Abstract
BackgroundPercutaneous kyphoplasty is the main method in the treatment of thoracolumbar osteoporotic compression fractures. However, much radiation exposure during the operation harms the health of surgeons and patients. In addition, the accuracy of this surgery still needs to be improved. This study aimed to assess the radiation exposure and clinical efficacy of Tirobot-assisted vertebroplasty in treating thoracolumbar osteoporotic compression fracture.MethodsIncluded in this retrospective cohort study were 60 patients (60–90 years) who had undergone unilateral vertebroplasty for thoracolumbar osteoporotic compression fracture at our hospital between June 2019 and June 2020. All showed no systemic diseases and were assigned to Tirobot group (treated with Tirobot-assisted approach) and control group (treated with traditional approach). Fluoroscopic frequency, operative duration, length of stay (LOS), post-operative complications (cement leakage, infection, and thrombosis), and pre-operative and pre-discharge indexes (VAS score, JOA score, and Cobb’s angle) were compared.ResultsThe fluoroscopic frequency (P < 0.001) and post-operative complications (P = 0.035) in Tirobot group were significantly lower than those in control group. The operative duration and LOS in the Tirobot group were shorter than those in the control group, but the differences were not statistically significant (P = 0.183). Pre-discharge VAS score and Cobb’s angle decreased, and JOA increased after surgeries in both groups. These three indexes showed a significant difference after surgery in each group (P < 0.001), but not between groups (PVAS = 0.175, PCobb’s = 0.585, PJOA = 0.448).ConclusionThe Tirobot-assisted vertebroplasty can reduce surgery-related trauma, post-operative complications, and patients’ and operators’ exposure to radiation. As a safe and effective strategy, this surgery can realize the quick recovery from thoracolumbar osteoporotic compression fracture.
Highlights
The incidence of thoracolumbar osteoporotic compression fracture keeps increasing in the elderly, often leading to low back pain, kyphosis, difficulty walking, and even neurological dysfunction [1, 2]
The patients were averaged to T7-L5. An orthopedic robotic system (Tirobot) group (30 cases treated with Tirobot-assisted approach) and control group (30 cases treated with traditional approach)
Mild-trauma-caused compression fracture was found in the thoracic vertebra of 13 cases (43.33%) and the lumbar vertebra of 17 cases (56.67%) in the Tirobot group (14 males (46.67%) and 16 females (53.33%), ages 61–89 years, mean 69.50 (65.25, 75.25) years) and 12 cases (40%) and 18 cases (60%) in the control group (13 males (43.33%) and 17 females (56.67%), ages 61–86 years, mean 70 (65.75, 78.75) years)
Summary
The incidence of thoracolumbar osteoporotic compression fracture keeps increasing in the elderly, often leading to low back pain, kyphosis, difficulty walking, and even neurological dysfunction [1, 2]. Vertebroplasty, one of the traditional surgical methods to treat thoracolumbar fracture, is effective to relieve back pain and bed-rest complication [3,4,5]. In this surgery, both surgeons and patients may face a risk of dermatitis, cataract, and cancer, due to high-radiation exposure from repeated fluoroscopy [6,7,8]. Percutaneous kyphoplasty is the main method in the treatment of thoracolumbar osteoporotic compression fractures. This study aimed to assess the radiation exposure and clinical efficacy of Tirobot-assisted vertebroplasty in treating thoracolumbar osteoporotic compression fracture
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