Objective To assess the effectiveness and viability of 5G-enabled robot-assisted thoracolumbar internal fixa-tion surgery,scrutinizing its benefits and potential limitations in a clinical setting.Methods This retrospective case series study analyzed 61 patients who underwent robot-assisted remote thoracolumbar internal fixation surgery between April and December 2021.The orthopaedic robotic telesurgery system,centered at Beijing Jishuitan Hospital and utilizing 5G technology for network transmission,was used to assist in screw placement.The surgeries,distributed across ten hospitals and executed over an average distance of 1 617 km(maximum exceeding 3 000 km),were appraised by examining the accuracy of screw placement,intraopera-tive communication efficacy,complication rates,among other metrics,and benchmarked against traditional local procedures.Re-sults Telesurgery was completed successfully in all patients,averaging 92±32 minutes per operation.Out of 354 screws placed,89.8％were positioned perfectly and 97.5％were deemed clinically acceptable.The 61 patients,followed-up for an average of 18.9±1.9 months,exhibited significant postoperative improvement in pain.The preoperative visual analogue scale(VAS)pain score was 5.74±1.30 and improved to 2.30±0.90 at discharge,a statistically significant difference(t=1 1.002,P＜0.001).6 patients with thoracolumbar degenerative spine disease showed significant relief of claudication and pain symptoms postoperatively.55 pa-tients with thoracolumbar spine fractures had a preoperative height ratio of 62.78％±12.60％at the anterior margin of the injured vertebrae,which recovered to 85.36％±8.35％postoperatively,a statistically significant difference(t=16.977,P＜0.001).All frac-tures were healed at final follow-up.No perioperative complications,such as vascular or nerve injuries or infections,occurred.Ad-ditionally,there were no complications related to the use of the robot.The 5G network ensured stable transmission of robotic con-trol signals,images,and audio signals during the procedure,with no signal delays or communication failures observed.The perfect rate(90.2％vs.93.8％,x2=0.169,P=0.681)and clinical acceptability rate(99.0％vs.100.0％,P=1.000)of remote versus local ro-botic-assisted screw placement in participating hospital 1(Shantou Xin Sheng Orthopaedic Hospital)were similar.The perfect rate(87.0％vs.85.4％,x2=0.075,P=0.784)and clinical acceptability rate(100.0％vs.96.6％,x2=0.580,P=0.446)of remote versus lo-cal robotic-assisted screw placement in participating hospital 2(Guizhou Provincial People's Hospital)were similar.Conclusion 5G technology enhances the remote application of robotic thoracolumbar surgery without compromising patient safety or outcome quality.It underscores the potential for broader adoption of surgical robotics,aiding in the standardization of medical practices across China,boosting healthcare efficiency,and aligning with the Healthy China strategy.
关键词
胸椎/腰椎/机器人手术/椎弓根钉/远程手术/第五代移动通信技术
Key words
Thoracic vertebrae/Lumbar vertebrae/Robotic surgical procedures/Pedicle screws/Telesurgery/5th genera-tion mobile communication technology
维普
万方数据