Background： Sacroiliac （SI） screw fixation is a demanding technique, with a high rate of screw malposition due to the complex pelvic anatomy. TiRobot- is an orthopedic surgery robot which can be used for SI screw f...Background： Sacroiliac （SI） screw fixation is a demanding technique, with a high rate of screw malposition due to the complex pelvic anatomy. TiRobot- is an orthopedic surgery robot which can be used for SI screw fixation. This study aimed to evaluate the accuracy of robot-assisted placement of SI screws compared with a freehand technique. Methods：Thirty patients requiring posterior pelvic ring stabilization were randomized to receive freehand or robot-assisted SI screw fixation, between January 2016 and June 2016 at Beijing Jishuitan Hospital. Forty-five screws were placed at levels S1 and S2. In both methods, the primary end point screw position was assessed and classified using postoperative computed tomography. Fisher＇s exact probability test was used to analyze the screws＇positions. Secondary end points, such as duration of trajectory planning, surgical time after reduction of the pelvis, insertion time for guide wire, number of guide wire attempts, and radiation exposure without pelvic reduction, were also assessed. Results： Twenty-three screws were placed in the robot-assisted group and 22 screws in the freehand group; no postoperative complications or revisions were reported. The excellent and good rate of screw placement was 100% in the robot-assisted group and 95% in the freehand group. The P value （0.009） showed the same superiority in screw distribution. The fluoroscopy time after pelvic reduction in the robot-assisted group was significantly shorter than that in the freehand group （median [Q1, Q3]： 6.0 [6.0, 9.0] s vs. median [Q1, Q3]： 36.0 [21.5, 48.0] s; χ2 = 13.590, respectively, P 〈 0.001）; no difference in operation time after reduction of the pelvis was noted （χ2 = 1.990, P = 0.158）. Time for guide wire insertion was significantly shorter for the robot-assisted group than that for the freehand group （median [Q1, Q3]： 2.0 [2.0, 2.7] min vs. median [Q1, Q3]： 19.0 [15.5, 45.0] min; χ2 = 20.952, respectively, P 〈 0.001）. The number of guide wire attempts展开更多
目的观察斜外侧腰椎椎间融合术（oblique lumbar interbody fusion，OLIF）联合后路导航经皮置钉固定治疗腰椎滑脱症的早期临床疗效。方法2014年10月至2016年5月期间，接受OLIF联合后路导航经皮置钉固定手术治疗I、Ⅱ度腰椎滑脱症患者2...目的观察斜外侧腰椎椎间融合术（oblique lumbar interbody fusion，OLIF）联合后路导航经皮置钉固定治疗腰椎滑脱症的早期临床疗效。方法2014年10月至2016年5月期间，接受OLIF联合后路导航经皮置钉固定手术治疗I、Ⅱ度腰椎滑脱症患者20例，男8例、女12例；年龄29~77岁，平均（54．1±12．3）岁。记录患者手术时间、术中出血量及并发症的情况；于术前、术后1周、术后3、6、12个月及末次随访时进行腰痛和下肢痛的疼痛视觉模拟评分（visual analogue scale，VAS）、Oswestry功能障碍指数（Oswestry disability index，ODI）、健康调查简表（the MOS item short from health survey，SF-36）评价以评估临床疗效；并同期行腰椎x线，术后6个月行腰椎CT±三维重建及MR检查，测量和评估椎间隙高度、椎间孔大小、硬膜囊面积和矢状径、间隙前凸角、腰椎前凸角、滑脱率、椎间融合率等改变情况。结果所有患者手术时间平均为（119．0±23．8）min，术中出血量平均为（57．8±20．6）ml。术后均获得随访，随访时间12-30个月，平均（22．9±4．8）个月。腰痛VAS评分、下肢痛VAS评分及ODl分别由术前（6．7±2．6）分、（6．3±2．7）分和50．5％±18．2％下降至末次随访时（1．3±1．0）分、（0．8±1．0）分和14．0％±9．6％，差异均有统计学意义；SF-36的PCS和MCS评分分别由术前（27．1±13．9）分和（51．O±22．7）分上升至末次随访时（67．3±18．9）分和（81．2±14．1）分，差异均有统计学意义。平均滑脱率由术前23．5％±7．4％下降至末次随访时4．2％±3．1％，差异有统计学意义；椎间隙高度、间隙前凸角及腰椎前凸角分别由术前（6．0±3．6）mm、1．8°±6．2°和39．2°±8．4°提高至末次随访时（10．8±1．7）mm、6．2°±3．5°和45．0°±7．8°，差异均有统计学意义。CT和MRI测量椎间孔大小分别由术前（140．展开更多
