北京生物醫(yī)學(xué)工程

遠(yuǎn)程機(jī)器人輔助經(jīng)皮椎體后凸成形術(shù)臨床效果研究

Clinical outcomes of telerobot-assisted percutaneousvertebral kyphoplasty

作者：范明星張琦房彥名趙經(jīng)緯王令瓏何達(dá) 田偉

單位：北京積水潭醫(yī)院脊柱外科(北京100035) 首都醫(yī)科大學(xué)燕京醫(yī)學(xué)院(北京101300) 通信作者：田偉，院士。E-mail:tianwei_victor@ 163.com

關(guān)鍵詞：遠(yuǎn)程手術(shù);5G ；機(jī)器人輔助手術(shù);經(jīng)皮椎體后凸成形術(shù);壓縮性骨折

分類號(hào)：R318

出版年·卷·期（頁(yè)碼）：2022·41·2（174-178）

摘要：

目的分析遠(yuǎn)程機(jī)器人輔助經(jīng)皮椎體后凸成形術(shù)(percutaneous kyphoplasty, PKP)治療胸腰椎壓縮性骨折的臨床效果，為遠(yuǎn)程機(jī)器人輔助脊柱手術(shù)的臨床應(yīng)用提供依據(jù)。方法回顧性分析2021 年3月至2021年12月由北京積水潭醫(yī)院專家遠(yuǎn)程操作其他醫(yī)院骨科手術(shù)機(jī)器人完成的PKP手術(shù)的 24例患者病例資料。統(tǒng)計(jì)患者基本資料、手術(shù)時(shí)間、腰背痛視覺(jué)模擬量表(visual analogue scale, VAS) 評(píng)分、局部后凸角、骨折椎體高度及并發(fā)癥發(fā)生情況，評(píng)估遠(yuǎn)程機(jī)器人手術(shù)臨床效果。結(jié)果24例遠(yuǎn)程機(jī) 器人輔助PKP手術(shù)均順利完成，平均手術(shù)時(shí)間為35.63 min ± 17.40 min。術(shù)后腰背痛VAS評(píng)分(2.02± 0.79)比術(shù)前(4.47±2.04)顯著下降(P<0.001),術(shù)后局部后凸角(4.17°±2.02°)較術(shù)前(11.53°± 6.03°)顯著下降(FcO.001)，術(shù)后骨折椎體高度(21.16 mm±5.55 mm)較術(shù)前(16.76 mm±3.90 mm)增加(P= 0.003)o未出現(xiàn)通訊故障、機(jī)器人故障和圍手術(shù)期并發(fā)癥。結(jié)論基于5G網(wǎng)絡(luò)的遠(yuǎn)程機(jī)器人輔助PKP手術(shù)治療胸腰椎壓縮性骨折可顯著緩解疼痛、改善局部后凸角、恢復(fù)椎體高度，是安全和有效的。

study retrospectively analyzed 24 patients accepted PKP surgery by experts from Beijing Jishuitan Hospital remotely manipulating orthopedic surgical robots of other hospitals from March 2021 to December 2021. Demographic data, operation time, low back pain visual analogue scale (VAS) score, local kyphosis angle, fractured vertebral body height and complications were collected to evaluate the clinical outcome of telerobot-assisted surgery. Results A total of 24 telerobot-assisted PKP surgeries were successfully completed, with an average operation time of 35.63 min ± 17.40 min. The postoperative low back pain VAS score (2.02±0.79) was significantly lower than the preoperative low back pain VAS score (4.47±2.04, P<0.001). The postoperative local kyphosis angle (4.17°±2.02°) was smaller than the preoperative local kyphosis angle ( 11.53° ±6.03°, P<0.001). The postoperative height of the fractured vertebral body after operation (21.16 mm±5.55 mm) was greater than the preoperative height ( 16.76±3.90, P- 0.003). There were no communication failures, robot failures, and no perioperative complications. Conclusions Based on 5G network, telerobot-assisted PKP surgery for thoracolumbar compression fractures can significantly relieve pain, improve local kyphosis, and restore vertebral height, which is safe and effective.

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