Abstract:

Objective  To study a novel orthopedic robotic system integrated with visualized tool packages and to compare the screw accuracy and clinical outcomes of the visualization robotic system with those of the traditional free-hand lumbar pedicle screw fixation. Methods  A total of 43 cases with visualized robot-assisted single-segment lumbar spinal canal decompression with fusion were retrospectively analyzed, matched with 85 cases with traditional free-hand pedicle screw placement as the control group. The accuracy of pedicle screws was evaluated on postoperative lumbar computed tomography (CT) images. The two groups were compared in terms of the number of pedicle track adjustments, the number of pedicle screw turnback, the Visual Analogue Scale (VAS), the Japanese Orthopaedic Association (JOA) scores, the operative time, the amount of blood loss, the postoperative hospitalization time, and the postoperative complications.  Results  The accuracy of screw placement in the robotic group was significantly higher than that in the control group (P<0.05),  the number of pedicle track adjustments and screw turnback were significantly lower than that in the control group (P<0.05), and the operation time was significantly longer than that in the control group (P<0.05), while  the other perioperative parameters were not significantly different from those in the control group (P>0.05). Conclusions   The accuracy of pedicle screw placement assisted by the novel visualized robotic system was significantly better than that of free-hand screw placement, and it could reduce the number of repeated adjustments of the pedicle track and screw turnback. Although its operation time is longer than that of traditional surgery, its clinical efficacy is not inferior to that of traditional surgery, and it has more advantages and potentials.

Key words: robot assisted surgery, lumbar, pedicle screw, internal fixation