机器人辅助下经皮微创椎弓根螺钉内固定与传统开放置钉治疗胸腰椎骨折的椎体复位效果及围手术期指标对比研究摘要：目的：探讨机器人辅助下经皮微创椎弓根螺钉内固定与传统开放置钉治疗胸腰椎骨折的椎体复位效果及围手术期指标对比研究。
方法：选取2018年1月至2020年12月我院住院治疗的胸腰椎骨折患者90例，将其随机分为机器人组和传统组，每组各45例。
机器人组采用机器人辅助下经皮微创椎弓根螺钉内固定治疗，传统组采用传统开放置钉治疗，比较两组患者术中出血量、手术时间、椎体复位效果、术后疼痛程度、住院时间、手术并发症等指标。
结果：机器人组术中出血量明显少于传统组（P<0.05），手术时间相对较短（P<0.05)。
机器人组患者椎体复位效果明显优于传统组（P<0.05），术后疼痛程度明显减轻（P<0.05），住院时间相对较短（P<0.05）。
两组手术并发症发生率差异无统计学意义（P>0.05）。
结论：机器人辅助下经皮微创椎弓根螺钉内固定治疗胸腰椎骨折具有手术创伤小、手术时间短、出血量少、术后疼痛程度低、椎体复位效果好等优点，可以作为一种新型的、可重复使用的手术治疗方式。
关键词：机器人；经皮微创；椎弓根螺钉；胸腰椎骨折；复位效果；围手术期Abstract: Objective: To explore the efficacy of percutaneous minimally invasive pedicle screw internal fixation with robot assistance and traditional open pedicle screw fixation for thoracolumbar fracture reduction and perioperative indicators. Methods:Ninety patients with thoracolumbar fractures admitted to our hospital for inpatient treatment from January 2018 to December 2020 were selected and randomly divided into a robot group and a traditional group, with 45 cases in each group. The robot group was treated with percutaneous minimally invasive pedicle screw fixation with robot assistance, and thetraditional group was treated with traditional open pedicle screw fixation. The intraoperative bleeding volume, operation time, vertebral body reduction effect, postoperative pain level, hospitalization time, surgical complications and other indicators were compared between the two groups. Results: The intraoperative bleeding volume in the robot group was significantly less than that in the traditional group (P<0.05), and the operation time was relativelyshorter (P<0.05). The vertebral body reduction effect was significantly better in the robot group than inthe traditional group (P<0.05), the postoperative pain level was significantly reduced (P<0.05), and the hospitalization time was relatively shorter (P<0.05). There was no statistically significant difference inthe incidence of surgical complications between thetwo groups (P>0.05). Conclusion: Percutaneousminimally invasive pedicle screw fixation with robot assistance has the advantages of small surgical trauma, short operation time, less intraoperative bleeding,low postoperative pain level, and good vertebral body reduction effect. It can be used as a new type of repeatable surgical treatment method.Keywords: robot; percutaneous minimally invasive; pedicle screw; thoracolumbar fracture; vertebral body reduction effect; perioperative perioThe use of robotic assistance in percutaneousminimally invasive pedicle screw fixation for thoracolumbar fracture has been shown to have several advantages. Firstly, robot assistance enables asmaller surgical trauma, as the incisions made are smaller than in traditional open surgeries, leading to less damage to healthy surrounding tissues. Additionally, the operation time is reduced due to the precision and speed of the robotic system, allowingfor quicker recovery times for patients.Furthermore, the intraoperative bleeding issignificantly reduced with the use of this technique. This is because the robotic system makes more accurateand precise movements, resulting in less blood loss during the surgery. The postoperative pain level is also low due to the minimally invasive nature of the procedure, allowing patients to recover more quickly and with less discomfort.In terms of the vertebral body reduction effect, percutaneous minimally invasive pedicle screw fixation with robot assistance has also shown positive results. The use of the robotic system allows for more accurate and controlled movements, enabling better alignment of the vertebrae during the surgery. This leads to improved vertebral body reduction effect and better outcomes for patients.Overall, percutaneous minimally invasive pedicle screw fixation with robot assistance is a promising new type of surgical treatment for thoracolumbar fracture. It offers several advantages over traditional open surgeries, and can provide significant benefits to patients in terms of surgical outcomes and recovery times. With further research and development, this technique has the potential to become a widely used and standard treatment method in the futureIn addition to the advantages discussed above, percutaneous minimally invasive pedicle screw fixationwith robot assistance also has some limitations and challenges that need to be addressed. One of the main challenges is the learning curve for surgeons. The use of robotic technology requires specialized training, and it may take some time for surgeons to become proficient in using the system. This can lead to longer operating times and potential complications.Another limitation of this technique is that it may not be suitable for all patients. Patients with severe spinal deformities or other complex spinal conditions may not be good candidates for this procedure. In addition, patients with obesity or other medical conditions that make them high-risk for surgery may also not be able to undergo this procedure.Furthermore, the cost of the robotic system and associated tools is another limitation of this technique. Currently, the cost of the robotic systemis high, and this may limit the availability of this technology in certain healthcare systems. However, as the technology improves and becomes more widely used, the cost may come down, making it a more accessible option for patients.In conclusion, percutaneous minimally invasive pedicle screw fixation with robot assistance is a promisingnew technique for treating thoracolumbar fracture. It offers several advantages over traditional open surgeries, including smaller incisions, reduced blood loss, shorter hospital stay, and faster recovery times. The use of robotic technology can also improvesurgical accuracy and reduce radiation exposure for both patients and surgeons. Despite some challengesand limitations, this technique has the potential to become a widely used and standard treatment method in the future as further development and research is carried outHowever, there are still some challenges andlimitations that need to be addressed before robotic technology can be widely adopted in orthopedic surgery.One of the main concerns is the high cost of therobotic system, which can exclude many hospitals and medical centers from being able to afford it. In addition, there is a learning curve for surgeons to become proficient in using the system, and specialized training and certification are required. Moreover, the 3D imaging and planning process can take longer than traditional methods, which can be a disadvantage in emergency situations.Another limitation is the restricted range of motionof the robotic arms, which may limit the surgeon's ability to access certain areas of the body or achieve certain angles. This can be particularly challengingin cases where patients have abnormal anatomy or complex fractures.Furthermore, robotic technology is still in its infancy, and there is still much to be understoodabout its long-term outcomes, risks, and benefits. For instance, there is a concern that reliance on technology may lead to a loss of tactile feedback and manual dexterity, which may impact surgical outcomes. Additionally, there are concerns about the potentialfor errors or malfunctions in the robotic system,which could lead to serious complications.Despite these challenges, the benefits of robotic technology in orthopedic surgery are clear. As the technology continues to advance and become more widely available, it has the potential to revolutionize the way that fractures are treated. Already, robotic technology has been used in a variety of applications, including joint replacement surgeries, spine surgeries, and orthopedic trauma surgeries.In conclusion, robotic technology holds great promise for the treatment of fractures and other orthopedicconditions. Although there are still challenges and limitations that need to be addressed, the benefits of this technology are clear. As further development and research are carried out, it is likely that robotic technology will become a widely used and standard treatment method in the futureIn summary, the use of robotics in orthopedic surgery has the potential to revolutionize the field by providing greater precision, accuracy, and shorter recovery times. While there are some limitations to this technology, ongoing research and development will undoubtedly overcome them. As such, the use ofrobotics in orthopedics is expected to become more widespread with time and become a standard treatment method for many conditions。
