Effectiveness of robot-assisted percutaneous vertebroplasty for osteoporotic vertebral compression fracture in the elderly_West China Medical Journal

Authors：

YANG Nan , WANG Shengbao , LIU Shuangfu , WANG Cong , HE Qiang ,  CAO Yun

Spine Surgery Department, Sichuan Science City Hospital, Mianyang, Sichuan 621000, P. R. China;

Corresponding author：

CAO Yun, Email: cdcaoyun@126.com

Keywords：

Robot; percutaneous vertebroplasty; osteoporotic vertebral compression fracture; minimally invasive surgery

DOI：

10.7507/1002-0179.202108283

Video：

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Objective To evaluate the effectiveness of robot-assisted percutaneous vertebroplasty (PVP) in the treatment of osteoporotic vertebral compression fracture (OVCF) in the elderly. Methods The clinical data of 90 elderly patients with OVCF treated in Sichuan Science City Hospital between June 2019 and March 2021 were retrospectively analyzed. The patients were divided into robot-assisted group (40 cases) and C-arm-assisted group (50 cases). The pre- and post-operative Visual Analogue Scale (VAS) score, pre- and post-operative Oswestry Disability Index (ODI) score, intraoperative cement leakage, intraoperative fluoroscopy frequency, operation time, and the loss of hemoglobin were recorded and compared between the two groups. Results The incidence of intraoperative cement leakage (5% vs. 20%), intraoperative fluoroscopy frequency [(18.3±3.2) vs. (41.3±7.8) times], operation time [(28.3±4.6) vs. (43.2±7.3) min] and the loss of hemoglobin [(7.2±2.0) vs. (15.2±4.4) g/L] of the robot-assisted group were less than those of the C-arm-assisted group (P<0.05). There was no statistically significant difference between the two groups in the decrease of VAS score or ODI score (3.63±1.64 vs. 3.40±1.65, P>0.05; 50.70±4.95 vs. 52.10±6.69, P>0.05). Conclusions Robot-assisted PVP for elderly patients with OVCF can significantly reduce the risk of cement leakage, shorten the operation time, reduce the intraoperative fluoroscopy frequency, and reduce the surgical hidden blood loss. It can be used for clinical promotion and application.

Citation： YANG Nan, WANG Shengbao, LIU Shuangfu, WANG Cong, HE Qiang, CAO Yun. Effectiveness of robot-assisted percutaneous vertebroplasty for osteoporotic vertebral compression fracture in the elderly. West China Medical Journal, 2022, 37(10): 1471-1475. doi: 10.7507/1002-0179.202108283 Copy

