手术机器人在入路规划、导航及微创精准操作等方面优势明显，临床应用越来越广泛，极大地提高了 手术的精准性、安全性和微创性。近年来，随着手术机器人迅速发展以及在神经外科、脊柱外科的应用逐步普及，其 超强稳定性必然推动脊柱神经外科疾病诊治更加合理。国内外已有多款产品应用于临床，涵盖了 DBS、脊柱外科及术 后康复等学科，其中应用于脑深部电刺激植入手术及椎弓根螺钉植入术的机器人技术相对成熟。但是，目前手术机器 人仍有一定局限性，且费用高、触觉反馈差，临床效果缺乏长期临床研究证据支持。因此，手术机器人未来的发展在 于扩大应用范围，降低成本，并将手术系统与 AI、3D 打印等技术结合，以期在脊柱神经外科领域发挥更重要的作用。

With significant advantages in surgical approach planning, navigation and precise operation in a minimally invasive way, surgical robots are more and more widespread, which has greatly improved the accuracy, safety, and minimally invasion of surgery. In recent years, with the rapid development of surgical robots, their application in neurosurgery and spinal surgery has gradually been popularized, the super stability of surgical robots will inevitably promote more reasonable diagnosis and treatment in spinal neurosurgical diseases. There are many mature products at home and abroad that have been applied in clinical practice, covering deep brain stimulation (DBS), spine surgery, and postoperative rehabilitation. Among them, the application of robotic technology in DBS implantation and pedicle screw implantation is relatively mature. At present, the application of surgical robots still has certain limitations, such as the high cost and poor tactile feedback, and evidence on its long-term outcomes is lacking. Therefore, the future development of surgical robots lies in expanding the scope of application, reducing costs, and combining surgical systems with AI, 3D printing and other technologies, hoping to play a more important role in the field of spinal neurosurgery.

收稿日期：2024-05-29  录用日期：2024-07-09 

Received Date: 2024-05-29  Accepted Date: 2024-07-09 

基金项目：陕西省重点研发计划（2024SF-YBXM-216） 

Foundation Item: Key R&D Plan Project of Shaanxi Province (2024SF-YBXM-216) 

通讯作者：李维新，Email：spinedr@163.com 

Corresponding Author: LI Weixin, Email: spinedr@163.com 

引用格式：熊东，程超，郑锋伟，等 . 手术机器人在脊柱神经外科的临床应用 [J]. 机器人外科学杂志（中英文），2024，5（6）： 1149-1153. 

Citation: XIONG D, CHENG C, ZHENG F W, et al. Clinical application of surgical robots in spinal neurosurgery[J]. Chinese Journal of Robotic Surgery, 2024, 5(6): 1149-1153.

[1] 许梓健 , 顾洪生 , 蒯声政 , 等 . 骨科手术机器人的临床应用与进 展 [J]. 机器人外科学杂志 ( 中英文 ), 2022, 3(5): 376-387. 

[2] 刘政鑫 . 华科精准 : 神外手术机器人实现临床突破 [J]. 机器人 产业 , 2023, (2): 65-67. 

[3] ZHOU S Y, GAO Y, LI R P, et al. Neurosurgical robots in China: State of the art and future prospect[J]. Iscience, 2023, 26(11): 107983. 

[4] Ringel F, Stüer C, Reinke A, et al. Accuracy of robot-assisted placement of lumbar and sacral pedicle screws[J]. Spine, 2012, 37(8): E496-E501. 

[5] 王紫合 , 寇楠楠 . 神经外科手术机器人临床应用的伦理探析 [J]. 医学与社会 , 2024, 37(2): 118-123. 

[6] Morley C T, Arreola D M, Qian L, et al. Mixed reality surgical navigation system; Positional accuracy based on food and drug administration standard[J]. Surgical Innovation, 2023, 31(1): 48-57. 

[7] Picht T, Vajkoczy P. Robotics and computer-assisted procedures in cranial neurosurgery[J]. 2023, 94(4): 299-306. 

[8] Bartolomei F, Lagarde S, Wendling F, et al. Defining epileptogenic networks: Contribution of SEEG and signal analysis[J]. Epilepsia, 2017, 58(7): 1131-1147. 

[9] 乔梁 , 遇涛 , 李勇杰 . 手术机器人在神经外科中的应用现状 [J]. 中华神经外科杂志 , 2020, 36(12): 1286-1289. 

[10] 田增民 , 王亚明 . 立体定向脑组织活检技术 [M]. 人民军医出版 社 , 2012. 

[11] 林涛 , 陈志杰 , 刘妲 , 等 . 神经外科机器人辅助脑深部病变立体 定向活检手术体会 [C]// 第十六届中国医师协会神经外科医师 年会摘要集 .2022: 283-284. 

