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. 2020 Sep 15;34(9):1136-1141.
doi: 10.7507/1002-1892.202002131.

[Robot-guided percutaneous kyphoplasty in treatment of multi-segmental osteoporotic vertebral compression fracture]

[Article in Chinese]
Shu Lin  1 , Jiang Hu  1 , Lun Wan  1 , Liuyi Tang  1 , Yue Wang  1 , Yang Yu  1 , Wei Zhang  1
Affiliations

[Robot-guided percutaneous kyphoplasty in treatment of multi-segmental osteoporotic vertebral compression fracture]

[Article in Chinese]
Shu Lin et al. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. .

Abstract
in English, Chinese

Objective: To evaluate the safety and effectiveness of robot-guided percutaneous kyphoplasty (PKP) in treatment of multi-segmental thoracolumbar osteoporotic vertebral compression fracture (OVCF).

Methods: A clinical data of 63 cases with multi-segmental thoracolumbar OVCF without neurologic deficit treated with PKP between October 2017 and February 2019 were analyzed retrospectively. The patients were divided into robot-guided group (33 cases) and traditional fluoroscopy group (30 cases). There was no significant difference in gender, age, fracture segment, bone mineral density, and preoperative visual analogue scale (VAS) score, midline vertebral height, and Cobb angle between the two groups ( P>0.05). The time to establish the tunnel, the times of fluoroscopy, the dose of fluoroscopy, the deviation of puncture, the distribution of bone cement, the leakage of bone cement, the puncture angle, and the postoperative VAS score, midline vertebral height, and Cobb angle were recorded and compared.

Results: The patients in two groups were followed up 11-13 months (mean, 12 months). Compared with traditional fluoroscopy group, the time to establish the tunnel, the times and dose of fluoroscopy in robot-guided group were significantly lower, the deviation of puncture was slighter, the distribution of bone cement was better, and the puncture angle was larger, the differences between the two groups were significant ( P<0.05). There were 8 segments (9.3%, 8/86) of bone leakage in robot-guided group and 17 segments (22.6%, 17/75) in traditional fluoroscopy group, the difference between the two groups was significant ( χ 2=5.455, P=0.020). There was no significant difference in VAS score, the midline vertebral height, and Cobb angle between the two groups at 2 days after operation and last follow-up ( P>0.05).

Conclusion: Robot-guided PKP in treatment of multi-segmental thoracolumbar OVCF can shorten the operation time, improve the accuracy of puncture, reduce the times and dose of fluoroscopy, reduce the leakage of bone cement, and achieve better cement distribution.

目的: 探讨机器人辅助经皮椎体后凸成形术（percutaneous kyphoplasty，PKP）治疗多节段胸腰椎骨质疏松性椎体压缩性骨折（osteoporotic vertebral compression fracture，OVCF）的安全性和有效性。.

方法: 回顾分析 2017 年 10 月— 2019 年 2 月采用 PKP 治疗的 63 例无神经损伤症状的多节段胸腰椎 OVCF 患者临床资料，其中 33 例采用机器人辅助手术（机器人辅助组），30 例采用传统透视下手术（传统透视组）。两组患者性别、年龄、骨折节段、骨密度以及术前疼痛视觉模拟评分（VAS）、椎体中线高度、Cobb 角等一般资料比较，差异均无统计学意义（ P>0.05），具有可比性。记录并比较两组术中通道建立时间、透视次数、透视剂量、穿刺偏移程度、骨水泥分布情况、骨水泥渗漏情况、穿刺角度以及术后 VAS 评分、椎体中线高度、Cobb 角。.

结果: 两组患者术后均获随访，随访时间 11～13 个月，平均 12 个月。与传统透视组相比，机器人辅助组通道建立时间、术中透视次数、透视剂量均明显减少，穿刺偏移程度降低，骨水泥分布情况更好，穿刺角度明显增大，差异均有统计学意义（ P<0.05）。机器人辅助组 8 个节段（9.3%，8/86）、传统透视组 17 个节段（22.6%，17/75）发生骨水泥渗漏，发生率差异有统计学意义（ χ 2=5.455， P=0.020）。两组患者术后 2 d 及末次随访时 VAS 评分、椎体中线高度、Cobb 角比较，差异均无统计学意义（ P>0.05）。.

结论: PKP 治疗多节段胸腰椎 OVCF 术中，机器人辅助治疗可缩短手术时间，提高穿刺准确性，减少透视次数及透视剂量，减少骨水泥渗漏，获得更好的骨水泥分布。.

Keywords: Robot; osteoporotic vertebral compression fracture; percutaneous kyphoplasty; thoracolumbar spine.

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Conflict of interest statement

利益冲突：所有作者声明，在课题研究和文章撰写过程中不存在利益冲突。经费支持没有影响文章观点和对研究数据客观结果的统计分析及其报道。

Figures

图 1
图 1
Schematic diagram of bone cement distribution 骨水泥分布示意图
图 2
图 2
A 72-year-old male patient with OVCF at T6 and T8 in robot-guided group 机器人辅助组患者，男，72 岁，T6、T8 OVCF
See this image and copyright information in PMC

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