2022, Vol. 26 ›› Issue (15): 2356-2360

Orthopedic robot-assisted cortical bone trajectory screw internal fixation for the treatment of lumbar degenerative diseases

Lin Shu, Hu Jiang, Wan Lun, Tang Liuyi, Wang Yue, Yu Yang   

Abstract: BACKGROUND: Traditional pedicle screw has the risk of screw loosening in osteoporotic lumbar spine internal fixation, and cortical bone trajectory screw fixation can increase the holding power of screws, which can improve the accuracy of screw placement and reduce radiation injury with the assistance of orthopedic robots.  
OBJECTIVE: To compare the accuracy and safety of robot-assisted and manual cortical bone trajectory screw fixation in the treatment of lumbar degenerative diseases with osteoporosis.
METHODS: The clinical data of 39 patients with lumbar spine diseases and osteoporosis admitted from January 2018 to April 2020 were retrospectively analyzed. According to the different operation methods, the patients were divided into a robot group (n=19) and a manual group (n=20). The data of operation time, fluoroscopy frequency, fluoroscopy dose, intraoperative blood loss, incision length, hospitalization costs, and accuracy of screw placement were collected. Japanese Orthopedic Association scores were also used to compare preoperative and postoperative lumbar nerve function. This study protocol was approved by the Medical Ethics Committee of Sichuan Provincial People’s Hospital (approval No. 2019[298]).
RESULTS AND CONCLUSION: Compared with the manual group, the operation time was shorter, and intraoperative fluoroscopy frequency and fluoroscopy dose were significantly lower in the robot group (P < 0.05). The robot group had significantly longer incision length and higher hospitalization cost than the manual group (both P < 0.05). There was no significant difference between the two groups of patients in intraoperative blood loss and Japanese Orthopedic Association scores before, 3 months and 6 months after operation (P > 0.05). Accuracy of screw placement was 93% (71/76) in the robot group and 80% (64/80) in the manual group, and there was a significant difference between the two groups (P=0.014). To conclude, robot-assisted screw placement can reduce operation time, fluoroscopy frequency, fluoroscopy dose and increase accuracy of placement, compared with manual cortical bone trajectory screw fixation.
Key words: robot, cortical bone trajectory screw, lumbar degenerative disease, accuracy, fluoroscopy dose