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三维图像配准技术在机器人辅助腰椎间盘突出症手术中的应用效果

Clinical efficiency of three-dimensional image registration in robot-assisted surgery for lumbar disc herniation

  • 摘要:
    目的 探讨机器人结合三维图像配准技术辅助腰椎间盘突出症手术中精准定位的效果。
    方法 回顾性选择2021年1月至2022年12月在宝鸡市中心医院行腰椎间盘突出症手术治疗的患者112例,按照手术方式分为机器人辅助组(机器人组,56例)和传统开放组(传统组,56例)。比较两组手术时间、术中出血量、术后住院时间等指标。采用视觉模拟评分(visual analogue scale,VAS)和Oswestry功能障碍指数(Oswestry disability index,ODI)评估两组患者术后6个月、12个月疗效。
    结果  机器人组和传统组性别、年龄、体质量指数(body mass index, BMI)、病程、病变节段等差异均无统计学意义。机器人组图像配准时间为(7.8±2.1)min,配准精度控制在1 mm以内,术中导航定位成功率为98.21%(55/56)。机器人组手术时间、术后住院时间短于传统组,术中出血量少于传统组(P<0.01)。机器人组术后并发症总发生率为3.57%(2/56),低于传统组的14.29%(8/56),差异无统计学意义。术后6个月、12个月机器人组VAS评分和ODI评分均低于传统组(P<0.01)。
    结论  机器人结合三维图像配准技术辅助腰椎间盘突出症手术能提高定位精准度,缩短手术时间、减少出血量、改善术后功能,值得临床推广应用。

     

    Abstract:
    Objective To explore the application effect of robot-assisted surgery combined with three-dimensional (3D) image registration for lumbar disc herniation.
    Methods 112 patients with lumbar disc herniation who underwent surgery in Baoji Central Hospital from January 2021 to December 2022 were selected, and were divided into the robot-assisted surgery group (robot group, n=56) and traditional open surgery group (traditional group, n=56). The operation time, intraoperative blood loss, postoperative hospital stay, and other indicators were compared between the two groups. Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate the efficacy at 6 and 12 months after surgery.
    Results There were no significant differences in gender, age, body mass index (BMI), disease course and lesion segment between the robot group and the traditional group. In the robot group, the average image registration time was (7.8±2.1) min, the registration accuracy was within 1 mm, and the success rate of intraoperative navigation positioning was 98.21% (55/56). Compared with traditional group, the operation time and postoperative hospital stay were shorter and intraoperative blood loss was less in the robot group (P<0.01). The total incidence of postoperative complications was 3.57% (2/56) and 14.29% (8/56) in the robot group and the traditional group, respectively (P>0.05). The VAS scores and ODI values in the robot group were lower than those in the traditional group at 6 and 12 months after surgery (P<0.01).
    Conclusions The application of 3D medical image registration technology in robot-assisted lumbar disc herniation surgery can significantly improve surgical precise positioning, shorten operation time, reduce blood loss, and improve postoperative function, which is worthy of clinical promotion and application.

     

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