Radiographic and Clinical Outcomes of Robot-Assisted Posterior Pedicle Screw Fixation: Two-Year Results from a Randomized Controlled Trial
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Purpose: We prospectively assessed the early radiographic and clinical outcomes (minimum follow-up of 2 years) of robot-assistedpedicle screw fixation (Robot-PSF) and conventional freehand pedicle screw fixation (Conv-PSF). Materials and Methods: Patients were randomly assigned to Robot-PSF (37 patients) or Conv-PSF (41 patients) for posterior interbodyfusion surgery. The Robot-PSF group underwent minimally invasive pedicle screw fixation using a pre-planned robotguidedscrew trajectory. The Conv-PSF underwent screw fixation using the freehand technique. Radiographic adjacent segmentdegeneration (ASD) was measured on plain radiographs, and clinical outcomes were measured using visual analogue scale (VAS)and Oswestry disability index (ODI) scores regularly after surgery. Results: The two groups had similar values for radiographic ASD, including University California at Los Angeles grade, vertebraltranslation, angular motion, and loss of disc height (p=0.320). At final follow-up, both groups had experienced significant improvementsin back VAS, leg VAS, and ODI scores after surgery (p<0.001), although inter-group differences were not significantfor back VAS (p=0.876), leg VAS (p=0.429), and ODI scores (p=0.952). In the Conv-PSF group, revision surgery was required fortwo of the 25 patients (8%), compared to no patients in the Robot-PSF group. Conclusion: There were no significant differences in radiographic ASD and clinical outcomes between Robot-PSF and Conv-PSF. Thus, the advantages of robot-assisted surgery (accurate pedicle screw insertion and minimal facet joint violation) do not appearto be clinically significant.
Abstract
Purpose: We prospectively assessed the early radiographic and clinical outcomes (minimum follow-up of 2 years) of robot-assistedpedicle screw fixation (Robot-PSF) and conventional freehand pedicle screw fixation (Conv-PSF). Materials and Methods: Patients were randomly assigned to Robot-PSF (37 patients) or Conv-PSF (41 patients) for posterior interbodyfusion surgery. The Robot-PSF group underwent minimally invasive pedicle screw fixation using a pre-planned robotguidedscrew trajectory. The Conv-PSF underwent screw fixation using the freehand technique. Radiographic adjacent segmentdegeneration (ASD) was measured on plain radiographs, and clinical outcomes were measured using visual analogue scale (VAS)and Oswestry disability index (ODI) scores regularly after surgery. Results: The two groups had similar values for radiographic ASD, including University California at Los Angeles grade, vertebraltranslation, angular motion, and loss of disc height (p=0.320). At final follow-up, both groups had experienced significant improvementsin back VAS, leg VAS, and ODI scores after surgery (p<0.001), although inter-group differences were not significantfor back VAS (p=0.876), leg VAS (p=0.429), and ODI scores (p=0.952). In the Conv-PSF group, revision surgery was required fortwo of the 25 patients (8%), compared to no patients in the Robot-PSF group. Conclusion: There were no significant differences in radiographic ASD and clinical outcomes between Robot-PSF and Conv-PSF. Thus, the advantages of robot-assisted surgery (accurate pedicle screw insertion and minimal facet joint violation) do not appearto be clinically significant.
참고문헌 (27)
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