[1]范明星 张琦 赵经纬 段芳芳 刘亚军 韩晓光 茅剑平 肖斌 刘波 田伟**.机器人辅助经皮微创单节段胸腰椎骨折内固定术的学习曲线[J].中国微创外科杂志,2019,01(9):808-811.
 Fan Mingxing,Zhang Qi,Zhao Jingwei,et al.Learning Curve for Roboticassisted Percutaneous Pedicle Screw Fixation for Singlesegment Thoracolumbar Fracture[J].Chinese Journal of Minimally Invasive Surgery,2019,01(9):808-811.
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机器人辅助经皮微创单节段胸腰椎骨折内固定术的学习曲线()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2019年9期
页码:
808-811
栏目:
临床研究
出版日期:
2019-09-25

文章信息/Info

Title:
Learning Curve for Roboticassisted Percutaneous Pedicle Screw Fixation for Singlesegment Thoracolumbar Fracture
作者:
范明星 张琦 赵经纬 段芳芳 刘亚军 韩晓光 茅剑平 肖斌 刘波 田伟**
(北京积水潭医院脊柱外科,北京100035)
Author(s):
Fan Mingxing Zhang Qi Zhao Jingwei et al.
Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
关键词:
骨科机器人胸腰椎微创手术学习曲线累积和分析
Keywords:
Orthopedic robotThoracolumbar spineMinimally invasive surgeryLearning curveCUSUM test
文献标志码:
A
摘要:
目的探讨骨科机器人辅助经皮微创单节段胸腰椎骨折内固定术的学习曲线。方法选择2015年8月~2017年8月由同一名主任医师连续完成的骨科机器人辅助经皮微创单节段胸腰椎骨折内固定术32例,使用累积和(cumulative sum,CUSUM)方法分析学习曲线,并比较不同阶段手术时间、术中出血量、螺钉置入精度和术后住院时间。结果所有患者均未发生术中、术后并发症。术后48小时行CT检查,显示螺钉置入位置均可接受,与设计位置偏差0.4~2.1 mm,平均1.16 mm。按手术时间CUSUM学习曲线形态分为3个阶段,前期为病例1~8,中期为病例9~20,后期为病例21~32。3个阶段的手术时间逐渐缩短(P<0.05)。螺钉置入偏差在3个阶段的差异具有统计学意义(P=0.027),后期的偏差显著低于前期和中期(P<0.05)。术中出血量和术后住院时间在3个时期无明显差异(P=0.685,P=0.057)。结论术者开展8~20例骨科机器人辅助经皮微创单节段胸腰椎骨折内固定术后,能够达到高水平,显著提高手术精度,降低手术时间。
Abstract:
ObjectiveTo investigate the learning curve of orthopaedic robotassisted percutaneous pedicle screw fixation in singlesegment thoracolumbar fracture.MethodsA total of 32 patients with singlesegment thoracolumbar fracture underwent robotassisted percutaneous pedicle screw fixation by the same surgeon between August 2015 and August 2017. The cumulative sum (CUSUM) test was used to analyze the learning curve, while the surgery time, intraoperative blood loss, screw placement accuracy and postoperative hospital stay were also compared.ResultsAll the patients had no intraoperative or postoperative complications. CT scanning at postoperative 48 hours showed the position of the screws was all acceptable, with an average deviation of 1.16 mm from the design position (range, 0.4-2.1 mm). According to the CUSUM of surgery time, the learning curve was divided into three stages. The early stage was case 1-8, the middle stage was case 9-20, and the late stage was case 21-32. The surgery time of the 3 stages was gradually shortened (P<0.05). The deviation of screw insertion among the 3 stages was statistically significant (P=0.027), with the deviation in the late stage being significantly lower than in the early stage and middle stage (P<0.05). There was no significant difference in intraoperative blood loss and postoperative hospital stay during the three periods (P=0.685, P=0.057).ConclusionThis study demonstrates that after 8 to 20 cases of orthopaedic robotassisted percutaneous pedicle screw fixation for singlesegment thoracolumbar fracture, the surgeon can achieve a high level of robotic application ability, significantly improve the accuracy of surgery, and reduce the surgery time.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金(U1713221);北京市科技计划(Z171100000417019)**通讯作者,Email:tianwei_victor@163.com
更新日期/Last Update: 2019-12-10