Comparison of the short-term efficacies between robot-assisted cortical bone screw and pedicle screw fixations in posterior lumbar interbody fusion for patients with osteoporotic lumbar spinal stenosis
10.3969/j.issn.1004-406X.2024.11.05
- VernacularTitle:机器人辅助皮质骨螺钉与椎弓根螺钉固定后路腰椎椎间融合术治疗合并骨质疏松腰椎管狭窄症的早期疗效比较
- Author:
Ruizhao ZHAO
1
;
Xinyao LÜ
1
;
Junjie QIAO
1
Author Information
1. 首都医科大学附属北京世纪坛医院骨科 100038 北京市
- Publication Type:Journal Article
- Keywords:
Lumbar Spinal Stenosis;
TiRobot system;
Cortical bone trajectory screws;
Pedicle screws;
Posterior lumbar interbody fusion;
Osteoporosis
- From:
Chinese Journal of Spine and Spinal Cord
2024;34(11):1155-1163
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To compare the short-term effectiveness and safety between robot-assisted cortical bone trajectory screw(CBTS)and traditional pedicle screw(TPS)fixations in posterior lumbar interbody fusion(PLIF)for lumbar spinal stenosis with osteoporosis.Methods:We retrospectively analyzed the clinical data of 113 patients who underwent robot-assisted PLIF and internal fixation in our hospital between September,2018 and June,2021.The patients were divided into two groups according to the internal fixation method.55 pa-tients fixed with CBTS were included in the CBTS group,and 58 patients fixed with TPS were included in the TPS group.The general data[age,sex ratio,height,weight,body mass index(BMI),hip bone mineral densi-ty(BMD)],surgical related data(operative time,incision length,intraoperative blood loss),perioperative indicators(postoperative length of hospital stay,surgical complications,screw loosening rate,adjacent facet joint violation rate,preoperative and postoperative blood glucose),and visual analogue scale(VAS)score of pain and Oswestry disability index(ODI)before and after surgery were recorded and compared.Results:There was no significant difference in age,sex ratio,height,weight,BMI and hip BMD between the two groups(P＞0.05).There was no significant difference in operative time,postoperative length of hospital stay,surgical complications,preoperative VAS score and ODI,and ODI at 1 month and 6 months after operation between the two groups(P＞0.05).The intraoperative blood loss,length of incision and VAS score at 6 months after operation in the CBTS group were significantly lower than those in the TPS group(500mL vs 600mL,P=0.007;8cm vs 10cm,P=0.006;2 vs 3,P＜0.001).There was no significant difference in blood glucose before operation and 1 day after operation between the two groups(P＞0.05),while at 1 week after operation,the CBTS group was significantly lower than the TPS group(4.75mmol/L vs 5.57mmol/L,P=0.041).At the final follow-up,the rates of screw loosening and adjacent facet joint violation in CBTS group were significantly lower than those in TPS group(1.68％vs 4.52％,P=0.044 and 13.83％vs 26.53％,P=0.029).Conclusions:For patients with lumbar spinal stenosis combined with osteoporosis,PLIF with robot-assisted CBTS fixation is less in surgical trauma,faster in early postoperative recovery,and fewer in screw-related complications than with TPS fixation.
