摘要
目的探讨应用"天玑"骨科手术机器人辅助胸腰椎椎弓根螺钉内固定术的学习曲线和临床意义。方法选择2015年11月至2017年11月北京积水潭医院应用"天玑"骨科手术机器人辅助胸腰椎椎弓根螺钉内固定术治疗的病历编号连续的125例患者,手术均由同一组医生完成。其中男56例,女69例,平均年龄为54岁(18～79岁)。统计分析全部患者的手术时间、术中出血量、并发症及椎弓根螺钉置入精度等资料。结果所有患者术后均未发生骨科手术机器人相关并发症。手术共置入椎弓根螺钉577枚,螺钉置入精度为(1.45±0.33)mm。曲线回归分析结果显示,机器人辅助胸腰椎椎弓根螺钉内固定术的螺钉置入精度随手术病例数的增加而显著增加(P=0.000)。机器人辅助单节段腰椎手术的平均术中出血量随手术病例数的增加而显著减少(早期组vs.中期组,P=0.181;中期组vs.后期组,P=0.045;早期组vs.后期组,P=0.001),但平均手术时间的变化差异无统计学意义(早期组vs.中期组,P=0.245;中期组vs.后期组,P=0.578;早期组vs.后期组,P=0.567)。结论 "天玑"骨科手术机器人辅助胸腰椎椎弓根螺钉内固定术的学习曲线随手术病例数的增加迅速趋于平稳。骨科手术机器人辅助技术是治疗胸腰椎疾患的一种安全准确的方法。
Objective To analyze the learning curve of the use of TianJi Robot in assisting thoracolumbar pedicle screw fixation and evaluate the clinical outcomes of using this technique. Methods A total of125 consecutive patients underwent thoracolumbar pedicle screw fixation with TianJ i Robot and performed by the same group of doctors between November 2015 and November 2017 were enrolled. There were 56 males and69 females,with an average age of 54 years（ ranged from 18 to 79 years）. All patients were statistically analyzed for surgery time,intraoperative blood loss,complications and pedicle screw placement accuracy. Results No complications related to TianJ i Robot~？ occurred during all operations. A total of 577 pedicle screws were placed,the accuracy of all screws was（ 1. 45 ± 0. 33） mm. Curvilinear regression showed that robotic assisted thoracolumbar pedicle screw fixation accuracy was increased significantly with the increase of the number of patients（ P = 0. 000）. The intraoperative blood loss during robotic-assisted single-segment lumbar surgery was reduced significantly with the increase of the number of patients（ early vs. midterm patients,P = 0. 181; midterm vs. late patients,P = 0. 045; early vs. late patients,P = 0. 001）,however,there was no statistical difference in surgery time（ early vs. midterm patients,P = 0. 245; midterm vs. late patients,P = 0. 578; early vs. late patients,P = 0. 567）. Conclusion The learning curve of orthopaedic robots quickly becomes stable with the increase of the number of patients. The orthopaedic robot technology is a safe and accuracy method for treatment of thoracolumbar diseases.
作者
范明星
刘亚军
段芳芳
韩晓光
赵经纬
田伟
Fan Mingxing;Liu Yajun;Duan Fan.tang;Hart Xiaoguang;Zhao Jingwei;Tian Wei(Department of Spine Surgery,Beijing Jishuitan Hospital,Bering 100035,China)
出处
《骨科临床与研究杂志》
2018年第4期213-217,共5页
Journal Of Clinical Orthopedics And Research
基金
国家自然科学基金(U1713221)
国家重点研发计划(2016YFC0105800)~~
