Robot-assisted navigation vs.C-arm fluoroscopy in percutaneous pedicle screw fixation for treating thoracolumbar burst fractures:a comparative study of efficacy
10.3969/j.issn.1004-406X.2025.03.02
- VernacularTitle:机器人辅助与C型臂X线机透视经皮椎弓根螺钉内固定术治疗胸腰椎爆裂骨折的疗效对比
- Author:
Lichuan LIANG
1
;
Liehua LIU
1
;
Chen ZHAO
1
Author Information
1. 重庆医科大学附属第三医院脊柱外科 401120 重庆市
- Publication Type:Journal Article
- Keywords:
Thoracolumbar fracture;
Robot-assisted;
Percutaneous reduction and internal fixation;
Pedicle screw
- From:
Chinese Journal of Spine and Spinal Cord
2025;35(3):236-242
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To evaluate the clinical efficacies of robot-assisted versus C-arm fluoroscopy-guided percutaneous pedicle screw fixation for thoracolumbar burst fractures.Methods:A retrospective analysis was conducted on 46 patients(26 males,20 females;age 27-69 years)with thoracolumbar burst fractures treated between January 2022 and December 2023.The patients were divided into the observation group of 21 cases(12 males,9 females;52.1±8.8 years)receiving robot-assisted navigation,and the control group of 25 cases(14 males,11 females;50.9±13.2 years)undergoing conventional C-arm fluoroscopy guidance.No significant differences were observed in baseline characteristics(case number,sex ratio,BMI;P＞0.05).Both groups of patients underwent percutaneous pedicle screw internal fixation of the injured vertebra.Intraoperative parameters(fluoroscopy frequency,operative time,blood loss),postoperative CT scans on 3d(assessed by Gertzbein-Robbins scale for screw placement accuracy),pre-and postoperative pain VAS scores(thoracolumbar back pain before surgery and at 1d,3d,and 1 month after surgery),and radiographic parameters(Cobb angle,anterior vertebral body height ratio at preoperation,and postoperative 3d,1 month,and 6 months)were recorded and compared using t-tests and Mann-Whitney U tests.Results:The observation group demonstrated significantly shorter operative time(90.71±9.52min vs 117.62±16.63min,P＜0.05),reduced blood loss(67.14±18.75mL vs 139.52±28.01mL,P＜0.05),and fewer fluoroscopy exposures(9.14±2.27 vs 18.86±2.86,P＜0.05)than the control group.No complications occurred during follow-up in both groups.The observation group exhibited superior screw placement accuracy(98.4％vs 90.7％,P＜0.05)with 124/126 screws graded as excellent/good versus 136/150 in controls.Postoperative pain VAS scores were lower in the observation group on 1d(2.67±0.57 vs 4.00±0.70,P＜0.05)and 3d(1.19±0.68 vs 1.95±0.59,P＜0.05),but comparable at 1 month(0.76±0.43 vs 1.10±0.53,P＞0.05).The postoperative 3d,1 month and 6 months'Cobb angles(6.08°±1.49° vs 6.09°±1.05°,6.26°±1.46° vs 6.28°±1.14°,6.78°±1.38° vs 6.91°±1.31°)and anterior vertebral height ratios[(90.14±1.56)％vs(90.06±1.69)％,(89.62±1.56)％vs(89.44±2.12)％,(88.87±1.72)％vs(88.92±1.88)％]showed no significant in-tergroup differences at different time points(P＞0.05).Conclusions:Robot-assisted percutaneous pedicle screw fixation for the treatment of thoracolumbar burst fractures has significant advantages in improving surgical ac-curacy,reducing intraoperative blood loss,shortening operative time,and decreasing the number of fluoroscopic exposures.