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2.	Wong X, Reiley M, Garfin S. Vertebroplasty/kyphoplasty. J Women Imaging, 2000, 2: 117-124.
3.	Wang B, Cao J, Chang J, et al. Effectiveness of Tirobot-assisted vertebroplasty in treating thoracolumbar osteoporotic compression fracture. J Orthop Surg Res, 2021, 16(1): 65.
4.	袁伟, 孟小童, 刘欣春, 等. 机器人辅助经皮椎体后凸成形术治疗单/双节段骨质疏松性椎体压缩骨折临床疗效. 中国修复重建外科杂志, 2021, 35(8): 1000-1006.
5.	Mitchell BD, Streeten EA. Clinical impact of recent genetic discoveries in osteoporosis. Appl Clin Genet, 2013, 6: 75-85.
6.	Kantelhardt SR, Martinez R, Baerwinkel S, et al. Perioperative course and accuracy of screw positioning in conventional, open robotic-guided and percutaneous robotic-guided, pedicle screw placement. Eur Spine J, 2011, 20(6): 860-868.
7.	Keric N, Doenitz C, Haj A, et al. Evaluation of robot-guided minimally invasive implantation of 2067 pedicle screws. Neurosurg Focus, 2017, 42(5): E11.
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9.	Schatlo B, Molliqaj G, Cuvinciuc V, et al. Safety and accuracy of robot-assisted versus fluoroscopy-guided pedicle screw insertion for degenerative diseases of the lumbar spine: a matched cohort comparison. J Neurosurg Spine, 2014, 20(6): 636-643.
10.	Kim HJ, Jung WI, Chang BS, et al. A prospective, randomized, controlled trial of robot-assisted vs freehand pedicle screw fixation in spine surgery. Int J Med Robot, 2017, 13(3): e1779.
11.	Baker JD, Sayari AJ, Basques BA, et al. Robotic-assisted spine surgery: application of preoperative and intraoperative imaging. Semin Spine Surg, 2020, 32(2): 100789.
12.	Mroz TE, Abdullah KG, Steinmetz MP, et al. Radiation exposure to the surgeon during percutaneous pedicle screw placement. J Spinal Disord Tech, 2011, 24(4): 264-267.
13.	van Dijk JD, van den Ende RP, Stramigioli S, et al. Clinical pedicle screw accuracy and deviation from planning in robot-guided spine surgery: robot-guided pedicle screw accuracy. Spine (Phila Pa 1976), 2015, 40(17): E986-E991.
14.	Solomiichuk V, Fleischhammer J, Molliqaj G, et al. Robotic versus fluoroscopy-guided pedicle screw insertion for metastatic spinal disease: a matched-cohort comparison. Neurosurg Focus, 2017, 42(5): E13.
15.	Han XG, Tian W, Liu YJ, et al. Safety and accuracy of robot-assisted versus fluoroscopy-assisted pedicle screw insertion in thoracolumbar spinal surgery: a prospective randomized controlled trial. J Neurosurg Spine, 2019, 30(5): 615-622.
16.	Roser F, Tatagiba M, Maier G. Spinal robotics: current applications and future perspectives. Neurosurgery, 2013, 72(Suppl 1): 12-18.
17.	Wu YS, Zhang H, Zheng WH, et al. Hidden blood loss and the influential factors after percutaneous kyphoplasty surgery. Eur Spine J, 2017, 26(7): 1878-1883.
18.	田野, 张嘉男, 陈浩, 等. 脊柱机器人与传统透视辅助下微创经皮复位内固定术治疗单节段无神经症状胸腰椎骨折对比研究. 中国修复重建外科杂志, 2020, 34(1): 69-75.
19.	王翔宇, 谭伦, 林旭, 等. 光电导航引导单侧穿刺椎体后凸成形术治疗胸腰椎骨质疏松性椎体压缩骨折. 中国修复重建外科杂志, 2018, 32(2): 203-209.
20.	林书, 胡豇, 万仑, 等. 骨科机器人辅助经皮椎体后凸成形治疗多节段脊柱转移瘤. 中国组织工程研究, 2020, 24(33): 5249-5254.
21.	Shi B, Jiang T, Du H, et al. Application of spinal robotic navigation technology to minimally invasive percutaneous treatment of spinal fractures: a clinical, non-randomized, controlled study. Orthop Surg, 2021, 13(4): 1236-1243.
22.	宗路杰, 干旻峰, 杨惠林, 等. 脊柱外科机器人及其临床应用进展. 中国脊柱脊髓杂志, 2021, 31(8): 754-758.
23.	Hu X, Scharschmidt TJ, Ohnmeiss DD, et al. Robotic assisted surgeries for the treatment of spine tumors. Int J Spine Surg, 2015, 9: 1.

