Object: To compare the safety, clinical efficacy, and complication rate of “Tianji” robot-assisted surgery with traditional open surgery in the treatment of cervical vertebrae fracture. Methods: 60 patients with upp...Object: To compare the safety, clinical efficacy, and complication rate of “Tianji” robot-assisted surgery with traditional open surgery in the treatment of cervical vertebrae fracture. Methods: 60 patients with upper cervical vertebrae fracture admitted to Baise People’s Hospital between November 2018 and April 2024 were retrospectively analyzed. Among these patients, 29 underwent “Tianji” robot-assisted surgery (Robot group), and 31 underwent traditional C-arm fluoroscopy-assisted open surgery (Open group). Statistical analysis of the data was performed using SPSS 27.0 software to compare general data (gender, age, BMI), preoperative and postoperative visual analogue scale (VAS) scores, neck disability index (NDI), intraoperative blood loss, accuracy of screw placement on imaging, and the number of complications in both groups for comprehensive evaluation. A P value < 0.05 was deemed to have achieved statistical significance. Results: There was no significant difference in preoperative VAS scores between the two groups (Robot group: 8.34 ± 0.61;Open group: 8.26 ± 0.68, P = 0.317). There was also no significant difference in VAS scores at 1 week postoperatively (Robot group: 6.90 ± 0.31;Open group: 6.94 ± 0.36, P = 0.3237). Preoperative NDI scores showed no significant difference between the two groups (Robot group: 43.31 ± 2.67;Open group: 43.84 ± 2.67, P = 0.2227), and the difference in NDI scores at 1 week postoperatively was also not significant (Robot group: 35.69 ± 4.24;Open group: 37.35 ± 3.48, P = 0.0509). Intraoperative blood loss in the Robot group was significantly lower than in the Open group (246.21 ± 209 ml vs 380.65 ± 328.04 ml, P = 0.0308), with a statistically significant difference. The operation time was longer in the Robot group (3.75 ± 0.74 h) compared to the Open group (2.74 ± 0.86 h). In terms of screw placement accuracy, the Robot group had a higher accuracy rate for Class A screws compared to the Open group (102 screws vs 94 screws, P = 0.0487), and the accuracy rate for Class B screws was also higher in the Robot group (13 screws vs 29 screws, P = 0.0333), with both differences being statistically significant. There was no significant difference in the number of complications between the two groups (Robot group: 8 cases;Open group: 10 cases, P = 0.6931). Conclusion: Patients treated with “Tianji” robot-assisted surgery for upper cervical vertebrae fracture had lower intraoperative blood loss and higher screw placement accuracy compared to those undergoing traditional C-arm fluoroscopy-assisted open surgery, indicating that this robot-assisted surgery can effectively reduce intraoperative blood loss and improve screw placement accuracy.展开更多
Objective: To compare the effectiveness and safety of two surgical methods for lumbar degenerative diseases;the combination of the concept of accelerated rehabilitation with the assistance of Tianji Robotics and the c...Objective: To compare the effectiveness and safety of two surgical methods for lumbar degenerative diseases;the combination of the concept of accelerated rehabilitation with the assistance of Tianji Robotics and the concept of accelerated rehabilitation combined with manual pedicle screw placement assisted by conventional C-arm fluoroscopy. Methods: A retrospective analysis was performed on 70 patients who received the concept of accelerated rehabilitation combined with spinal surgery for lumbar degenerative diseases in Baise People’s Hospital from January 2022 to January 2024. Among them, 35 patients in the robot group received accelerated rehabilitation concept combined with robot-assisted surgery;In the conventional C-arm group, 35 patients received the accelerated rehabilitation concept combined with manual pedicle screw placement assisted by conventional C-arm fluoroscopy. VAS score (preoperative/postoperative), ODI score (preoperative/postoperative), intraoperative bleeding volume, postoperative hospital stay, postoperative complications and the accuracy rate of screw placement were compared between the two groups. Result: There was no statistically significant difference in preoperative VAS scores between the robot group and the conventional C-arm group (6.45 ± 0.82 VS 6.63 ± 0.81, P = 0.6600). The postoperative VAS score of the robot group was better than that of the conventional C-arm group (1.69 ± 0.80 VS 2.45 ± 0.85, P = 0.0000*). There was no statistically significant difference in preoperative ODI scores between the robot group and the conventional C-arm group (32.11 ± 3.18 VS 31.66 ± 2.25, P = 0.4900). The postoperative ODI score of the robot group was better than that of the conventional C-arm group (22.68 ± 1.94 VS 24.57 ± 2.25, P = 0.0000*). The postoperative complications in the robot group were less than those in the conventional C-arm group (2.7778% VS 28.5724%, P = 0.0030*). The intraoperative bleeding in the robot group was lower than that in the conventional C-arm group (320.85 ± 276.28 VS 490.00 ± 395.34, P = 0.0420*). The postoperative hospital stay of the robot group was shorter than that of the conventional C-arm group (10.00 ± 9.32 VS 14.49 ± 7.55, P = 0.0300*). The screw placement inaccuracy score of the robot group was lower than that of the conventional C-arm group (0.17 ± 0.51 VS 1.45 ± 1.46, P = 0.0000*). Conclusion: The combination of the concept of accelerated rehabilitation and Tianji Orthopedic robot-assisted surgery is more effective and safer in posterior lumbar decompression and internal fixation surgery with a screw rod system, and is worthy of promotion and application.展开更多
