北京生物医学工程

远程机器人辅助经皮椎体后凸成形术临床效果研究

Clinical outcomes of telerobot-assisted percutaneousvertebral kyphoplasty

作者：范明星张琦房彦名赵经纬王令珑何达田伟

单位：北京积水潭医院脊柱外科(北京100035) 首都医科大学燕京医学院(北京101300) 通信作者：田伟，院士。E-mail:tianwei_victor@ 163.com

分类号：R318

出版年·卷·期（页码）：2022·41·2（174-178）

摘要：

目的分析远程机器人辅助经皮椎体后凸成形术(percutaneous kyphoplasty, PKP)治疗胸腰椎压缩性骨折的临床效果，为远程机器人辅助脊柱手术的临床应用提供依据。方法回顾性分析2021 年3月至2021年12月由北京积水潭医院专家远程操作其他医院骨科手术机器人完成的PKP手术的 24例患者病例资料。统计患者基本资料、手术时间、腰背痛视觉模拟量表(visual analogue scale, VAS) 评分、局部后凸角、骨折椎体高度及并发症发生情况，评估远程机器人手术临床效果。结果24例远程机器人辅助PKP手术均顺利完成，平均手术时间为35.63 min ± 17.40 min。术后腰背痛VAS评分(2.02± 0.79)比术前(4.47±2.04)显著下降(P<0.001),术后局部后凸角(4.17°±2.02°)较术前(11.53°± 6.03°)显著下降(FcO.001)，术后骨折椎体高度(21.16 mm±5.55 mm)较术前(16.76 mm±3.90 mm)增加(P= 0.003)o未出现通讯故障、机器人故障和围手术期并发症。结论基于5G网络的远程机器人辅助PKP手术治疗胸腰椎压缩性骨折可显著缓解疼痛、改善局部后凸角、恢复椎体高度，是安全和有效的。

study retrospectively analyzed 24 patients accepted PKP surgery by experts from Beijing Jishuitan Hospital remotely manipulating orthopedic surgical robots of other hospitals from March 2021 to December 2021. Demographic data, operation time, low back pain visual analogue scale (VAS) score, local kyphosis angle, fractured vertebral body height and complications were collected to evaluate the clinical outcome of telerobot-assisted surgery. Results A total of 24 telerobot-assisted PKP surgeries were successfully completed, with an average operation time of 35.63 min ± 17.40 min. The postoperative low back pain VAS score (2.02±0.79) was significantly lower than the preoperative low back pain VAS score (4.47±2.04, P<0.001). The postoperative local kyphosis angle (4.17°±2.02°) was smaller than the preoperative local kyphosis angle ( 11.53° ±6.03°, P<0.001). The postoperative height of the fractured vertebral body after operation (21.16 mm±5.55 mm) was greater than the preoperative height ( 16.76±3.90, P- 0.003). There were no communication failures, robot failures, and no perioperative complications. Conclusions Based on 5G network, telerobot-assisted PKP surgery for thoracolumbar compression fractures can significantly relieve pain, improve local kyphosis, and restore vertebral height, which is safe and effective.

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