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. 2025 Aug 26;25(1):395.
doi: 10.1186/s12893-025-03049-7.

TiRobot-assisted percutaneous vertebroplasty in the management of middle and upper thoracic osteoporotic vertebral compression fracture

Juyi Lai #  1   2 , Huangsheng Tan #  1   2 , Pengwei Deng  1 , Yinbo Wang  1 , Yong Huang  1 , Hualong Feng  2 , Zhiming Lan  2 , Zhitao Sun  2 , Jian Wang  2 , Yuanfei Fu  2 , Shenghua He  3
Affiliations

TiRobot-assisted percutaneous vertebroplasty in the management of middle and upper thoracic osteoporotic vertebral compression fracture

Juyi Lai et al. BMC Surg. .

Abstract

Purpose: This study aimed to evaluate the clinical efficacy and safety of TiRobot-assisted PVP surgery in the treatment of middle and upper thoracic OVCF. We also aimed to determine (1) changes in Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) before and after treatment, (2) imaging changes of the fractured vertebra, (3) operation time and intraoperative blood loss, (4) frequency of puncture and fluoroscopy, hospital stay, radiation exposure of patient and surgeon, and (5) bone cement leakage and distribution and operation-related complications.

Methods: A retrospective analysis was performed on 62 patients with OVCF of the middle and upper thoracic vertebrae (T1-T8) who underwent PVP surgery in Shenzhen Traditional Chinese Medicine Hospital from January 2017 to January 2023. Of them, 30 and 32 patients underwent TiRobot-assisted PVP surgery (robot group) and conventional C-arm-assisted PVP surgery (conventional group), respectively. VAS and ODI scores and the anterior height and local kyphotic angle of the fractured vertebra were compared before surgery and 3 days, 1 month, and 1 year after surgery. Simultaneously, the operation time, intraoperative blood loss, puncture frequency, fluoroscopy frequency, hospital stay, surgeon radiation exposure, patient radiation exposure, bone cement leakage, cement distribution, and complication were compared between the two groups.

Results: VAS score and ODI score at 3 days, 1 month, and 1 year after surgery were significantly improved in both groups compared with those before surgery (p < 0.05). The VAS score of the robot group was lower than that of the conventional group 3 days after surgery (p < 0.05), with no significant difference observed before and after surgery (p > 0.05). No significant difference was observed in anterior height and local kyphotic angle of fractured vertebra between the two groups before and after the surgery (p > 0.05). The operation time, intraoperative blood loss, puncture frequency, fluoroscopy frequency, hospital stay, surgeon radiation exposure, patient radiation exposure, bone cement leakage, and cement distribution of the robot group were all better than those of the conventional group (p < 0.05). Simultaneously, the incidence of complications in the robot group was 3.33% (1/30) lower than that of the conventional group (15.62%) (5/32) (p < 0.05).

Conclusions: Compared with traditional PVP surgery, the use of TiRobot-assisted PVP in the treatment of middle and upper thoracic OVCF has the advantages of accuracy, safety, and low-radiation exposure, which can further improve surgical safety, reduce bone cement leakage, and achieve satisfactory clinical efficacy.

Keywords: Osteoporotic compression fractures; Percutaneous vertebroplasty; Therapeutic study; Thoracic; TiRobot; Upper.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Shenzhen Traditional Chinese Medicine Hospital, China (No: K2022012). All participants signed informed consent of permitting their clinical data to be used for the study. Consent for publication: The authors affirm that all participants signed informed consent of permitting their clinical data to be used for the study, and the participants provided informed consent for publication of the images in Figs. 2 and 3. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Consort flowchart of patient selection. A total of 139 patients were screened, with 77 excluded based on criteria, leaving 62 patients for final analysis
Fig. 2
Fig. 2
A 60-year-old woman with back pain for 5 days after a fall. A-B Preoperative spine X-ray and magnetic resonance imaging (MRI) indicated osteoporotic compression fracture of T6 vertebral body; C The robotic tracer was fixed to the iliac bone through Kirschner wires during the operation; D-E Bilateral transpedicle puncture paths were planned during the operation; F Local anesthesia was performed before intraoperative puncture; G-H Intraoperative C-arm fluoroscopy showed that the puncture site was satisfactory; I-J X-ray examination 3 days after surgery showed good distribution of bone cement
Fig. 3
Fig. 3
An 82-year-old female patient suffered neck and back pain for 5 days due to a fall, underwent T12 and L1PVP surgery 2 years ago. A-B Preoperative X-rays showed that the patient had undergone T12 and L1PVP surgery; C-E Preoperative CT and MRI showed compression fracture of T2 vertebra. F X-ray was reexamined 3 days later; G-I CT reexamination 3 days after surgery showed the distribution of bone cement in the T2 vertebra
See this image and copyright information in PMC

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