目的：探讨应用机器人辅助经皮椎弓根螺钉内固定术治疗的单节段胸腰椎压缩性骨折患者的临床效 果。方法：回顾性分析 2018 年 1 月—2023 年 1 月襄阳市中心医院收治的 73 例单节段胸腰椎压缩性骨折患者的临床 资料，其中 43 例采用常规经皮微创椎弓钉内固定术（常规微创组），30 例采用手术机器人辅助下经皮椎弓根螺钉 内固定术（机器人微创组），术后随访至 2024 年 1 月。比较两组患者围手术期相关手术指标、植钉准确率及安全率、 手术前后病椎前缘高度百分比和矢状面 Cobb 角的改变、疼痛、生活质量及功能障碍评分的差异。结果：机器人微 创组的手术时间、术中出血量、术中透视次数和住院时间均明显低于常规微创组（P<0.05），植钉准确率高于常规 微创组（P<0.05）。与手术前相比，两组患者术后病椎前缘高度百分比逐渐增加、Cobb 角逐渐降低、视觉模拟评分 （VAS）和 Oswestry 功能障碍指数（ODI）评分逐渐降低、巴塞尔指数评分量表（Barthel）评分逐渐增加（P<0.05）， 但两组患者间的差异无统计学意义（P>0.05）。结论：机器人辅助下治疗胸腰椎骨折植钉准确率更高，术中出血量 及透视次数均明显减少，极大程度缩短了患者住院时间，且效果确切，值得在临床上推广。

Objective: To investigate the clinical effect of robot-assisted percutaneous pedicle screw fixation in the treatment of patients with single segmental thoracolumbar compression fracture. Methods: Clinical data of 73 patients with single segmental thoracolumbar fracture who were admitted to Xiangyang Central Hospital from January 2018 to January 2023 were retrospectively analyzed, of which 43 cases who were treated with conventional percutaneous pedicle screw fixation were divided into the conventional minimally invasive group, and 30 cases who were treated with robot-assisted percutaneous pedicle screw fixation (robotic minimally invasive group). Patients were followed up until January 2024. The perioperative indicators, the accuracy and safety rate of implants, the percentage of affected anterior vertebral height and the changes of sagittal Cobb angle before and after surgery, pain level, quality of life, and dysfunction were compared between the two groups. Results: The operative time, intraoperative blood loss, intraoperative fluoroscopy times and length of hospital stay in the robotic minimally invasive group were significantly lower than those in the conventional minimally invasive group (P<0.05). The accuracy of implant in robotic minimally invasive group was higher than that in the conventional minimally invasive group (P<0.05). Compared with that before operation, the percentage of affected anterior vertebral height in the two groups were both increased, the angle of Cobb decreased, visual analogue scale (VAS) and Oswestry disability index (ODI) scores decreased, and Barthel index scores increased (P<0.05), but there was no statistically significant difference between the two groups (P>0.05). Conclusion: Orthopedic robotassisted treatment of thoracolumbar fracture has higher accuracy, less intraoperative blood loss and radiation times, and shorter length of hospital stay, which is worthy of clinical promotion.

收稿日期：2024-04-16  录用日期：2024-06-26 

Received Date: 2024-04-16  Accepted Date: 2024-06-26 

基金项目：“科普 + 乡村振兴”服务工程项目（K2022010103） 

Foundation Item: Science Popularization + Rural Revitalization Program Supporting Project (K2022010103) 

通讯作者：柴俊，Email：252954413@qq.com 

Corresponding Author: CHAI Jun, Email: 252954413@qq.com 

引用格式：郑冲，柴俊，卢伟杰 . 机器人辅助经皮微创椎弓钉内固定术治疗单节段胸腰椎压缩性骨折的临床疗效分析 [J]. 机器人外 科学杂志（中英文），2024，5（5）：818-824. 

Citation: ZHENG C, CHAI J, LU W J. Clinical effect of robot-assisted percutaneous pedicle screw fixation in the treatment of patients with single segmental thoracolumbar compression fracture [J]. Chinese Journal of Robotic Surgery, 2024, 5(5): 818-824.

