Application of the Third Generation TiRobot-Assisted Percutaneous Screw Placement in Lumbar Fusion and Internal Fixation via Wiltse Approach
Objective:To investigate the safety and clinical efficacy of the third generation TiRobot-assisted percutaneous screw placement versus freehand placement of screws in lumbar spine fusion and internal fixation via Wiltse approach.Methods:48 patients with lumbar spine who underwent the third generation TiRobot-assisted fusion and internal fixation via Wiltse approach from December 2021 to July 2022 were selected,including 28 males and 20 females,aged 32-74 years old.All 48 patients had symptoms of unilateral nerve compression.Robot-assisted percutaneous pedicle screw placement was used on the side of the lumbar spine,and the lumbar spine on the other side was placed with screws through the Wilt-se approach.The preoperative and last follow-up visual analogue scale(VAS)and lumbar Japanese orthopedic association(JOA)scores of 48 patients were compared,and the Richter classification criteria and screw cohesion angle were used to compare the accuracy of pedicle screw placement on the both sides.The time and bleeding volume of bilateral nail placement were statistically analyzed.Results:The VAS score and JOA score of the patients at the last follow-up after op-eration were significantly improved compared with those before operation(P＜0.05).The Richter classification crite-ria were used to evaluate the accuracy of screw placement 2 d after surgery.There were 108 nails placed on the healthy side,and 101 were grade Ⅰ,6 of grade Ⅱ and 1 of grade Ⅲ.There were 104 nails placed on the affected side,including 80 of grade Ⅰ,20 of grade Ⅱ,and 4 of grade Ⅲ.The accuracy of robot assisted nailing was 93.52％,and that of manual nailing was 76.92％.The accuracy of robot assisted nailing was significantly better than manual nailing,and the difference was statistically significant(x2=7.727,P=0.005).The aver-age cohesion angle of pedicle screws placed under robotic assistance was 25.19°±3.85°,and the average cohesion angle of pedicle screws placed was 29.19°±4.37°,and the difference was statistically significant(t=10.24,P=0.03).The amount of bleeding and the time of placing nails assisted by robot are better than those of unarmed nails(P＜0.05).Con-clusion:The results show that the robot-assisted percutaneous nail placement can further improve the safety of surgery and improve the clinical efficacy compared with manual nail placement.
万方数据
维普
