Abstract:Objective This research aimto observe the difference of clinical efficacy of robot-assisted versus conventional freehand pedicle screw insertion in thoracolumbar surgery,and toevaluate the accuracy,safety and radiation doseof the robot-assisted system.Methods 88 patientswere randomly assigned toreceive pedicle screw insertion by using random digits table from April 2017 to February 2018.45 patients were treated by robot-assisted spinal instrumentation and 43 patients were treated by freehand surgery.Then the operation time and blood loss of 2 groups were compared,and intraoperative X-ray exposure was also done.The computer tomographic scans were used to assess the accuracy and safety of the inserted pedicle screws between thetwo groups using the Gertzbein-Robbins grade scores.Results There were no significant differences in terms of the baseline,such as gender,age and diseaseetc.between the two groups(P>0.05).The average operation time was (48.87±8.82) min in therobotassisted group and(46.57±7.05) min in the freehand group(P>0.05).The blood loss was (21.27±13.13)mL in robot-assisted group and(20.95 ±17.37)mL in the freehand group(P>0.05).208 pedicle screws were inserted in the robot-assisted group,and the Gertzbein-Robbins scores was categorized as A of 203 screws and B in 5 screws;202 pedicle screws were placed in the freehand group.The Gertzbein-Robbins scores were A in 164,Bin 22,C in 15 and D in 1 screw,respectively;and the significant differences were shown in accuracy of pedicle screws placement (P<0.05).Robot-assisted system also significantly decreases intraoperative radiation exposure(P<0.05).Conclusion The accuracy and safety of robot-assistedpedicle screw placement compared with the traditional freehandprocedurewere significantly improved without increasing the amount of bleeding,operation time,and also significantly reducing the radiation dose of intraoperative fluoroscopy.
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