【摘要】 目的：探讨椎弓根螺钉自动规划系统在机器人辅助腰椎手术中的应用。方法：回顾性分析2024年6月—2025年2月于中国医科大学附属第一医院骨科接受基于O臂术中CBCT图像进行椎弓根螺钉自动规划的机器人辅助腰椎后路椎弓根螺钉内固定术的45例患者临床资料。采用Gertbein-Robbins分级评估螺钉规划的准确性；比较手动标注与自动规划的螺钉轨迹；记录螺钉规划时间和螺钉调整率。结果：共成功规划螺钉232枚，正常椎体中可接受螺钉216枚，规划准确度达99.08%。伤椎中可接受螺钉10枚，规划准确度达71.43%。手动标注和自动规划螺钉轨迹对比，差异无统计学意义（P>0.05）。平均螺钉规划时间为（8.29±0.53）s。正常椎体中调整螺钉137枚，调整率为62.84%；伤椎中调整螺钉12枚，调整率为85.71%；横断面上调整螺钉143枚，调整率为61.64%；矢状面上调整螺钉6枚，调整率为2.59%。结论：本研究采用的椎弓根螺钉自动规划系统在实现腰椎椎弓根螺钉置钉高准确性的同时，还能够缩短螺钉规划时间，值得临床推广。更多还原

【Abstract】 Objective: To investigate the application of an automated pedicle screw planning system in robot-assisted lumbar spine surgery. Methods: Clinical data of 45 patients who underwent robot-assisted posterior lumbar pedicle screw fixation using an automated planning system based on intraoperative O-arm cone-beam computed tomography(CBCT) images at the Department of Orthopedics, the First Hospital of China Medical University from June 2024 to February 2025 were retrospectively analyzed. Screw planning accuracy was assessed using the Gertbein-Robbins grading system. Screw trajectories from manual annotation and automated planning were compared. Planning time and screw adjustment rates were recorded. Results: A total of 232 screws were successfully planned. Among normal vertebrae, 216 screws were acceptable, achieving a planning accuracy of 99.08%. Among fractured vertebrae, 10 screws were acceptable, with a planning accuracy of 71.43%. No statistically significant difference was found between manual annotation and automated planning of screw trajectories(P>0.05). The average screw planning time was(8.29±0.53) s. 137 screws were adjusted in normal vertebrae(adjustment rate: 62.84%), and 12 screws were adjusted in fractured vertebrae(adjustment rate: 85.71%). Among these adjustments, 143 screws were modified in the transverse plane(adjustment rate: 61.64%), while 6 screws were adjusted in the sagittal plane(adjustment rate: 2.59%). Conclusion: The automated pedicle screw planning system used in this study can achieve high accuracy in lumbar pedicle screw placement while significantly reducing planning time, which is worthy of clinical promotion.更多还原