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2022, Vol. 26 ›› Issue (9): 1434-1438Advantage and disadvantage of robot-assisted sacroiliac screw placement and traditional fluoroscopy in orthopedic surgeryLi Canhui, Wu Zhengjie, Zeng Yanhui, He Yinghao, Situ Xiaopeng, Du Xuelian, Hong Shi, He Jiaxiong
Abstract: BACKGROUND: Patients with pelvic fractures are often accompanied by sacroiliac joint separation, and the most effective surgical treatment for this condition is the placement of sacroiliac screws. At present, the commonly used nail placement method is mainly for the surgeon to place it by hand under fluoroscopy. The accuracy and safety are poor, and the screw position after surgery is closely related to the experience of the surgeon. Orthopedic surgical robot-assisted sacroiliac screw placement is an advanced surgical method recently. However, due to the high cost of robots and limited clinical applications, there are currently many controversies regarding the safety and reliability of the operation. OBJECTIVE: To investigate the clinical effect of robot-assisted sacroiliac screw placement. METHODS: A total of 95 patients with pelvic fractures treated in Foshan Hospital of Traditional Chinese Medicine from January 2018 to January 2020 were reviewed. Among them, 48 patients underwent percutaneous sacroiliac screw placement and 47 patients underwent robot-assisted sacroiliac screw placement. The operation time of sacroiliac screw placement, the number of postoperative complications, Matta score, Majeed score, and Merle D 'Aubigne and Postel score were compared between the two groups. RESULTS AND CONCLUSION: (1) The operation time of the robot-assisted sacroiliac screw placement group was significantly shorter than that in the percutaneous sacroiliac screw placement group (P < 0.05). The incidence of complications was significantly lower in the robot-assisted sacroiliac screw placement group than that in the percutaneous sacroiliac screw placement group (P < 0.05). Five cases of internal fixation failure and three cases of fracture nonunion were found in the percutaneous sacroiliac screw placement group. One case of fracture nonunion was found in the robot-assisted sacroiliac screw placement group. The healing of the above cases was finally achieved by replacing internal fixation. (2) The excellent and good rates of Matta score, Majeed score, and Merle D 'Aubigne and Postel score were significantly higher in the robot-assisted sacroiliac screw placement group than those in the percutaneous sacroiliac screw placement group (P < 0.05). (3) The fluoroscope time was significantly shorter in the robot-assisted sacroiliac screw placement group (7.2±1.5) s/times than that in the percutaneous sacroiliac screw placement group (25.7±7.6) s/times (P < 0.05). (4) The results showed that the robot-assisted sacroiliac screw placement had the advantages of short operation time and high accuracy. Key words:pelvic fracture, sacroiliac screw">, surgical robot">, percutaneous screw placement">, Matta score">, Majeed score |