摘要
由于脊柱解剖结构的复杂性，开放或经皮置入椎弓根螺钉时均存在损伤神经或血管的风险。在术前CT评估及术中导航等多种手段的辅助下，置钉失败率仍然达到4.1%~28.9%。近年来，手术机器人系统在脊柱外科的发展可能将为这一问题的解决带来新的思路。外科机器人系统在脊柱外科领域的应用历史已逾20年，但近年来随着术中导航、术中CT监测等新技术的发展，脊柱外科机器人系统得到了快速发展，部分脊柱外科机器人系统已获得了FDA或CE等权威部门的认证。脊柱外科机器人系统辅助下实施脊柱侧凸矫形、重度脊柱滑脱复位固定等难度较大的手术成功病例也越发见诸于文献报道。目前，已有众多文献验证了脊柱外科机器人系统具有置钉精确度高、稳定性强、学习曲线短等优势，在将来或许能够成为脊柱外科手术的主流趋势之一。因此，对当前较为成熟的脊柱外科机器人系统进行系统介绍，以及总结现阶段的临床应用指征和临床应用成果等相关问题有着重的临床意义。
Open and percutaneous pedicle screw insertion would have the risk of damaging the nerve or blood vessels, due to the complexity of the spine structure. Despite the aid of various means of preoperative CT and intraoperative navigation, pedicle screw insertion failure rate is still 4.1%-28.9%. In recent years, the development of spine surgical robots might bring new solutions to this problem. The use of the spine surgical robots has been more than 20 years, and developed rapidly with the development of intraoperative navigation and intraoperative CT in recent years. Some robots have been certified by the FDA or the CE. And the number of reported robot-assisted surgeries such as scoliosis surgeries or severe lumbar spondylolisthesis surgeries has increased rapidly as well. Current literatures have verified the robot-assisted pedicle screw insertion has high accuracy, good stability and short learning curve, which may be able to become one of the main trend of spinal surgery in the future. This article mend to review some developed spine surgery robot and their clinical application indication and results.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2017年第24期1556-1560,共5页
Chinese Journal of Orthopaedics
