机器人辅助的最小侵入性变形腰间体融合
Chad Z Simon1, Joshua Zhang1, Kasra Araghi1
1Hospital for Special Surgery, New York, NY.
JBJS essential surgical techniques
|December 12, 2025
概括
与传统方法相比,机器人辅助的微创性变形腰间体融合 (RA MI-TLIF) 提供了更高的准确性和更少的并发症. 这种先进的技术改善了脚螺丝的位置,降低了风险,并提高了治疗腰部退行性病理的患者结果.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 最少侵入性的技术
- 机器人在医学中的机器人
背景情况:
- 由于缺乏直接可视化,极少侵入性变形椎体融合 (MI-TLIF) 需要放射指导来准确地放置脚螺丝,因为缺乏直接可视化.
- 机器人辅助 (RA) 系统通过机器人臂在计划轨迹上的引导提供了提高准确性的潜力.
- RA MI-TLIF将机器人辅助与最少的侵入性手术相结合,以改善腰部退行性病理的结果.
研究的目的:
- 为了评估机器人辅助的微创性跨关腰部体融合 (RA MI-TLIF) 的疗效和结果.
- 为了将RA MI-TLIF与传统的光学引导和开放外科手术技术进行比较.
- 突出机器人指导在提高仪表准确性和尽量减少侵入性的优势.
主要方法:
- 患者在倾斜的位置进行全身麻醉,并使用用于手术内CT和机器人仪器校准的参考阵列.
- 手术规划是使用机器人接口软件进行的,用于螺丝和子放置.
- 使用机器人手臂放置皮肤穿脚螺丝,然后进行圆盘切除,子插入和皮肤穿杆放置.
主要成果:
- 与光镜相比,RA螺丝放置显示了更高的准确性,脚壁透率和面部关节入侵率较低.
- 与开放的TLIF相比,RA MI-TLIF显示血液流失减少,停留时间缩短,患者报告的结果更好.
- RA MI-TLIF具有与光学辅助MI-TLIF相似的融合速率,但具有更高的精度,更少的并发症和更少的辐射暴露.
结论:
- 机器人辅助的微创性变形膜腰部体融合 (RA MI-TLIF) 是治疗腰部退行性病理的一种安全有效的技术.
- 与光学指导和开放程序相比,RA MI-TLIF具有显著的优势,包括提高准确性和减少并发症.
- 使用机器人指导可以提高外科手术的精度,并尽量减少TLIF手术的侵入性.
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