16.09) s vs (34.43±16.91) s, P=0.000］.Conclusions Robot-assisted CBT screw implantation can effectively improve the accuracy of screw placement and reduce the invasion rate of superior facet and radiation exposure of medical staff, but it will increase the screw placement time and operation time of screws. Our center achieved a smooth learning curve after approximately 12 procedures.

Key words: cortical bone trajectory, orthopedic surgical robot, freehand screw placement, degenerative lumbar disease

CLC Number:

R681.5+7

Zhang Xinuo, Liu Yuzeng, Li Yue, Su Qingjun, Li Dongyue, Guan Li, Hai yong. linical comparative study of robot-assisted and fluoroscopy-assisted free-hand cortical bone trajectory screw placement in the treatment of single-level degenerative lumbar diseases[J]. Journal of Capital Medical University, 2023, 44(5): 836-844.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2023.05.019

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2023/V44/I5/836

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