Orthopaedic Robot Assisted Sacroiliac Joint Screw Placement In The Treatment Of Sacrum Fractures

Objectives: To evaluate the accuracy,safety,and efficacy of percutaneous sacroiliac joint screw implantation in the treatment of longitudinal sacrum fractures with the assistance of orthopaedic surgery robots.Methods: A total of 24 patients with sacrum fractures,admitted in Inner Mongolia medical university affiliated hospital from September 2018 and December 2019,were included in study.According to the surgical methods selected by the patients,the patients were randomly divided into the robot assisted group(test group)and the percutaneous sacroiliac screw fixation group(control group),both completed in the preoperative surgical planning.Statistical indicators included operation time,intraoperative blood loss,intraoperative fluoroscopy times,screw placement angle deviation(the included angle between the line segment where the guide pin is placed and the line where the actual guide pin is located,in degrees)and the guide pin placement Angle deviation(the entry point offset distance + the exit point offset distance /2,in millimeters),were conducted to evaluate the accuracy,safety and effectiveness of the orthopaedic robot assistant system.Results: Postoperative X-ray and CT fluoroscopy were performed in the two groups of patients to check the placement position of screws,and the results were satisfactory.The Angle deviation of screw placement in the two groups(unit: degree)was 1.45 ± 0.86 in the experimental group and 2.27 ± 0.81 in the control group,respectively.The data difference between the two groups was statistically significant(P=0.024).The guide wire placement deviation(in mm)was 1.98±0.98 in the experimental group and 3.07±1.51 in the control group.The difference between the two groups was statistically significant(P =0.047).The intraoperative fluoroscopy time(unit: second)was 7.25±1.73 in the experimental group and 40.93±4.64 in the control group,respectively.The difference between the two groups was statistically significant(P < 0.001).Intraoperative blood loss(ml)was 100.2±7.37 in the experimental group and 102.5±8.40 in the control group.There was no statistically significant difference between the two groups(P=0.493).The placement time of each sacroiliac joint screw during the operation(unit: minute)was 13.80±2.53 for the experimental group and 29.90±5.22 for the control group,and the difference between the two groups was statistically significant(P < 0.001).Intraoperative fluoroscopic observation showed that the screw placement positions in both groups were satisfactory,and no wound infection or other related complications were found after surgery.After the postoperative follow-up,the good and good rate of all the 24 patients was 92.7%,and the good and good rate of the 12 patients who completed the surgery by using the Majeed system was 100.0%.Conclusion: Percutaneous sacroiliac joint screw implantation assisted by orthopaedic surgery robot for the treatment of longitudinal sacrum fracture is more accurate,less radiation and safer than the traditional freehand screw placement by orthopaedic surgeons.