天玑骨科机器人辅助椎弓根螺钉置入的临床应用及体会

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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 therobotassisted 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.

Key words： surgical robot pedicle screw insertion accuracy safety radiation dose

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