Clinical outcomes of percutaneous vertebroplasty using robot-assisted cross-puncture technique for osteoporotic...

Our study sought to explore the therapeutic outcomes and safety of robot-assisted cross-puncture percutaneous vertebroplasty (PVP) for patients with osteoporotic vertebral compression fractures (OVCF). A retrospective review was performed on the clinical records of 153 individuals diagnosed with OVCF from September 2023 to September 2024. On the basis of the surgical technique used, patients were assigned to either Group A (robot-assisted cross-puncture PVP, n = 82) or Group B (conventional puncture PVP, n = 71). During the study, various perioperative metrics, such as operative time and number of fluoroscopic exposures, were carefully measured and contrasted across different cases. Subsequently, a comprehensive assessment and comparison of various outcomes were conducted, such as the first-attempt puncture success rate, bone cement volume, the occurrence rate of cement leakage, the manner in which cement was distributed, the pain relief assessed by the visual analogue scale (VAS), the disability levels indicated by the Oswestry Disability Index (ODI), injured vertebral body height, Cobb angle, the clinical effectiveness based on modified Macnab criteria, and complication rates. The outcomes of the procedures, including the patients' recovery status and relevant surgical parameters, were analyzed. The operations were successfully completed in all patients, and the average follow-up period was 12 months. When comparing the two groups, Group A required a slightly extended period of operation, though this variation did not reach statistical significance. Group A required significantly fewer intraoperative fluoroscopic exposures (P < 0.05), exhibited a considerably greater first-attempt puncture success rate (P < 0.01), a significantly lower occurrence of bone cement leakage (9.8% vs. 28.2%, P < 0.01), and a more favorable cement distribution pattern (P < 0.01). The injected bone cement volume was similar between the two groups (with no significant difference, Group A: 5.50 ± 0.70 mL vs. Group B: 5.33 ± 0.75 mL, P > 0.05). After surgery, both groups exhibited significant improvements in VAS scores, ODI scores, injured vertebral body height, and Cobb angle relative to preoperative values (P < 0.05). At 12 months postoperatively, Group A had significantly superior outcomes compared to Group B, including better maintenance of vertebral body height and more effective correction of the Cobb angle. Additionally, Group A had a significantly lower complication rate (9.76%) compared to Group B 32.39%, P < 0.01). While Group B had an excellent and good rate of 87.32%, Group A showed a significantly higher rate of 96.34% (P < 0.05). Both robot-assisted cross-puncture PVP and conventional PVP are effective treatment modalities for OVCF. Both groups achieved significant pain relief and functional improvement, with no statistically significant intergroup differences in VAS or ODI scores at any time point. However, robot-assisted cross-puncture PVP demonstrated superior cement distribution, lower leakage rate, better maintenance of vertebral height and Cobb angle correction at 12 months, and a higher excellent/good rate by modified Macnab criteria.