北京生物醫(yī)學(xué)工程

天璣Ⅱ機器人輔助胸腰椎椎弓根螺釘內(nèi)固定術(shù)的臨床應(yīng)用

Clinical application of 2nd generation TiRobot-assisted thoracolumbar pedicle screw fixation

作者：閻凱張琦劉波何達劉亞軍田偉

單位：北京積水潭醫(yī)院脊柱外科，骨科機器人技術(shù)北京市重點實驗室（北京 100035） <p>通信作者：田偉。E-mail：[email protected]</p> <p> </p>

分類號：R318.01

出版年·卷·期（頁碼）：2022·41·3（297-301）

摘要：

目的分析天璣Ⅱ機器人輔助胸腰椎椎弓根螺釘內(nèi)固定術(shù)的臨床效果，為天璣Ⅱ機器人在脊柱外科手術(shù)的臨床應(yīng)用提供依據(jù)。方法天璣Ⅱ骨科手術(shù)機器人優(yōu)化了主控觸屏、機械臂末端和機械臂示蹤器。本研究分析2020年12月至2021年5月期間在北京積水潭醫(yī)院實施天璣Ⅱ機器人輔助胸腰椎椎弓根螺釘內(nèi)固定術(shù)20例患者的病例資料，使用圖像融合法測量導(dǎo)針偏差，使用術(shù)后影像測量螺釘準確性，同時記錄手術(shù)時間、術(shù)中出血量、術(shù)后平均住院時間和并發(fā)癥情況，評估天璣Ⅱ機器人系統(tǒng)的臨床應(yīng)用效果。結(jié)果 20例機器人輔助手術(shù)均順利完成，共置入了92枚椎弓根螺釘。導(dǎo)針的入點偏差為1.44 (0.93, 1.93) mm，止點偏差為1.47 (1.02, 2.22) mm，綜合偏差為1.55 (0.96, 1.99) mm。軸位角度偏差為1.90 (1.40, 2.20)°，矢狀位角度偏差為1.00 (0.60, 1.20)°。螺釘位置優(yōu)秀率為90.2%，螺釘位置優(yōu)良率為100%。手術(shù)時間為(206±60)min，術(shù)中出血量為200 (113, 200) mL，術(shù)后住院時間為5 (4, 6) d，未出現(xiàn)圍手術(shù)期并發(fā)癥。結(jié)論天璣Ⅱ機器人系統(tǒng)較前一代手術(shù)機器人進行了多項升級，有助于更加準確、高效地完成胸腰椎椎弓根螺釘內(nèi)固定術(shù)。

Objective To investigate the clinical outcome of 2nd generation TiRobot-assisted thoracolumbar pedicle screw fixation.，and to provide evidence for the clinical application of 2nd generation TiRobot in spine surgery. Methods The 2nd generation TiRobot optimizes the main control touch screen, the remote end and the tracker of the robotic arm. A total of 20 patients undergone 2nd generation TiRobot-assisted thoracolumbar pedicle screw fixation at Beijing Jishuitan Hospital from December 2020 to May 2021 were analyzed. By measuring the guide-wire deviation (based on image fusion), screw accuracy (based on postoperative image), and perioperative data (operation time, intraoperative blood loss, postoperative hospital stay and complications), the clinical application of the 2nd generation TiRobot system was evaluated. Results All 20 robot-assisted surgeries were completed successfully with a total of 92 pedicle screws inserted. The entry point deviation of the guide-wire was 1.44 (0.93, 1.93) mm, the end point deviation was 1.47 (1.02, 2.22) mm, and the mean deviation for each screw was 1.55 (0.96, 1.99) mm. The axial angular deviation was 1.90 (1.40, 2.20)°, and the sagittal angular deviation was 1.00 (0.60, 1.20)°. The perfect rate of screw position was 90.2%, and the clinically acceptable rate was 100%. The operation time was 206±60 minutes, the intraoperative blood loss was 200 (113, 200) mL, and the postoperative hospital stay was 5 (4, 6) days. There were no perioperative complications. Conclusions The 2nd generation TiRobot system, undergone numerous upgrades compared with its previous generation, helps to complete the thoracolumbar pedicle screw internal fixation more accurately and efficiently.

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