1. 中国康复医学会骨质疏松预防与康复专业委员会. 骨质疏松性椎体压缩骨折诊治专家共识(2021 版). 中华医学杂志, 2021, 101(41): 3371-3379.
2. Wong X, Reiley M, Garfin S. Vertebroplasty/kyphoplasty. J Women Imaging, 2000, 2: 117-124.
3. Wang B, Cao J, Chang J, et al. Effectiveness of Tirobot-assisted vertebroplasty in treating thoracolumbar osteoporotic compression fracture. J Orthop Surg Res, 2021, 16(1): 65.
4. 袁伟, 孟小童, 刘欣春, 等. 机器人辅助经皮椎体后凸成形术治疗单/双节段骨质疏松性椎体压缩骨折临床疗效. 中国修复重建外科杂志, 2021, 35(8): 1000-1006.
5. Mitchell BD, Streeten EA. Clinical impact of recent genetic discoveries in osteoporosis. Appl Clin Genet, 2013, 6: 75-85.
6. Kantelhardt SR, Martinez R, Baerwinkel S, et al. Perioperative course and accuracy of screw positioning in conventional, open robotic-guided and percutaneous robotic-guided, pedicle screw placement. Eur Spine J, 2011, 20(6): 860-868.
7. Keric N, Doenitz C, Haj A, et al. Evaluation of robot-guided minimally invasive implantation of 2067 pedicle screws. Neurosurg Focus, 2017, 42(5): E11.
8. Kuo KL, Su YF, Wu CH, et al. Assessing the intraoperative accuracy of pedicle screw placement by using a bone-mounted miniature robot system through secondary registration. PLoS One, 2016, 11(4): e0153235.
9. Schatlo B, Molliqaj G, Cuvinciuc V, et al. Safety and accuracy of robot-assisted versus fluoroscopy-guided pedicle screw insertion for degenerative diseases of the lumbar spine: a matched cohort comparison. J Neurosurg Spine, 2014, 20(6): 636-643.
10. Kim HJ, Jung WI, Chang BS, et al. A prospective, randomized, controlled trial of robot-assisted vs freehand pedicle screw fixation in spine surgery. Int J Med Robot, 2017, 13(3): e1779.
11. Baker JD, Sayari AJ, Basques BA, et al. Robotic-assisted spine surgery: application of preoperative and intraoperative imaging. Semin Spine Surg, 2020, 32(2): 100789.
12. Mroz TE, Abdullah KG, Steinmetz MP, et al. Radiation exposure to the surgeon during percutaneous pedicle screw placement. J Spinal Disord Tech, 2011, 24(4): 264-267.
13. van Dijk JD, van den Ende RP, Stramigioli S, et al. Clinical pedicle screw accuracy and deviation from planning in robot-guided spine surgery: robot-guided pedicle screw accuracy. Spine (Phila Pa 1976), 2015, 40(17): E986-E991.
14. Solomiichuk V, Fleischhammer J, Molliqaj G, et al. Robotic versus fluoroscopy-guided pedicle screw insertion for metastatic spinal disease: a matched-cohort comparison. Neurosurg Focus, 2017, 42(5): E13.
15. Han XG, Tian W, Liu YJ, et al. Safety and accuracy of robot-assisted versus fluoroscopy-assisted pedicle screw insertion in thoracolumbar spinal surgery: a prospective randomized controlled trial. J Neurosurg Spine, 2019, 30(5): 615-622.
16. Roser F, Tatagiba M, Maier G. Spinal robotics: current applications and future perspectives. Neurosurgery, 2013, 72(Suppl 1): 12-18.
17. Wu YS, Zhang H, Zheng WH, et al. Hidden blood loss and the influential factors after percutaneous kyphoplasty surgery. Eur Spine J, 2017, 26(7): 1878-1883.
18. 田野, 张嘉男, 陈浩, 等. 脊柱机器人与传统透视辅助下微创经皮复位内固定术治疗单节段无神经症状胸腰椎骨折对比研究. 中国修复重建外科杂志, 2020, 34(1): 69-75.
19. 王翔宇, 谭伦, 林旭, 等. 光电导航引导单侧穿刺椎体后凸成形术治疗胸腰椎骨质疏松性椎体压缩骨折. 中国修复重建外科杂志, 2018, 32(2): 203-209.
20. 林书, 胡豇, 万仑, 等. 骨科机器人辅助经皮椎体后凸成形治疗多节段脊柱转移瘤. 中国组织工程研究, 2020, 24(33): 5249-5254.
21. Shi B, Jiang T, Du H, et al. Application of spinal robotic navigation technology to minimally invasive percutaneous treatment of spinal fractures: a clinical, non-randomized, controlled study. Orthop Surg, 2021, 13(4): 1236-1243.
22. 宗路杰, 干旻峰, 杨惠林, 等. 脊柱外科机器人及其临床应用进展. 中国脊柱脊髓杂志, 2021, 31(8): 754-758.
23. Hu X, Scharschmidt TJ, Ohnmeiss DD, et al. Robotic assisted surgeries for the treatment of spine tumors. Int J Spine Surg, 2015, 9: 1.

West China Medical Journal

Effectiveness of robot-assisted percutaneous vertebroplasty for osteoporotic vertebral compression fracture in the elderly

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