共 19 条
Clinical Effects of Oblique Lateral Interbody Fusion by Conventional Open versus Percutaneous Robot-Assisted Minimally Invasive Pedicle Screw Placement in Elderly Patients
被引:48
作者:
Feng, Shuo
[1
]
Tian, Wei
[1
]
Wei, Yi
[1
]
机构:
[1] Beijing Jishuitan Hosp, Dept Spine Surg, 31 Xinjiekou East St, Beijing 100035, Peoples R China
基金:
中国国家自然科学基金;
国家高技术研究发展计划(863计划);
关键词:
Minimally invasive;
Oblique lumbar interbody fusion;
Pedicle screw;
Percutaneous;
Robot;
SPINAL SURGERY;
ACCURACY;
COMPLICATIONS;
FIXATION;
DECOMPRESSION;
FLUOROSCOPY;
NAVIGATION;
D O I:
10.1111/os.12587
中图分类号:
R826.8 [整形外科学];
R782.2 [口腔颌面部整形外科学];
R726.2 [小儿整形外科学];
R62 [整形外科学(修复外科学)];
学科分类号:
摘要:
Objectives To compare the clinical outcomes of percutaneous robot-assisted minimally invasive pedicle screw insertion versus freehand fluoroscopy-assisted pedicle screw insertion using a traditional open technique in elderly patients undergoing an oblique lumbar interbody fusion (OLIF) procedure. Methods Based on the inclusion and exclusion criteria, 80 patients with lumbar degenerative disease who attended the spinal surgery department of the Beijing Jishuitan Hospital between January 2017 and April 2018 were enrolled in the present study. Patients were randomized 1:1 to undergo percutaneous robot-assisted minimally invasive pedicle screw insertion (experimental group, n = 40) or freehand fluoroscopy-assisted pedicle screw insertion using a traditional open technique (control group, n = 40). Outcomes were accuracy of screw placement evaluated on postoperative CT using the modified Gertzbein and Robbins scale, operative time, blood loss, postoperative drainage, lower back and leg pain evaluated using a visual analogue scale (VAS), lumbar function evaluated using the Oswestry disability index (ODI), and complication rates. Results A total of 344 vertebral pedicle screws were inserted: 170 screws in the experimental group, and 174 screws in the control group. Accurate screw placement was significantly higher in the experimental group (98.2% [167/170]) than in the control group (93.1% [162/174]). Clinical outcomes showed significant differences between the experimental and control groups in operative time, intraoperative blood loss, and postoperative VAS for lower back pain in the immediate postoperative period. Conclusion Robot-assisted pedicle screw insertion in OLIF is an effective strategy for the management of elderly patients with lumbar degenerative diseases.
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页码:86 / 93
页数:8
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