Comparative Clinical Efficacy of TiRobot- and Mazor X-Assisted Posterior Thoracolumbar Pedicle Screw Internal Fixation with Bone Graft Fusion
Abstract
assisting posterior thoracolumbar pedicle screw internal fixation with bone graft fusion, and to provide evidence for clinical decision-making
in surgical strategy selection. Method: A retrospective study design was adopted. Eighty-six patients who underwent robot-assisted posterior
thoracolumbar pedicle screw internal fixation with bone graft fusion in the Department of Spine Surgery of Xi'an Honghui Hospital from
May 2022 to May 2024 were included. According to the robotic system used during surgery, patients were divided into the TiRobot group (44
cases) and the Mazor X group (42 cases). No statistically significant differences were found between the two groups in sex, age, fracture level,
disease course, or other baseline characteristics. Operative duration, intraoperative blood loss, number of intraoperative X-ray exposures, and
intraoperative transfusion volume were recorded. Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS) score, and Oswestry Disability Index (ODI) were compared preoperatively and at 1 week, 1 month, 3 months, and the final follow-up after surgery. Screw
placement accuracy was graded using Neo's screw trajectory evaluation method, and total hospitalization cost was recorded for both groups.
Result: All patients completed surgery successfully, and no serious complications occurred. No statistically significant differences were
observed between the two groups in operative duration, intraoperative blood loss, number of intraoperative X-ray exposures, intraoperative
transfusion volume, or screw placement accuracy (grade-A screw placement rate) (P > 0.05). JOA scores improved significantly at all postoperative time points compared with preoperative values in both groups (P < 0.05), whereas no significant between-group differences were
observed at corresponding time points (P > 0.05). Total hospitalization cost was significantly lower in the TiRobot group than in the Mazor
X group (P < 0.05). Conclusion: TiRobot- and Mazor X-assisted posterior thoracolumbar pedicle screw internal fixation with bone graft fusion showed no significant differences in the main clinical outcomes (JOA score and complication rate). However, a statistically significant
difference was observed at the long-term follow-up point for a secondary outcome indicator (VAS score). In addition, the TiRobot group had
significantly lower hospitalization costs, indicating a greater health-economic advantage.
Keywords
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[1] Chen HJ, Zhang JN, Hao DJ, et al. Multifactorial analysis of screw placement errors in spinal robotics. Orthopedics. 2020;11(6):523-
528.
[2] Fan Y, Du JP, Liu JJ, et al. Accuracy of pedicle screw placement comparing robot-assisted technology and the free-hand with fluoroscopy-guided method in spine surgery: an updated meta-analysis. Medicine (Baltimore). 2018;97(22):e10970.
[3] Zhang TT, Wang ZP, Wang ZH, et al. Clinical application of the TiRobot orthopedic robot in surgical treatment of thoracolumbar fractures. China Journal of Orthopaedics and Traumatology. 2021;34(5):440-444.
[4] Aoude AA, Fortin M, Figueiredo R, et al. Methods to determine pedicle screw placement accuracy in spine surgery: a systematic review.
European Spine Journal. 2015;24(5):990-1004.
[5] Patel NA, Kuo CC, Pennington Z, et al. Robot-assisted percutaneous pedicle screw placement accuracy compared with alternative guidance in lateral single-position surgery: a systematic review and meta-analysis. Journal of Neurosurgery: Spine. 2023;39(4):443-451.
[6] Ma M, Wang Z, Ye J, et al. Comparison of TiRobot-assisted and freehand transpedicular kyphoplasty for thoracic osteoporotic compression fractures. Chinese Journal of Reparative and Reconstructive Surgery. 2023;37(9):1106-1112.
[7] Lee NJ, Buchanan IA, Zuckermann SL, et al. What is the comparison in robot time per screw, radiation exposure, robot abandonment,
screw accuracy, and clinical outcomes between percutaneous and open robot-assisted short lumbar fusion?: a multicenter, propensitymatched analysis of 310 patients. Spine (Phila Pa 1976). 2022;47(1):42-48.
[8] Fang GF, Wu ZX, Fan Y, et al. Application of the Renaissance spinal robot-assisted surgical system in spinal diseases. Chinese Journal
of Orthopaedic Trauma. 2017;19(4):299-303.
[9] Ringel F, Ster C, Reinke A, et al. Accuracy of robot-assisted placement of lumbar and sacral pedicle screws: a prospective randomized
comparison to conventional freehand screw implantation. Spine (Phila Pa 1976). 2012;37(8):E496-E501.
[10] Gan MF, Yang HL, Zhou F, et al. Observation of the accuracy of robot-assisted pedicle screw placement. Chinese Journal of Anatomy
and Clinics. 2016;21(4):326-330.
[11] Sheng WC, Zhang JY, Yang G, et al. Failure analysis and countermeasures of Renaissance robot-assisted screw placement in adolescent
idiopathic scoliosis. Orthopaedic Biomechanics Materials and Clinical Study. 2022;19(2):1-4.
[12] Tian W, Fan MX, Han XG, et al. Clinical comparative study of robot-assisted and conventional fluoroscopy-assisted spinal pedicle
screw internal fixation. Journal of Clinical Orthopaedics and Research. 2016;1(1):4-10.
[13] Wu JC, Huang WC, Tsai HW, et al. Pedicle screw loosening in dynamic stabilization: incidence, risk, and outcome in 126 patients. Neurosurgical Focus. 2011;31(4):E9.
[14] Li T, Liao ZWJ, Liu XL, Wang F, Hu J. Robot-assisted minimally invasive posterior lumbar fusion for lumbar degenerative disease.
Chinese Journal of Tissue Engineering Research. 2024;28(12):1855-1862.
DOI: http://dx.doi.org/10.70711/pmr.v3i8.9535
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