Analysis of learning curve of TiRobot-assisted lumbar pedicle screw fixation based on the cumulative sum test
10.3760/cma.j.cn115455-20240105-00018
- VernacularTitle:基于累积和分析法对天玑骨科机器人辅助腰椎椎弓根螺钉内固定术学习曲线的分析
- Author:
Yuquan LIU
1
;
Xiang LI
1
;
Qi FEI
1
;
Kuo CHEN
1
;
Weiyang ZUO
1
;
Bin ZHU
1
;
Guoqiang ZHANG
1
;
Lingjia YU
1
;
Xuehu XIE
1
;
Ning LIU
1
;
Haining TAN
1
;
Hai MENG
1
;
Tianqi FAN
1
;
Yong YANG
1
Author Information
1. 首都医科大学附属北京友谊医院骨科，北京 100050
- Publication Type:Journal Article
- Keywords:
Robotic surgical procedures;
Pedicle screws;
Learning curve;
Lumbar vertebrae
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(1):10-17
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the learning curve of TiRobot-assisted lumbar pedicle screw fixation (LPSF) by cumulative sum (CUSUM) test method.Methods:The clinical data of 50 patients who underwent TiRobot-assisted LPSF from January 2020 to December 2022 in Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed. CUSUM analysis and learning curve fitting were performed with robot usage time as the main indicator with the time for each step refined (robot registration time, path planning time and guide wire placement time), to select the best learning curve fitting model with the R2 value closest to 1. Using the turning point of the learning curve as the boundary, the learning curve was divided into two stages as learning stage and maturity stage, and then the observation indexes were compared between the two stages. Results:All 50 patients successfully completed the surgery without perioperative complications, with a total of 244 pedicle screws implanted. The total robot usage time and robot registration time showed a gradually decreasing trend with the increase of case number, and the learning curves were successfully fitted and reached their peaks at the seventeenth and thirteenth cases respectively. The entire learning process was divided into learning stage (17 cases) and maturity stage (33 cases) based on the turning point of the learning curve of total robot usage time. The path planning time and guide wire placement time did not show significant changes with the increase in the case number. The total robot usage time, robot registration time and the intraoperative blood loss in the learning stage were significantly higher than those in the maturity stage: (35.35 ± 1.58) min vs. (30.61 ± 0.43) min, (20.83 ± 1.56) min vs. (14.94 ± 0.29) min and 400 (150, 500) ml vs. 200 (110, 300) ml, the guide wire placement time of per screw was significantly lower than that in the maturity stage: 2.00 (1.83, 2.34) min/screw vs. 2.33 (2.13, 2.69) min/screw, and there were statistical differences ( P<0.05 or <0.01). There were no statistical difference in the path planning time, path planning time of per screw, guide wire placement time and the accuracy of screw placement between two stages ( P>0.05). Conclusions:TiRobot-assisted LPSF is a new technology with safety and effectiveness, and it has a relatively short learning curve. To achieve technological maturity, at least 17 surgeries are required with accumulated experience, and the robot registration is the main step of the learning process. After reaching maturity stage, the robot usage time is significantly shortened and intraoperative trauma is significantly reduced while the relatively high screw placement accuracy is ensured.
