Abstract：Objective To investigate the clinical application value of orthopedic robot-assisted percutaneous kyphoplasty in the treatment of thoracolumbar compression fractures. Methods A prospective randomized controlled trial was conducted between April 2021 and July 2021 among 30 patients, including 15 males and 15 females aged 60-75 years old, with thoracolumbar compression fracture at the First Affiliated Hospital of Xinjiang Medical University. There were 26 cases of single segment fracture and 4 cases of double segment fracture. The compression fracture sites were T10 in 2 cases, T11 in 2 cases, T12 in 10 cases, L1 in 8 cases, L2 in 5 cases, and L3 in 7 cases. The patients were randomly divided into conventional and study groups with 15 cases in each group. The conventional group underwent traditional percutaneous kyphoplasty, and the study group underwent robot-assisted percutaneous kyphoplasty. The positioning time, the number of fluoroscopy, blood loss, leakage of bone cement, and ralative height of anterior edge of injured vertebra before and after operation (anterior height of the injured vertebra/average height of upper and lower adjacent anterior vertebrae) between the two groups were recorded and compared. The differences in the transverse section angle, sagittal section angle, and distance from the midline of the vertebral body were compared between the preoperative planned needle insertion tunnel and actual needle insertion tunnel in the study group to evaluate the accuracy of the orthopedic robot system. Results The two groups showed no significant difference in gender, age, height, weight, distribution of injured vertebrae, and preoperative relative height of injured vertebrae (all P values >0.05). The average positioning time and the number of intraoperative fluoroscopy of the study group were (283.5±118.7) s and (12.4±5.7) times, respectively. Those of the conventional group were (469.2±113.9) s and (16.5±4.7) times. Compared with the conventional group, the study group had less positioning time and radiation (t=-5.68, -2.78; all P values <0.05). The blood loss and postoperative relative height of the injured vertebrae in the study group were (8.8±4.6) mL and 0.9±0.1, respectively, and those of the conventional group were (10.3±5.3) mL and 0.9±0.5. The blood loss and postoperative height ratio of the injured vertebrae between the two groups showed no significant difference (all P values >0.05). The postoperative relative height of the two groups were higher than those before operation, and the differences were statistically significant (t=3.81, 3.59; P=0.002, 0.003). Two cases of intraoperative bone cement leakage occurred in the study group, whereas four cases were recorded in the conventional group. No significant difference was observed between the two groups in terms of the occurrence of bone cement leakage (P=0.387). The transverse section angle, sagittal section angle, and distance from the midline of the vertebral body in the preoperatively planned insertion tunnel in the study group were 16.7°±3.4°, 10.0°±6.6°, and (33.3±6.2) mm, respectively. The transverse section angle, sagittal section angle, and distance from the midline of the vertebral body in the actual needle insertion tunnel of the study group were 16.6°±3.8°, 8.5°±6.2°, and (33.3±6.2) mm, respectively. No significant difference was observed between the preoperative planned insertion tunnel and actual insertion tunnel in the study group (t=0.08, 0.82, -0.01; all P values >0.05). Conclusion Compared with the traditional percutaneous kyphoplasty, robot-assisted percutaneous kyphoplasty has the same effect of restoring the height of the injured vertebrae. In addition, robot-assisted percutaneous kyphoplasty has the advantages of good accuracy, short positioning time, and less radiation times. Trial Registration This study was registrated at Chinese Trial Registry with the registration number of ChiCTR200004033.
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2022, Vol. 27 
