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2022, Vol. 26 ›› Issue (16): 2467-2472Robot-assisted percutaneous vertebroplasty in the treatment of pathological fractures of thoracolumbar multivertebraYu Yang, Tang Liuyi, Hu Jiang, Wan Lun, Zhang Wei, Lin Shu, Wang Fei
Abstract: BACKGROUND: Vertebroplasty can effectively treat spinal pathological fractures, but the side effects and bone cement leakage caused by this operation are often reported. OBJECTIVE: To investigate the clinical efficacy of robot-assisted percutaneous vertebroplasty in the treatment of pathological fractures of thoracic and lumbar vertebrae. METHODS: From June 2017 to December 2019, 25 patients with pathological fractures of thoracolumbar vertebrae in the Sichuan Provincial People’s Hospital were retrospectively analyzed, including 7 males and 18 females, aged from 57 to 80 years old. There were 10 cases of osteoporotic vertebral fracture, 15 cases of vertebral tumor, 16 cases of 3 diseased vertebrae, 6 cases of 4 diseased vertebrae, and 3 cases of more than 5 diseased vertebrae. There were 13 patients (50 vertebrae) with robot assisted vertebroplasty (robot group), and 12 patients (38 vertebrae) with freehand vertebroplasty (conventional group). The number of puncture, fluoroscopy, operation time, intraoperative blood loss, bone cement distribution, bone cement leakage and intraoperative radiation dose of the operator were recorded and compared between the two groups. Oswestry disability index and visual analogue scale scores of the patients were recorded and compared before and after operation. This study was approved by Ethics Committee of Sichuan Provincial People’s Hospital. RESULTS AND CONCLUSION: (1) The operation time, number of puncture, fluoroscopy, intraoperative blood loss, intraoperative radiation dose, and bone cement leakage in the robot group were all lower than those in the conventional group (P < 0.05). The bone cement distribution was better in the robot group than that in the conventional group (P < 0.05). (2) Oswestry disability index and visual analogue scale scores were significantly improved in the two groups at postoperative 2 days compared with those preoperatively (P < 0.05). Visual analogue scale score and Oswestry disability index of the robot group and the conventional group showed no statistical significance before and 2 days after surgery (P > 0.05). (3) For patients with multiple vertebral pathological fractures, robot-assisted vertebroplasty improves the accuracy of puncture, which can not only reduce the puncture injury of patients, obtain satisfactory bone cement dispersion and reduce bone cement leakage, but also reduce the operator’s radiation exposure and obtain satisfactory clinical efficacy. Key words:bone, implant, robot, vertebroplasty, thoracolumbar spine, pathological fracture, bone cement, radiation exposure |