Objective: With the aging population and changes in lifestyle, lumbar spinal stenosis has become a common spinal disorder. Treatment modalities have been advancing, and the application of Enhanced Recovery After Surge...Objective: With the aging population and changes in lifestyle, lumbar spinal stenosis has become a common spinal disorder. Treatment modalities have been advancing, and the application of Enhanced Recovery After Surgery (ERAS) principles provides a new approach to postoperative recovery in patients. This study aims to investigate the clinical application effects of ERAS principles in single-level lumbar spinal stenosis surgery. Methods: This study included 64 patients who underwent lumbar fusion surgery in the Spinal Surgery Department of Baise People’s Hospital from July 2022 to July 2024. These patients were divided into an experimental group (ERAS group, 33 cases) and a control group (conventional group, 31 cases) based on perioperative care, receiving ERAS principles and traditional treatment, respectively. A comparison was made between the two groups in terms of gender, age, BMI, intraoperative blood loss, postoperative length of hospital stay, postoperative complications, hospital costs, VAS scores (preoperative/postoperative day 3), and ODI scores (preoperative/postoperative day 3). Results: There were no significant differences in gender, age, and BMI between the ERAS group and the conventional group (gender: χ2 = 0.5008, P = 0.4792;age: 54.55 ± 8.51 years vs. 57.39 ± 8.16 years, P = 0.0892;BMI: 25.11 ± 2.70 vs. 24.77 ± 2.75, P = 0.3098). However, during surgery, patients in the ERAS group had significantly less blood loss than those in the conventional group (197.58 ± 195.51ml vs. 438.71 ± 349.22 ml, P = 0.0006), and the postoperative length of hospital stay was significantly shorter (7.00 ± 2.24 days vs. 11.55 ± 5.23 days, P = 0.0000). On postoperative day 3, VAS scores were significantly better in the ERAS group compared to the conventional group (3.70 ± 0.88 vs. 4.32 ± 0.87, P = 0.0031), and the ODI scores showed significant improvement as well (46.00 ± 3.04 vs. 48.00 ± 3.39, P = 0.0078). Although there were no significant differences in postoperative complications and hospital costs (complications: 3 cases vs. 0 cases, P = 0.2154;hospital costs: 63524.29 ± 17891.80 RMB vs. 58733.84 ± 13280.82 RMB, P = 0.1154), ERAS demonstrated better postoperative recovery outcomes in single-level lumbar spinal stenosis surgery. Conclusion: The study results support the implementation of ERAS principles in single-level lumbar spinal stenosis surgery to promote rapid recovery, reduce healthcare resource consumption, and improve overall patient satisfaction.展开更多
Objective: This research aims to explore the clinical curative effect for the treatment peripheral nerve injury growth factor of Mecobalamin combined with nerve. Methods: 150 cases of patients with peripheral nerve in...Objective: This research aims to explore the clinical curative effect for the treatment peripheral nerve injury growth factor of Mecobalamin combined with nerve. Methods: 150 cases of patients with peripheral nerve injury treated in the hospital in July were selected from 2011 to 2013. Those patients were randomly divided into three groups according to the types of injured nerve and the undergoing treatment order. 50 cases are for each group. Patients in group A were injected with 0.5 mg Mecobalamin by intravenous injection. It lasted for once a day, for 10 days. Later, 0.5 mg Mecobalamin was changed to be taken orally, three times a day, a course of treatment. And a course is 3 to 6 weeks. 50 patients in group B were injected with nerve growth factor for 30 micrograms by intramuscular injection, once a day, a course of treatment. And a course is 3 to 6 weeks. While in group C, 50 patients were treated with Mecobalamin (0.5 mg, intravenous injection, once a day) combined with nerve growth factor (30 mg, intramuscular injection, once a day). A course lasted 3 to 6 weeks. The purpose is to observe the therapeutic effect of two different drugs on patients with peripheral nerve injury. Results: The curative effect of Mecobalamin combined with nerve growth factors for the treatment of peripheral nerve injury in group C is more significant than the single drug treatment in group A and group B. Peripheral nerve injury after sensorimotor function rating evaluation of curative effect made by The British Medical Research Institute of Neurotrauma Society was applied in this research. The comparison of the results of 3 groups after treatment is showed as follows. As to the sensory recovery above level II, the curative effect in C group is generally better than in group A and group B, the approximate chi square test H = 13.6573, P = 0.0011. About motion recovery situation, there is a statistical significance in group A and group C which recovered V level X<sup>2</sup> = 3.8431, P = 0.0499, while there is no obvious difference in group B (P > 0.05). Conclusion: Some certain curative effect is presented of Mecobalamin combined with nerve growth factor in the treatment of peripheral nerve injury, which has an important clinical significance. Therefore, it is worth taking into application.展开更多
