Effectiveness of Mazor spine robot-assisted percutaneous vertebroplasty with modified approach in treating lumbar osteoporotic vertebral compression fractures

English Keywords:Lumbar osteoporotic vertebral compression fractures  Percutaneous vertebroplasty  Modified approach  Robot-assisted  Clinical effectiveness

English Abstract:

  【Abstract】 Objectives: To explore the effectiveness of Mazor spine robot-assisted percutaneous vertebroplasty(PVP) with the modified approach to treat lumbar osteoporotic vertebral compression fractures(OVCF). Methods: A retrospective analysis on 50 patients with lumbar OVCF who underwent PVP surgery were performed in our hospital from July 2020 to December 2020. 23 cases were included in group A(Mazor spine robot-assisted lumbar modified PVP group), while 27 cases were included in group B(free-hand lumbar transpedicular PVP). In both groups, the operation time, number of fluoroscopy, radiation exposure dose, hospital stay time and bone cement diffusion were recorded. The preoperative, postoperative day 3, and postoperative month 3 vertebral body height recovery, low back pain visual analogue scale(VAS) scores, and quality of life ODI scores were also recorded. Results: The average operation time of group A was 40.61±3.85 minutes, which was significantly longer than that of group B(30.70±3.26 minutes). In group A, the time of robot matching and registration was TA1(23.43±2.97 minutes), and the time from puncture to incision closure was TA2(16.74±5.13 minutes). In group A, the average number of intraoperative fluoroscopy was 6.96±1.80 times with 0.55±0.07mSv radiation exposure, among which robot matching and registration accounts for 2.12±0.35 times with 0.15±0.03mSv radiation exposure. In group B, the average number of intraoperative fluoroscopy was 17.70±3.98 times with 1.25±0.12mSv radiation exposure. The average number of intraoperative fluoroscopy and dose of radiation exposure in group A were significantly lower than those in group B(P＜0.05). In group A, bone cement was diffused into the center of the vertebral body(type Ⅱ), while in group B bone cement was mainly unilaterally diffused except for 14.87%(4/27) towards into center(type Ⅱ)(P＜0.05). The VAS scores of back pain on the third day and third month after surgery were significantly lower than those before surgery(P＜0.05). There was no difference in VAS scores between the two groups after surgery(P＞0.05). The ODI scores of the two groups on the third day and third month after surgery were significantly lower than those before surgery(P＜0.05). There was no difference in the postoperative ODI scores between the two groups(P＞0.05). Conclusions: Mazor spine robot assisted PVP with the lumbar modified approach for treating lumbar osteoporotic fractures is a safe and effective surgery to quickly relieve the pain caused by fractures with the reduced intraoperative radiation and surgeon workload.