【摘要】 目的 对机器人辅助与传统透视下椎弓根螺钉内固定术治疗胸腰椎骨折的相关指标进行荟萃分析。方法检索PubMed、Embase、CBM、中国知网（CNKI）及万方数据从建库至2022年11月关于机器人辅助与传统透视下椎弓根螺钉内固定术治疗胸腰椎骨折的对照研究，按照筛选标准选取文献并提取数据，通过Jadad质量评分法对纳入文献进行质量评价，采用Review Manager 5.4软件对数据进行荟萃分析。结果 共22篇文献纳入研究，其中回顾性研究16篇，前瞻性研究4篇，随机对照研究2篇；共纳入患者1 454例，其中机器人辅助组700例，传统透视下徒手置钉组754例。荟萃分析结果表明，机器人辅助组在术中出血量、术中透视次数、住院天数、单钉置入时间、置钉一次性成功率、术后腰痛视觉模拟量表（VAS）评分、术后Oswestry功能障碍指数（ODI）等方面优于传统透视组，差异均有统计学意义（P <0.05），而在手术时间、置钉准确率、术后伤椎矢状面Cobb角、手术前后伤椎前缘高度百分比等方面差异无统计学意义（P> 0.05）。结论 与传统透视下徒手置钉相比，机器人辅助置钉可显著降低术中出血量、术中透视次数、单钉置入时间及术后功能障碍的发生率，减轻术后腰痛，提高置钉一次性成功率，减少患者住院天数。2种术式在手术时间、置钉准确率、术后伤椎矢状面Cobb角、手术前后伤椎前缘高度百分比方面无显著差异。更多还原

【Abstract】 Objective To conduct a meta-analysis of the relative indexes of robot-assisted and traditional fluoroscopic pedicle screw fixation in the treatment of thoracolumbar fracture. Methods PubMed,Embase,CBM,China National Knowledge Infrastructure(CNKI) and Wanfang Data were searched for controlled studies of the treatment of thoracolumbar fracture with robot-assisted and traditional fluoroscopic pedicle screw fixation from database inception to November 2022. The literatures were selected according to the screening criteria,and data were extracted. Jadad quality scoring method was used to evaluate the quality of the included literatures,and Review Manager 5.4 software was used for meta-analysis of the data. Results A total of 22 literatures were included in the study,consisting of 16 retrospective cohort studies,4 prospective cohort studies and 2 randomized controlled clinical studies. A total of 1 454 patients were included,consisting of 700 in the robot-assisted group and 754 in the traditional fluoroscopy group. The results of meta-analysis showed that the robot-assisted group was superior to the traditional fluoroscopy group in terms of intraoperative blood loss,intraoperative fluoroscopy frequency,length of hospital stay,time of single screw placement,one-time success rate of screw placement,postoperative visual analogue scale(VAS) score,postoperative Oswestry disability index(ODI),all with a statistical significance(P < 0.05);and there was no significant difference between the 2 groups in operation time,screw placement accuracy,sagittal Cobb angle of injured vertebra after surgery,and percentage of anterior height of injured vertebrae before and after surgery(P > 0.05). Conclusions Compared with traditional fluoroscopic pedicle screw placement by hand,robot-assisted screw placement in the treatment of thoracolumbar fracture can significantly reduce intraoperative blood loss,intraoperative fluoroscopy frequency,single screw placement time and incidence of postoperative dysfunction,alleviate postoperative low back pain,improve one-time success rate of screw placement,and reduce the length of hospital stay of patients. There is no significant differences in operation time,screw placement accuracy,sagittal Cobb angle of injured vertebra after surgery,and percentage of anterior height of injured vertebrae before and after surgery between the 2 methods.更多还原