Accuracy and deviation analysis of robot-assisted spinal implants: A retrospective overview of 105 cases and preliminary comparison to open freehand surgery in lumbar spondylolisthesis
Accuracy and deviation analysis of robot-assisted spinal implants: A retrospective overview of 105 cases and preliminary comparison to open freehand surgery in lumbar spondylolisthesis
复制标题
机器人辅助脊柱植入物的准确性和偏差分析：105例腰椎滑脱症的回顾性分析及与开放徒手手术的初步比较
DOI：
10.1002/rcs.2273
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发表时间：
2021-05-06
影响因子：
2.5
通讯作者：
Ma, Xue-xiao
中科院分区：
文献类型：
--
作者：
Wang, Chao;Zhang, Hao;Ma, Xue-xiao
背景机器人辅助脊柱螺钉置入的准确性是否显著高于徒手置入，以及机器人偏离的来源尚不清楚。方法收集105例接受机器人辅助脊柱手术患者的临床资料，根据改良Gertenglin Robbins分类，通过CT评估螺钉置入的准确性。患者按经皮和开放手术分组。对临床和螺钉准确性参数进行了组间比较。确定偏离原因。31例腰椎滑脱症患者进行开放式机器人辅助手术和开放徒手手术治疗的患者相同数量的螺钉accuracy.Results螺钉准确性没有显着差异经皮和开放组在两个内部和术后评价。工具刮削被确定为偏差的主要原因。徒手组螺钉错位（B + C + D级）的比例显著高于机器人辅助组。然而，明显错位（C + D级）螺钉显示两组之间无显著差异。结论机器人辅助脊柱内固定术具有准确性高、神经损伤发生率低的特点。工具刮削是植入物偏离的主要原因。
Background Whether the accuracy of robot-assisted spinal screw placement is significantly higher than that of freehand and the source of robotic deviation remain unclear.Methods Clinical data of 105 patients who underwent robot-assisted spinal surgery was collected, and screw accuracy was evaluated by computed tomography according to the modified Gertzbein-Robbins classification. Patients were grouped by percutaneous and open surgery. Intergroup comparisons of clinical and screw accuracy parameters were performed. Reasons for deviation were determined. Thirty-one patients with lumbar spondylolisthesis undergoing open robot-assisted surgery and the same number of patients treated by open freehand surgery were compared for screw accuracy.Results Screw accuracy was not significantly different between the percutaneous and open groups in both intra- and postoperative evaluations. Tool skiving was identified as the main cause of deviation. The proportion of malpositioned screws (grade B + C + D) was significantly higher in the freehand group than in the robot-assisted group. However, remarkably malpositioned (grade C + D) screws showed no significant differences between the groups. No revision surgery was necessary.Conclusions Robot-assisted spinal instrumentation manifests high accuracy and low incidence of nerve injury. Tool skiving is a major cause of implant deviation.