[1] Katsuura Y, Osborn J M, Cason G W. The epidemiology of thoracolumbar trauma: a meta-analysis[J]. J Orthop, 2016, 13(4): 383-388. 

[2] 赵玉峰 , 彭海文 . 胸腰椎骨折的分类和手术治疗 [J]. 创伤外科 杂志 , 2023, 25(7): 481-484. 

[3] 郭振国 , 年利伟 , 赵建民 , 等 . 胸腰椎骨折的治疗进展 [J]. 内蒙 古医科大学学报 , 2019, 41(1): 108-111. 

[4] 王天 . PKP 与经皮椎弓根螺钉内固定治疗外伤性新发椎体压缩 性骨折疗效分析 [J]. 中外医疗 , 2023, 42(31): 33-36. 

[5] DU S Y, DAI J, ZHOU Z T, et al. Size selection and placement of pedicle screws using robot-assisted versus fluoroscopy-guided techniques for thoracolumbar fractures: possible implications for the screw loosening rate[J]. BMC Surg, 2022, 22(1): 365. 

[6] YE S, CHEN Y Z, ZHONG L J, et al. TINAVI robot-assisted one-stage anteroposterior surgery in lateral position for severe thoracolumbar fracture dislocation: a case report[J]. World J Clin Cases, 2023, 11(22): 5358-5364. 

[7] 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. 

[8] 张在田 , 张绪华 , 卫志华 , 等 . 机器人在脊柱外科手术的研究与 应用进展 [J]. 中国矫形外科杂志 , 2021, 29(18): 1677-1679. 

[9] Schuijt H J, Hundersmarck D, Smeeing D P J, et al. Robot-assisted fracture fixation in orthopaedic trauma surgery: a systematic review[J]. OTA Int, 2021, 4(4): e153. 

[10] 潘大洋 , 刘炯 , 龙浩 , 等 . 机器人导航伤椎置钉固定胸腰椎骨折 [J]. 中国矫形外科杂志 , 2023, 31(24): 2278-2281. 

[11] Certzbein S D, Robbins S E. Accuracy of pedicular screw placement in vivo[J]. Spine (Phila Pa 1976), 1990, 15(1): 11-14. 

[12] 邹守平 , 卢道云 , 叶力 . 微创经皮伤椎置钉治疗胸腰椎骨折 : 6 个月随访脊柱生物力学变化 [J]. 中国组织工程研究 , 2021, 25(24): 3865-3869. 

[13] Palacios P, Palacios I, Palacios A, et al. Efficacy and safety of the extreme lateral interbody fusion (XLIF) technique in spine surgery: Meta-analysis of 1409 patients[J]. J Clin Med, 2024, 13(4): 960. 

[14] ZHANG Y, LU Y Z, LIN W C, et al. Surgical management of lower limb radiculopathy following acute singe-level osteoporotic vertebral fracture of lower lumbar spine in geriatric patient: a retrospective study[J]. BMC Musculoskelet Disord, 2024, 25(1): 262. 

[15] 代文杰 , 李成 , 余海宁 , 等 . 经伤椎椎弓根植骨置钉后路内固 定对胸腰椎骨折患者 Cobb 角、ODI 评分的影响 [J]. 贵州医药 , 2021, 45(1): 79-81. 

[16] 史家兴 , 罗建平 , 李宗阳 , 等 . 中青年胸腰椎骨折分型与治疗研 究进展 [J]. 中国医刊 , 2022, 57(12): 1294-1298. 

[17] 赵树雄 , 王增平 , 邹月超 , 等 . 机器人辅助与传统透视下椎弓根 螺钉内固定术治疗胸腰椎骨折的荟萃分析 [J]. 脊柱外科杂志 , 2023, 21(4): 263-274. 

[18] Vadalà G, de Salvatore S, Ambrosio L, et al. Robotic spine surgery and augmented reality systems: a state of the art[J]. Neurospine, 2020, 17(1): 88-100. 

[19] 王丽莉 , 吕兰婷 , 刘新颖 , 等 . 机器人辅助椎弓根螺钉置入治 疗胸腰椎骨折的临床疗效 Meta 分析 [J]. 中国医学装备 , 2024, 21(2): 149-156.