<strong>Objective: </strong>To explore the therapeutic effect of autologous blood reinfusion combined with controlled hypotension in surgical spinal fixation during the outbreak of COVID-19. <strong>...<strong>Objective: </strong>To explore the therapeutic effect of autologous blood reinfusion combined with controlled hypotension in surgical spinal fixation during the outbreak of COVID-19. <strong>Methods: </strong>30 patients with spinal internal fixation autologous blood transfusion combined with controlled hypotension were selected as the subjects during the epidemic period from December 2019 to June 2020 in our hospital and during the operation, on the basis of routine blood pressure reduction, the American Haemonetice Corporation autologous blood continuous reinfusion system was used to infuse the blood recovered during the operation to the patient through filtration and other procedures. <strong>Results:</strong> 30 patients had no complications such as fever and hemolysis;And after the operation, the tube was dialed according to the drainage volume, the cervical thoracic and lumbar brace was customized, and the patient walked on the ground for one week;After no abnormalities, the patient was discharged. Intraoperative comparison of white blood cells (WBC), red blood cells (RBC), red blood cell pressure (HCT), hemoglobin (HGB), and coagulation time (PT) of patients with autologous blood before and after transfusion showed statistically significant differences before and after surgery (P < 0.001). <strong>Conclusion:</strong> During the new coronavirus pneumonia epidemic, the internal fixation of spinal surgery used a recovery machine to collect intraoperative blood for reinfusion. Intraoperative antihypertensive drugs were used to control blood pressure within a certain safe range. The postoperative clinical observation effect was significant and safe;especially at present the clinical significance during the epidemic was significant.展开更多
文摘Object: To compare the safety, clinical efficacy, and complication rate of “Tianji” robot-assisted surgery with traditional open surgery in the treatment of cervical vertebrae fracture. Methods: 60 patients with upper cervical vertebrae fracture admitted to Baise People’s Hospital between November 2018 and April 2024 were retrospectively analyzed. Among these patients, 29 underwent “Tianji” robot-assisted surgery (Robot group), and 31 underwent traditional C-arm fluoroscopy-assisted open surgery (Open group). Statistical analysis of the data was performed using SPSS 27.0 software to compare general data (gender, age, BMI), preoperative and postoperative visual analogue scale (VAS) scores, neck disability index (NDI), intraoperative blood loss, accuracy of screw placement on imaging, and the number of complications in both groups for comprehensive evaluation. A P value < 0.05 was deemed to have achieved statistical significance. Results: There was no significant difference in preoperative VAS scores between the two groups (Robot group: 8.34 ± 0.61;Open group: 8.26 ± 0.68, P = 0.317). There was also no significant difference in VAS scores at 1 week postoperatively (Robot group: 6.90 ± 0.31;Open group: 6.94 ± 0.36, P = 0.3237). Preoperative NDI scores showed no significant difference between the two groups (Robot group: 43.31 ± 2.67;Open group: 43.84 ± 2.67, P = 0.2227), and the difference in NDI scores at 1 week postoperatively was also not significant (Robot group: 35.69 ± 4.24;Open group: 37.35 ± 3.48, P = 0.0509). Intraoperative blood loss in the Robot group was significantly lower than in the Open group (246.21 ± 209 ml vs 380.65 ± 328.04 ml, P = 0.0308), with a statistically significant difference. The operation time was longer in the Robot group (3.75 ± 0.74 h) compared to the Open group (2.74 ± 0.86 h). In terms of screw placement accuracy, the Robot group had a higher accuracy rate for Class A screws compared to the Open group (102 screws vs 94 screws, P = 0.0487), and the accuracy rate for Class B screws was also higher in the Robot group (13 screws vs 29 screws, P = 0.0333), with both differences being statistically significant. There was no significant difference in the number of complications between the two groups (Robot group: 8 cases;Open group: 10 cases, P = 0.6931). Conclusion: Patients treated with “Tianji” robot-assisted surgery for upper cervical vertebrae fracture had lower intraoperative blood loss and higher screw placement accuracy compared to those undergoing traditional C-arm fluoroscopy-assisted open surgery, indicating that this robot-assisted surgery can effectively reduce intraoperative blood loss and improve screw placement accuracy.
