Comparison Of Orthopedic Robot-assisted And Traditional Percutaneous Screw Surgery For Sacroiliac Joint Trauma

Purpose: In this paper,orthopedic robot-assisted surgery and traditional percutaneous screw surgery for sacroiliac joint trauma were used to compare the relevant indicators of the two groups of patients during and after surgery,evaluate the effectiveness and safety of the two methods in surgery,and further discuss the advantages and disadvantages of the currently popular robot-assisted surgery for sacroiliac joint trauma,as well as its clinical applicability.Methods: The clinical data of 62 patients with unstable sacroiliac joint trauma admitted to Sichuan People’s Hospital from January 2017 to August 2022 and meeting the criteria were retrospectively analyzed.All patients underwent sacroiliac joint screw pinning surgery,and were divided into experimental group(33 patients with robot assisted pinning)and control group(29 patients with traditional pinning)according to different surgical methods.A total of 106 screws were inserted.Statistical analysis was performed on the variance homogeneity test of age,gender,BMI and trauma score among different groups,and relevant data records were consulted and compared between the two groups of patients with operative time,fluoroscopy time,fluoroscopy dose,fluoroscopy times and the number of guide needles used during the operation.After reviewing the imaging data,the fracture-recovery of the sacroiliac joint was evaluated using the Matta criteria of imaging,and the position of all screws was evaluated according to the modified Gertzbein-Robbins classification of postoperative CT scan.By consulting the data of rehabilitation group,clinical function evaluation of Majeed function score 1 month and 6 months after surgery.P<0.05 was considered statistically significant.Results: A total of 106 screws were inserted into the iliosacral joint.Sixty-two RA(Robot Assistance)nails in the robot group(33 patients)and 44CF(Conventional Flouroscopic)nails in the traditional fluoroscopic group(29patients).There were no vascular injury,wound infection,urinary tract infection or neurological complications in both groups.There were no significant differences in gender,age,BMI and trauma score between the two groups(P>0.05).All patients in each group successfully completed the operation.A total of 62 screws were implanted in the robot assisted group.The average implantation time of a single screw was 11.88±1.24 minutes.Patients received an average radiation dose of 131.45±18.65 u Gycm~2 for single screw insertion,and the average number of fluoroscopy times per screw insertion was 13.52±1.18.The average number of guide pins used for single screw insertion was2.42±0.90.A total of 44 screws were inserted in the traditional fluoroscopy group.The average time of single screw placement was 36.77±2.86 minutes.Patients received an average radiation dose of 226.37±26.39 u Gycm~2 for single screw insertion,and the average number of fluoroscopy times per screw insertion was 26.24±2.50.The average number of guide pins used for single screw insertion was 6.86±1.60.The time of single screw,puncture times of guide needle,fluoroscopy dose and fluoroscopy times of experimental group were significantly lower than those of control group,and the differences were statistically significant(P<0.05).The results of postoperative follow-up X-ray and CT scan were reviewed and the relevant data were measured to evaluate the effect of fracture rectification according to the modified Matta score.There was no significant difference in the percentage of excellent between the two groups(P >0.05).In terms of the accuracy of screw placement,the deviation from the original design path was evaluated by referring to the postoperative CT scan results and combining with the improved Gertzbein-Robbins classification standard method.The nail placement accuracy of the robot group was 93.548%,and that of the traditional fluoroscopy group was 77.272%.The comparison between the two groups showed statistical significance(P=0.015).One month after operation,the Majeed function score in the robot-assisted group was excellent in 18 cases,good in 9 cases,medium in 6cases,poor in 0 cases,and the excellent and good rate was 81.81%.Over 6 months after operation,27 cases had excellent function and 6 cases had good function.In the traditional fluoroscopy group one month after surgery,13 cases had excellent functional scores,9 cases were good,6 cases were fair,and 1 case was poor,with an excellent and good rate of 75.86%.More than 6 months after surgery,23 cases had excellent functional scores and 6 cases were good.The non-parametric test of functional recovery assessment data between the two groups was mann-whiteyu test,and there was no statistical significance(P > 0.05).Conclusion: Compared with the traditional percutaneous nail implantation,robot-assisted nail implantation has a high success rate in the treatment of sacroiliac joint injury.it is a highly accurate,safe and minimally invasive surgical method,and has great clinical application value.