机器人辅助微创经椎间孔腰椎间融合术中精准置钉在腰椎退变患者中的应用OA

Objective:To evaluate the clinical efficacy of precise screw placement in robot-assisted minimally invasive transforaminal lumbar interbody fusion(RA-MIS-TLIF)for patients with lumbar degenerative disease.Methods:80 patients with lumbar degenerative disease who were treated at Beijing Friendship Hospital,Capital Medical University from December 2020 to December 2024 were enrolled.They were randomly divided into the robot-assisted group(n=40,undergoing MIS-TLIF with robot-assisted precise screw placement)and the conventional manual group(n=40,undergoing MIS-TLIF with conventional manual screw placement)using a random number table.Single screw insertion time,total operative time,intraoperative blood loss,number of fluoroscopic exposures,screw placement accuracy,pain intensity,time to first ambulation after surgery,functional recovery,and incidence of complications were compared between the two groups.Results:The robot-assisted group showed significantly shorter total operative time,shorter time for single screw insertion,and earlier time to first ambulation compared to the conventional manual group(P＜0.05).Intraoperative blood loss,number of fluoroscopic exposures,and postoperative 72 h ODI scores were also significantly lower in the robot-assisted group than those in the conventional manual group(P＜0.05).The excellent-good rate of screw placement was higher,and the total complication rate was lower in the robot-assisted group compared to the conventional manual group(P＜0.05).VAS scores at 6 h,24 h,48 h,and 72 h after surgery were all significantly lower in the robot-assisted group than those in the conventional manual group(P＜0.05).Repeated-measures ANOVA indicated significant main effects of group,time,and group-by-time interaction(P＜0.001).Conclusion:Robot-assisted precise screw placement in MIS-TLIF can significantly lower operative time,single screw insertion time,and time to first ambulation in patients with lumbar degenerative disease,it can improve screw placement accuracy,alleviate postoperative pain,reduce complications,and promote functional recovery,which is worthy of clinical promotion.