文摘Background： Sacroiliac （SI） screw fixation is a demanding technique, with a high rate of screw malposition due to the complex pelvic anatomy. TiRobot- is an orthopedic surgery robot which can be used for SI screw fixation. This study aimed to evaluate the accuracy of robot-assisted placement of SI screws compared with a freehand technique. Methods：Thirty patients requiring posterior pelvic ring stabilization were randomized to receive freehand or robot-assisted SI screw fixation, between January 2016 and June 2016 at Beijing Jishuitan Hospital. Forty-five screws were placed at levels S1 and S2. In both methods, the primary end point screw position was assessed and classified using postoperative computed tomography. Fisher＇s exact probability test was used to analyze the screws＇positions. Secondary end points, such as duration of trajectory planning, surgical time after reduction of the pelvis, insertion time for guide wire, number of guide wire attempts, and radiation exposure without pelvic reduction, were also assessed. Results： Twenty-three screws were placed in the robot-assisted group and 22 screws in the freehand group; no postoperative complications or revisions were reported. The excellent and good rate of screw placement was 100% in the robot-assisted group and 95% in the freehand group. The P value （0.009） showed the same superiority in screw distribution. The fluoroscopy time after pelvic reduction in the robot-assisted group was significantly shorter than that in the freehand group （median [Q1, Q3]： 6.0 [6.0, 9.0] s vs. median [Q1, Q3]： 36.0 [21.5, 48.0] s; χ2 = 13.590, respectively, P 〈 0.001）; no difference in operation time after reduction of the pelvis was noted （χ2 = 1.990, P = 0.158）. Time for guide wire insertion was significantly shorter for the robot-assisted group than that for the freehand group （median [Q1, Q3]： 2.0 [2.0, 2.7] min vs. median [Q1, Q3]： 19.0 [15.5, 45.0] min; χ2 = 20.952, respectively, P 〈 0.001）. The number of guide wire attempts
文摘目的观察斜外侧腰椎椎间融合术（oblique lumbar interbody fusion，OLIF）联合后路导航经皮置钉固定治疗腰椎滑脱症的早期临床疗效。方法2014年10月至2016年5月期间，接受OLIF联合后路导航经皮置钉固定手术治疗I、Ⅱ度腰椎滑脱症患者20例，男8例、女12例；年龄29~77岁，平均（54．1±12．3）岁。记录患者手术时间、术中出血量及并发症的情况；于术前、术后1周、术后3、6、12个月及末次随访时进行腰痛和下肢痛的疼痛视觉模拟评分（visual analogue scale，VAS）、Oswestry功能障碍指数（Oswestry disability index，ODI）、健康调查简表（the MOS item short from health survey，SF-36）评价以评估临床疗效；并同期行腰椎x线，术后6个月行腰椎CT±三维重建及MR检查，测量和评估椎间隙高度、椎间孔大小、硬膜囊面积和矢状径、间隙前凸角、腰椎前凸角、滑脱率、椎间融合率等改变情况。结果所有患者手术时间平均为（119．0±23．8）min，术中出血量平均为（57．8±20．6）ml。术后均获得随访，随访时间12-30个月，平均（22．9±4．8）个月。腰痛VAS评分、下肢痛VAS评分及ODl分别由术前（6．7±2．6）分、（6．3±2．7）分和50．5％±18．2％下降至末次随访时（1．3±1．0）分、（0．8±1．0）分和14．0％±9．6％，差异均有统计学意义；SF-36的PCS和MCS评分分别由术前（27．1±13．9）分和（51．O±22．7）分上升至末次随访时（67．3±18．9）分和（81．2±14．1）分，差异均有统计学意义。平均滑脱率由术前23．5％±7．4％下降至末次随访时4．2％±3．1％，差异有统计学意义；椎间隙高度、间隙前凸角及腰椎前凸角分别由术前（6．0±3．6）mm、1．8°±6．2°和39．2°±8．4°提高至末次随访时（10．8±1．7）mm、6．2°±3．5°和45．0°±7．8°，差异均有统计学意义。CT和MRI测量椎间孔大小分别由术前（140．
