Comparison of application of robot-assisted surgery and three-dimensional C-arm X-ray machine during pedicle screw internal fixation for patients with thoracolumbar fractures without nerve injury
Objective To compare the application effect of robot-assisted surgery and three-dimensional C-arm X-ray machine on patients with thoracolumbar fractures without nerve injury during pedicle screw internal fixation.Methods A retrospective analysis was conducted on 85 patients with thoracolumbar fractures without nerve injury.All patients were treated with percutaneous pedicle screw internal fixation.According to different surgical procedures,the patients were divided into observation group(robot-assisted screw placement)and control group(screw placement under three-dimensional C-arm X-ray fluoroscopy).The surgical time,intraoperative blood loss,intraoperative fluoroscopy frequency and postoperative hospital stay in two groups were recorded;and the screw placement and reduction were compared between two groups.Postoperative pain[visual analogue scale(VAS)]and functional recovery[Oswestry disability index(ODI)]were evaluated after 1 month of follow-up.Results Compared with control group,observation group shortened surgical time(P<0.05)and reduced intraoperative fluoroscopy frequency(P<0.05),but the differences between two groups in intraoperative blood loss and postoperative hospital stay were trivial(P>0.05).The accuracy rate of screw placement in observation group was 94.57%,significantly higher than 83.59%in control group(P<0.05).One week postoperatively,the injured vertebral anterior height ratio was increased in both groups as compared with that before surgery(P<0.05),and the Cobb angle and local kyphosis angle of injured vertebrae were lower than those before surgery(P<0.05),but the injured vertebral anterior height ratio,Cobb angle and local kyphosis angle of injured vertebrae didn't differ significantly between two groups at the same time point(P>0.05).One month postoperatively,the VAS score and ODI in both groups were lower than those before surgery(P<0.05),but there were no statistical differences in VAS score and ODI between two groups at the same time point(P>0.05).Conclusion Both robot-assisted screw placement and three-dimensional C-arm X-ray screw placement in patients with thoracolumbar fractures without nerve injury can achieve good reduction effect of injured vertebrae and promote early functional recovery.However,robot-assisted screw placement can shorten surgical time,reduce intraoperative fluoroscopy frequency,and enhance the accuracy rate of screw placement,which makes it more advantageous in clinical practice.
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