Therapeutic Efficacy Of 2^nd Generation TiRobot In Thoracic And Lumbar Fracture Surgery In Spine Surgery

Objective:Comparison of the clinical results of 2^ndgeneration Ti Robot-assisted percutaneous pedicle screw placement and traditional freehand percutaneous screw in the treatment of patients with thoracolumbar spine fractures,the clinical efficacy of the 2^ndgeneration Ti Robot-assisted screw placement surgery was objectively evaluated.Methods:Retrospective analysis of patients with fresh single-segment thoracolumbar fractures（T10-L2）without nerve injury admitted to our spine surgery department from November 2021 to January 2023,the two groups were divided into experimental and control groups according to the different surgical methods.In the control group,traditional freehand percutaneous pedicle screw fixation was adopted,In another group,percutaneous pedicle screw fixation with the assistance of the 2^ndgeneration Ti Robot was used.To record and compare whether the differences in the basic characteristics of the two groups of patients in the perioperative period were statistically significant;Clinical outcomes and surgical repositioning were assessed by comparing the Cobb angle in sagittal plane,percentageo fanterior height compression（PAHC）,visual analog score（VAS）,and the oswestry disability index（ODI）of patients at different time stages of follow-up before and after surgery;Based on postoperative pedicle CT of patients,compare the effect of two groups of screw placement through Gertzbein-Robbins standard and measurement of the transverse the screw transverse angle（STA）.Results:A total of 40 patients meeting the inclusion criteria from November 2021 to January2023 were collected,with 20 patients in the experimental group and 20 patients in the control group.Among them,there was 1 case of T10 fracture,11 cases of T12 fracture,18 cases of L1fracture,and 10 cases of L2 fracture.In general data,there was no statistically significant difference in the comparison of patients’gender,age,BMI and cause of injury,the two data sets are comparable（p>0.05）.In the perioperative period,patients in both groups were similar in terms of bleeding volume and postoperative hospital stay（p>0.05）;The operation time of the experimental group was（94.80±38.67 min）,The operation time for the control group was（67.65±10.90 min）,the differences were statistically significant（p<0.05）;The radiation dose in the experimental group was much lower than that in the control group（13.85±3.48m Gy vs 53.60±21.50 m Gy）,there were significant differences（p<0.001）;In terms of complication rates,one case of fat liquefaction in the experimental group,in the control group,one case of incisional infection,one case of subcutaneous hematoma,and one case of screw loosening intraoperatively occurred.The incidence of complications differed significantly between the two groups,but there was no statistical value.The accuracy of screw placement in the experimental and control groups were 94.02%（110/117）and 82.46%（94/114）,there was a statistically significant difference in the comparison of accuracy and safety rates（p<0.05）.The experimental group had a greater angle of the screw transverse angle（18.22±5.37 vs.15.12±4.40）°,with a statistically significant difference between the two groups（p<0.001）.VAS,ODI,Cobb angle in sagittal plane and PAHC improved in both groups at all postoperative follow-up time periods compared to preoperative（p<0.001）.However,the difference between the two groups was not statistically significant（p>0.05）.Conclusion:In comparison to freehand percutaneous screw,the 2^ndgeneration Ti Robot-assisted pedicle screw,although there is still a learning curve in terms of procedure time,but on the basis of significantly lower radiation levels,its precision screw placement and protected joint capsule are remarkable.