文摘Objective: To compare the effectiveness and safety of two surgical methods for lumbar degenerative diseases;the combination of the concept of accelerated rehabilitation with the assistance of Tianji Robotics and the concept of accelerated rehabilitation combined with manual pedicle screw placement assisted by conventional C-arm fluoroscopy. Methods: A retrospective analysis was performed on 70 patients who received the concept of accelerated rehabilitation combined with spinal surgery for lumbar degenerative diseases in Baise People’s Hospital from January 2022 to January 2024. Among them, 35 patients in the robot group received accelerated rehabilitation concept combined with robot-assisted surgery;In the conventional C-arm group, 35 patients received the accelerated rehabilitation concept combined with manual pedicle screw placement assisted by conventional C-arm fluoroscopy. VAS score (preoperative/postoperative), ODI score (preoperative/postoperative), intraoperative bleeding volume, postoperative hospital stay, postoperative complications and the accuracy rate of screw placement were compared between the two groups. Result: There was no statistically significant difference in preoperative VAS scores between the robot group and the conventional C-arm group (6.45 ± 0.82 VS 6.63 ± 0.81, P = 0.6600). The postoperative VAS score of the robot group was better than that of the conventional C-arm group (1.69 ± 0.80 VS 2.45 ± 0.85, P = 0.0000*). There was no statistically significant difference in preoperative ODI scores between the robot group and the conventional C-arm group (32.11 ± 3.18 VS 31.66 ± 2.25, P = 0.4900). The postoperative ODI score of the robot group was better than that of the conventional C-arm group (22.68 ± 1.94 VS 24.57 ± 2.25, P = 0.0000*). The postoperative complications in the robot group were less than those in the conventional C-arm group (2.7778% VS 28.5724%, P = 0.0030*). The intraoperative bleeding in the robot group was lower than that in the conventional C-arm group (320.85 ± 276.28 VS 490.00 ± 395.34, P = 0.0420*). The postoperative hospital stay of the robot group was shorter than that of the conventional C-arm group (10.00 ± 9.32 VS 14.49 ± 7.55, P = 0.0300*). The screw placement inaccuracy score of the robot group was lower than that of the conventional C-arm group (0.17 ± 0.51 VS 1.45 ± 1.46, P = 0.0000*). Conclusion: The combination of the concept of accelerated rehabilitation and Tianji Orthopedic robot-assisted surgery is more effective and safer in posterior lumbar decompression and internal fixation surgery with a screw rod system, and is worthy of promotion and application.
文摘Objective: With the aging population and changes in lifestyle, lumbar spinal stenosis has become a common spinal disorder. Treatment modalities have been advancing, and the application of Enhanced Recovery After Surgery (ERAS) principles provides a new approach to postoperative recovery in patients. This study aims to investigate the clinical application effects of ERAS principles in single-level lumbar spinal stenosis surgery. Methods: This study included 64 patients who underwent lumbar fusion surgery in the Spinal Surgery Department of Baise People’s Hospital from July 2022 to July 2024. These patients were divided into an experimental group (ERAS group, 33 cases) and a control group (conventional group, 31 cases) based on perioperative care, receiving ERAS principles and traditional treatment, respectively. A comparison was made between the two groups in terms of gender, age, BMI, intraoperative blood loss, postoperative length of hospital stay, postoperative complications, hospital costs, VAS scores (preoperative/postoperative day 3), and ODI scores (preoperative/postoperative day 3). Results: There were no significant differences in gender, age, and BMI between the ERAS group and the conventional group (gender: χ2 = 0.5008, P = 0.4792;age: 54.55 ± 8.51 years vs. 57.39 ± 8.16 years, P = 0.0892;BMI: 25.11 ± 2.70 vs. 24.77 ± 2.75, P = 0.3098). However, during surgery, patients in the ERAS group had significantly less blood loss than those in the conventional group (197.58 ± 195.51ml vs. 438.71 ± 349.22 ml, P = 0.0006), and the postoperative length of hospital stay was significantly shorter (7.00 ± 2.24 days vs. 11.55 ± 5.23 days, P = 0.0000). On postoperative day 3, VAS scores were significantly better in the ERAS group compared to the conventional group (3.70 ± 0.88 vs. 4.32 ± 0.87, P = 0.0031), and the ODI scores showed significant improvement as well (46.00 ± 3.04 vs. 48.00 ± 3.39, P = 0.0078). Although there were no significant differences in postoperative complications and hospital costs (complications: 3 cases vs. 0 cases, P = 0.2154;hospital costs: 63524.29 ± 17891.80 RMB vs. 58733.84 ± 13280.82 RMB, P = 0.1154), ERAS demonstrated better postoperative recovery outcomes in single-level lumbar spinal stenosis surgery. Conclusion: The study results support the implementation of ERAS principles in single-level lumbar spinal stenosis surgery to promote rapid recovery, reduce healthcare resource consumption, and improve overall patient satisfaction.