[12] Elia A, Paun L, Pallud J, et al. Robot-assisted endoscopic third ventriculostomy under intraoperative CT imaging guidance[J]. Acta Neurochirurgica, 2023, 165(9): 2525-2531. 

[13] 姚展成 . 开颅手术机器人的器械定位与自主磨削规划研究 [D]. 天津理工大学 , 2023. 

[14] 刘羽阳 , 刘嘉霖 , 陈凌 , 等 . 开拓创新技术 , 推动神经外科进入 机器人辅助显微手术新时代 [J]. 国际神经病学神经外科学杂志 , 2021, 48(1): 1-3. 

[15] 张剑宁 , 刘嘉霖 . 手术机器人推动神经外科进入新时代 [J]. 四 川大学学报 ( 医学版 ), 2022, 53(4): 554-558. 

[16] Paydarfar J A, WU X T, Halter R J. Initial experience with imageguided surgical navigation in transoral surgery[J]. 2019, 41(1): E1-E10. 

[17] 刘元钦 , 李翠玲 , 张磊 , 等 . ROSA 机器人在神经外科手术中初 步应用体会 [J]. 中华神经创伤外科电子杂志 , 2019, 5(1): 47-51. 

[18] Michel L, Cyril C, Anne S P, et al. The impact of the reference imaging modality, registration method and intraoperative flat-panel computed tomography on the accuracy of the ROSA® stereotactic robot[J]. Stereotactic and Functional Neurosurgery, 2014, 92: 242-250. 

[19] Gonen L, Chakravarthi Srikant-S., Monroy-sosa A, et al. Initial experience with a robotically operated video optical telescopicmicroscope in cranial neurosurgery: feasibility, safety, and clinical applications[J]. Neurosurgical Focus, 2017, 42: E9. 

[20] Piloni M, Bailo M, Gagliardi F, et al. Resection of intracranial tumors with a robotic-assisted digital microscope: A preliminary experience with robotic scope[J]. World Neurosurgery, 2021, 152: e205-e211. 

[21] 周晓明 , 曹子忆 , 徐鹏 , 等 . 医学图像标志点提取方法在神经外 科手术机器人中的应用分析 [J]. 中国仪器仪表 , 2023, (4): 27-31. 

[22] 刘京运 . 华科精准 : 将 3D 结构光融入神经外科手术机器人 [J]. 机器人产业 , 2021, (2): 51-55. 

[23] Watkins R G, Gupta A, Watkins R G. Cost-Effectiveness of ImageGuided Spine Surgery[J]. The Open Orthopaedics Journal, 2010, 4: 228-233. 

[24] 夏光明 , 王瑞 , 张丽娜 , 等 . 基于振动信号融合的手术机器人椎 板磨削剩余厚度识别 [J]. 天津大学学报 ( 自然科学与工程技术 版 ), 2022, 55(10): 1016-1025. 

[25] Huntsman K T, Ahrendtsen L A, Riggleman J R, et al. Roboticassisted navigated minimally invasive pedicle screw placement in the first 100 cases at a single institution[J].J Robot Surg, 2020, 14(1): 199-203. 

[26] Godzik J, Walker C T, Hartman C, et al. A quantitative assessment of the accuracy and reliability of robotically guided percutaneous pedicle screw placement: Technique and application accuracy[J]. Oper Neurosurg, 2019, 17(4): 389-395. 

[27] Tian W. Robot-assisted posterior C1-2 transarticular screw fixation for atlantoaxial instability a case report[J]. 2016, 41(19B): B2-B5. 

[28] LI J Y, HUANG L, ZHOU W Y, et al. Evaluation of a new spinal surgical robotic system of Kirschner wire placement for lumbar fusion: A multi-centre, randomised controlled clinical study[J].Int J Med Robot, 2021, 17(2): e2207. 

[29] Farber S H, Pacult M A, Godzik J, et al. Robotics in spine surgery: A technical overview and review of key concepts[J].Front Surg, 2021, 8: 578674. 

[30] ZHANG Q, HAN X G, XU Y F, et al. Robotic navigation during spine surgery[J].Expert Rev Med Devices, 2020, 17(1): 27-32. 

[31] 杜付鑫 , 张体冲 , 李倩倩 , 等 . 脊柱手术机器人研究进展 [J]. 山 东大学学报 ( 医学版 ), 2023, 61(3): 46-56. 

[32] Sekhar L N, Tariq F, Kim L J, et al. Commentary: Virtual reality and robotics in neurosurgery[J].Neurosurgery, 2013, 72: 1-6. 

[33] Sutherland G. Introduction to virtual reality and robotics in neurosurgery[J].Neurosurgery, 2013, 72: 7.