Clinical efficacy of robot-assisted spinal endoscopic lumbar interbody fusion for the treatment of single-segment lumbar spinal stenosis

English Keywords:Orthopedic robot  Unilateral biportal endoscopic spinal fusion  Lumbar spinal stenosis  Clinical efficacy

English Abstract:

  【Abstract】 Objectives: To investigate the clinical efficacy of robot-assisted(RA) unilateral biportal endoscopic lumbar interbody fusion(UBE-LIF) in the treatment of single-level lumbar spinal stenosis(LSS). Methods: A retrospective analysis was conducted on the clinical data of 90 patients with LSS admitted to the Spine Department of Foshan Hospital of Traditional Chinese Medicine from August 2023 to February 2024. The patients were divided into an observation group(42 patients, treated with RA-UBE-LIF) and a control group(48 patients, treated with UBE-LIF). The patients′ baseline information and clinical data were collected, including age, gender, duration of illness, and lesion segments. The number of fluoroscopic exposures, operative time, intraoperative blood loss, postoperative drainage volume, length of hospital stay, screw placement accuracy(based on the Gertzbein criteria), and the occurrence of complications were compared between the two groups. The visual analogue scale(VAS) score and Oswestry disability index(ODI) were used to quantitatively assess the improvement in back and leg pain and the recovery of lumbar function in patients before surgery and at 1 week, 3 months, and 6 months postoperatively. Results: All the patients successfully completed the surgery and were followed up for a period ranging from 6 to 12 months. Compared with the control group, the observation group had significantly fewer fluoroscopic exposures(4.40±0.83 vs 9.92±1.62), less intraoperative blood loss(90.76±13.27mL vs 121.21±16.75mL), postoperative drainage volume(75.93±14.43mL vs 93.02±17.04mL), and length of hospital stay(4.43±1.52d vs 7.19±1.79d)(all P<0.05). There was no significant difference in operative time between the two groups(118.24±8.91min vs 120.67±10.43min)(P>0.05). The accuracy rate of RA percutaneous screw placement in the observation group was 97.62%, which was significantly different from that of the control group(89.58%)(P<0.05). The complication rate in the observation group was 2.38%, which was not significantly different from that of the control group(6.25%)(P>0.05). The VAS scores for back and leg pain and ODI of both groups at each postoperative time point were significantly lower than those at the previous time point(P<0.05). There were no significant differences between the two groups preoperatively(P>0.05), but the improvements in VAS scores and ODI at each postoperative time point(1 week, 3 months, 6 months) were better in the observation group compared to the control group(P<0.05). Conclusions: Orthopedic RA-UBE-LIF for the treatment of LSS is accurate and safe, which has satisfactory therapeutic effects.