文摘Objective: This research aims to explore the clinical curative effect for the treatment peripheral nerve injury growth factor of Mecobalamin combined with nerve. Methods: 150 cases of patients with peripheral nerve injury treated in the hospital in July were selected from 2011 to 2013. Those patients were randomly divided into three groups according to the types of injured nerve and the undergoing treatment order. 50 cases are for each group. Patients in group A were injected with 0.5 mg Mecobalamin by intravenous injection. It lasted for once a day, for 10 days. Later, 0.5 mg Mecobalamin was changed to be taken orally, three times a day, a course of treatment. And a course is 3 to 6 weeks. 50 patients in group B were injected with nerve growth factor for 30 micrograms by intramuscular injection, once a day, a course of treatment. And a course is 3 to 6 weeks. While in group C, 50 patients were treated with Mecobalamin (0.5 mg, intravenous injection, once a day) combined with nerve growth factor (30 mg, intramuscular injection, once a day). A course lasted 3 to 6 weeks. The purpose is to observe the therapeutic effect of two different drugs on patients with peripheral nerve injury. Results: The curative effect of Mecobalamin combined with nerve growth factors for the treatment of peripheral nerve injury in group C is more significant than the single drug treatment in group A and group B. Peripheral nerve injury after sensorimotor function rating evaluation of curative effect made by The British Medical Research Institute of Neurotrauma Society was applied in this research. The comparison of the results of 3 groups after treatment is showed as follows. As to the sensory recovery above level II, the curative effect in C group is generally better than in group A and group B, the approximate chi square test H = 13.6573, P = 0.0011. About motion recovery situation, there is a statistical significance in group A and group C which recovered V level X<sup>2</sup> = 3.8431, P = 0.0499, while there is no obvious difference in group B (P > 0.05). Conclusion: Some certain curative effect is presented of Mecobalamin combined with nerve growth factor in the treatment of peripheral nerve injury, which has an important clinical significance. Therefore, it is worth taking into application.
文摘<strong>Objective: </strong>To explore the therapeutic effect of autologous blood reinfusion combined with controlled hypotension in surgical spinal fixation during the outbreak of COVID-19. <strong>Methods: </strong>30 patients with spinal internal fixation autologous blood transfusion combined with controlled hypotension were selected as the subjects during the epidemic period from December 2019 to June 2020 in our hospital and during the operation, on the basis of routine blood pressure reduction, the American Haemonetice Corporation autologous blood continuous reinfusion system was used to infuse the blood recovered during the operation to the patient through filtration and other procedures. <strong>Results:</strong> 30 patients had no complications such as fever and hemolysis;And after the operation, the tube was dialed according to the drainage volume, the cervical thoracic and lumbar brace was customized, and the patient walked on the ground for one week;After no abnormalities, the patient was discharged. Intraoperative comparison of white blood cells (WBC), red blood cells (RBC), red blood cell pressure (HCT), hemoglobin (HGB), and coagulation time (PT) of patients with autologous blood before and after transfusion showed statistically significant differences before and after surgery (P < 0.001). <strong>Conclusion:</strong> During the new coronavirus pneumonia epidemic, the internal fixation of spinal surgery used a recovery machine to collect intraoperative blood for reinfusion. Intraoperative antihypertensive drugs were used to control blood pressure within a certain safe range. The postoperative clinical observation effect was significant and safe;especially at present the clinical significance during the epidemic was significant.
