Clinical effects of robot-assisted minimal invasive transforaminal lumbar interbody fusion in the treatment of single-segment lumbar disc herniation

Chao Jiang; Yongyuan Zhang; Xiaohui Wang; Zhe Chen; Tonghao Wang; Zhiyuan Wang; Fang Tian; Qing LU; Si Yin; Heng DU; Dingjun Hao

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Clinical effects of robot-assisted minimal invasive transforaminal lumbar interbody fusion in the treatment of single-segment lumbar disc herniation

VernacularTitle:机器人辅助微创通道下经椎间孔椎间融合术治疗单节段腰椎间盘突出症的临床疗效
Author: Chao JIANG ¹ ; Yongyuan ZHANG ¹ ; Xiaohui WANG ^{1
,

2} ; Zhe CHEN ^{1
,

2} ; Tonghao WANG ³ ; Zhiyuan WANG ^{1
,

2} ; Fang TIAN ^{1
,

2} ; Qing LU ¹ ; Si YIN ⁴ ; Heng DU ⁴ ; Dingjun HAO ¹
Author Information

1. Department of Spine Surgery, Honghui Hospital of Xi’an Jiaotong University, Xi’an 710054
2. Department of Orthopedics, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061
3. The First Department of Traumatic Orthopedics, Baoji Hospital of Traditional Chinese Medicine, Baoji 721001, China
4. Department of Orthopedics, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061
Publication Type:Journal Article
Keywords: robot; lumbar disc herniation; minimal invasive transforaminal lumbar interbody fusion; screw placement accuracy
From: Journal of Xi'an Jiaotong University(Medical Sciences) 2022;43(5):713-719
CountryChina
Language:Chinese
Abstract: 【Objective】 To compare the clinical effects and screw placement accuracy for treating lumbar disc herniation between robot-assisted minimal invasive transforaminal lumbar interbody fusion (RA-MIS-TLIF) and minimal invasive transforaminal lumbar interbody fusion (MIS-TLIF). 【Methods】 We retrospectively recruited 69 patients with single segment lumbar disc herniation treated between January 2018 and August 2019 at Honghui Hospital of Xi’an Jiaotong University. There were cases of 33 RA-MIS-TLIF (RA group) and 36 MIS-TLIF (MIS-TLIF group). Subsequently, the patients’ baseline characteristics were collected, including age, gender, body mass index, complication with diabetes, duration of symptoms, operated segment, and follow-up time. We also collected perioperative parameters such as operation time, intraoperative blood loss, intraoperative fluoroscopy frequency, screw placement accuracy, wound drainage, hospitalization duration, postoperative complicatins, and fusion rate. Lower back pain, lower extremity pain visual analogue score (VAS), and lumbar Japanese Orthopaedic Association Scores (JOA) were obtained preoperatively, postoperative 3 days/6 months/12 months, and the last follow-up. 【Results】 All the procedures were successfully completed and the follow-up time was 14.82±1.83 (RA group) and 15.11±1.62 (MIS-TLIF group) months, without significant difference (P>0.05). Compared with MIS-TLIF group, RA group had less intraoperative blood loss [(116.67±18.48) min vs. (128.06±22.53) min], fluoroscopy frequency [(12.42±2.28) vs. (15.67±2.46)], screw placement accuracy (93.18% vs. 84.03%), postoperative drainage [(73.03±23.52) mL vs. (88.33±28.54) mL], and shorter hospitalization stay [(6.45±1.52)d vs. (7.69±1.85) d] (all P<0.05). However, operation time did not significantly differ (P>0.05). The VAS of lower back pain and lower extremity pain, and lumbar JOA were significantly improved after the operation (P<0.001). At the same time point, there was no significant difference between the two groups (P>0.05). Meanwhile, fusion rate and incidence of complications did not significantly differ between the two groups (P>0.05). 【Conclusion】 Both robot-assisted MIS-TLIF and MIS-TLIF can achieve excellent clinical effects in treating single-segment lumbar disc herniation. However, the former can improve the accuracy of screw placement and reduce intraoperative blood loss, fluoroscopy frequency, postoperative drainage and hospitalization time, which indicates a promising application.