【摘要】 目的 评估微创经椎间孔腰椎间融合术(minimally invasive transforaminal lumbar interbody fusion，MIS-TLIF)中机器人辅助通道下置入椎弓根螺钉的准确性。方法 回顾性分析2023年2月至2024年3月于福州大学附属省立医院行单节段MIS-TLIF手术的64例退变性腰椎疾病患者临床资料，根据置钉方式将患者分成徒手组和机器人组，其中徒手组34例，机器人组30例。通过术后CT影像对所有螺钉进行位置分类，其中A类：无皮质侵犯；B类：皮质侵犯<2mm；C类：2mm≤皮质侵犯<4mm；D类：皮质侵犯≥4mm，比较两组螺钉分类的差异。比较两组的手术并发症、手术时间及Oswestry功能障碍指数(Oswestry disability index，ODI)等指标。结果 机器人组与徒手组的椎弓根螺钉位置分类等级比较，差异有统计学意义(P<0.05)。机器人组和徒手组的A+B类螺钉的占比分别是98.3%和93.4%(P=0.051)。两组均无神经损伤并发症及翻修病例。机器人组的手术时间[(128.3±9.2)min]长于徒手组(121.4±11.1)min，差异有统计学意义(P<0.05)。机器人组和徒手组的住院天数及两组术后1年的ODI评分差异均无统计学意义(P>0.05)。结论 在单节段退变性腰椎疾病的通道下置钉中，相较于徒手置钉，机器人辅助技术虽延长手术时间，但能显著提高螺钉置入准确性，且不增加神经损伤等手术并发症风险。更多还原

【Abstract】 Objective To evaluate the accuracy of robot-assisted pedicle screw placement in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).Method A retrospective study was conducted on 64 patients undergoing single-segment MIS-TLIF at a single center.Patients were divided into a manual group and a robotic group based on screw placement methods,with 34 patients in the manual group and 30 in the robotic group.Postoperative CT images were used to classify the positions of all screws into four categories:A:no cortical breach;B:cortical breach <2 mm;C:2 mm ≤ cortical breach < 4 mm;D:cortical breach ≥ 4 mm.The differences in screw classification between the two groups were compared.Surgical complications,operative time,and Oswestry Disability Index (ODI) scores were also compared between the two groups.Result The accuracy of screw placement in the robotic group was significantly higher than that in the manual group (P<0.05).The proportions of Class A+B screws in the robotic and manual groups were 98.3% and 93.4%,respectively (P=0.051).No cases of nerve injury complications or revision surgeries were reported in either group.The operative time was (121.4±11.1) minutes in the manual group and (128.3±9.2) minutes in the robotic group (P<0.05).There was no statistically significant difference in the hospitalization duration and the ODI scores at 1 year postoperatively between the two groups (P>0.05).Conclusion Compared with manual screw placement,robot-assisted pedicle screw placement in single-level MIS-TLIF improves the overall distribution layout of screw positions without increasing the risk of surgical complications such as nerve injury,despite requiring a longer operative time.更多还原