文献类型：期刊文献

中文题名：天玑机器人改良导航系统在脊柱内镜髓核摘除术中的应用

英文题名：Application of iRobot II of orthopedic robotic system in percutaneous endoscopic nucleus pulposectomy

作者：李军杰[1];唐兰兰[1];杨镇源[1];邓强[1];张彦军[1];刘宴东[2]

第一作者：李军杰

机构：[1]甘肃省中医院,兰州730050;[2]甘肃中医药大学研究生院,兰州730000

第一机构：甘肃省中医院,兰州730050

年份：2023

卷号：39

期号：12

起止页码：1564

中文期刊名：实用医学杂志

外文期刊名：The Journal of Practical Medicine

收录：CSTPCD;;北大核心:【北大核心2020】；

基金：甘肃省自然科学基金项目(编号:20JR10RA356,22JR5RA624)。

语种：中文

中文关键词：改良辅助二维导航;腰椎间盘突出症;经皮脊柱内镜髓核摘除术

外文关键词：improved auxiliary two?dimensional navigation;lumbar disc herniation;percutaneous spinal endoscopy

摘要：目的探讨在经皮脊柱内镜髓核摘除术(percutaneous transforaminal endoscopic discectomy,PTED)中应用天玑骨科机器人改良导航系统的临床效果。方法选取甘肃省中医院2020年6月至2022年8月,完成天玑机器人改良二维导航辅助下PTED手术操作32例(改良导航组),与同期在C臂引导下完成35例PTED术(C臂透视组),对两组X线透视次数、辐射剂量、工作通道置入时间、手术总时长、VAS评分、ODI评分、技术学习曲线、手术并发症等进行统计分析。结果改良导航组在X线透视次数、辐射剂量、工作通道置入时间、手术总时长方面优于C臂透视组(P<0.05);两组患者手术前后VAS评分、ODI评分比较,差异均无统计学意义(P>0.05),术后各时间点与术前组内比较差异均有统计学意义(P<0.05);两组患者术中椎间孔成型情况、术后住院时间及患者术后并发症比较差异无统计学意义(P>0.05);改良导航组学习曲线较C臂透视组低平,且手术时间恒定,随手术例数增加呈明显减少趋势(P<0.05);两组并发症发生率比较差异无统计学意义(P<0.05);两组患者在术后末次随访时改良MacNab评分优良率比较,差异无统计学意义(P>0.05)。结论天玑机器人改良导航系统在PTED术中应用,能减少手术时间,降低术中辐射、手术风险,缩短PTED技术的学习曲线。
Objective To investigate the clinical effect of iRobotⅡof orthopedic robotic system in per?cutaneous endoscopic nucleus pulposectomy(PTED).Methods From June 2020 to August 2022,32 patients(improved navigation group)who completed the modified two?dimensional navigation?assisted PTED by iRobotⅡof orthopedic robotic system in our hospital and 35 patients(C?arm fluoroscopy group)who completed PTED under the guidance of C?arm in the same period were selected.The number of X?ray fluoroscopy,radiation dose,insertion time of working channel,total operation time,VAS score,ODI score,technical learning curve,and surgical complications of the two groups were statistically analyzed.Results Less X?ray fluoroscopy times,lower radiation dose,reduced working channel insertion time and shorter total operation time were observed in improved navigation group(P<0.05).There was no significant difference in VAS score and ODI score between the two groups before and after operation(P>0.05),but the comparison of VAS score and ODI score between the two groups at different time points after operation and intra?group comparison before operation showed statistical significance(P<0.05).There was no significant difference between the two groups in the formation of intervertebral foramen,the length of hospital stay and postoperative complications(P>0.05).The learning curve of the improved navigation group was lower and flater than that of the C?arm fluoroscopy group,and the operation time was constant,which was signifi?cantly shortened with the increase of the number of operations(P<0.05).There was no significant difference in the incidence of complications between the two groups(P<0.05).There was no statistical difference in the excellent and good rate of the modified MacNab score between the two groups in the last follow?up(P>0.05).Conclusion There are shortened operation time,reduced radiation and operation risk during the operation and shortened learning curve of PTED with the application of iRobotⅡof orthopedic robotic system in PTED.