Risk Factors of Unsatisfactory Robot-Assisted Pedicle Screw Placement: A Case-Control Study

Qi Zhang; Ming-Xing Fan; Xiao-Guang Han; Ya-Jun Liu; Da He; Bo Liu; Wei Tian

doi:10.14245/ns.2142560.180

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자료유형: 학술저널

저자정보: Qi Zhang (Department of Spine Surgery Beijing Jishuitan Hospital) Ming-Xing Fan (Department of Spine Surgery Beijing Jishuitan Hospital) Xiao-Guang Han (Department of Spine Surgery Beijing Jishuitan Hospital) Ya-Jun Liu (Department of Spine Surgery Beijing Jishuitan Hospital) Da He (Department of Spine Surgery Beijing Jishuitan Hospital) Bo Liu (Department of Spine Surgery Beijing Jishuitan Hospital) Wei Tian (Department of Spine Surgery Beijing Jishuitan Hospital)

저널정보: 대한척추신경외과학회 Neurospine Neurospine 제18권 제4호

발행연도: 2021.12

수록면: 839 - 844 (6page)

DOI: 10.14245/ns.2142560.180

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Objective: To identify potential risk factors of unsatisfactory screw position during robot-assisted pedicle screw fixation. Methods: A retrospective analysis of robot-assisted pedicle screw fixation performed in Beijing Jishuitan Hospital from March 2018 to March 2019 was conducted. Research data was collected from the medical record and imaging systems. Univariate tests were performed on the potential risk factors (patient’s characteristics and surgical factors) of unsatisfactory screw position during robot-assisted pedicle screw fixation. For statistically significant variables in univariate tests, a logistic regression test was used to identify independent risk factors for unsatisfactory screw position. Results: A total of 780 pedicle screws placed in 163 robot-assisted surgeries were analyzed. The rate of perfect screw positions was 93.08%, and the unsatisfactory rate was 6.92%. In patients with severe obesity (body mass index≥30 kg/m2) (odds ratio [OR], 2.459; 95% confidence interval [CI], 1.199?5.044; p=0.014), osteoporosis (T≤-2.5) (OR, 1.857; 95% CI, 1.046?3.295; p=0.034), and the segments 3 levels away from the tracker (OR, 2.216; 95% CI, 1.119?4.387; p=0.022), robot-assisted pedicle screw placement has a higher risk of screw malposition. Conclusion: During robot-assisted pedicle screw placement for patients with severe obesity, osteoporosis, and segments 3 levels away from the tracker, vigilance should be maintained during surgery to avoid postoperative complications due to unsatisfactory screw position.

#Robot-assisted surgery #Pedicle screw #Accuracy #Risk factor

참고문헌 (26)

참고문헌 신청

Boos N / 1997 / Pedicle screw fixation in spinal disorders : a European view / Eur Spine J 6:2~18

Gaines RW Jr / 2000 / The use of pedicle-screw internal fixation for the operative treatment of spinal disorders / J Bone Joint Surg Am 82:1458~1476

Esses SI / 1993 / Complications associated with the technique of pedicle screw fixation. A selected survey of ABS members / Spine 18:2231~2238

Schwarzenbach O / 1997 / Accuracy of computer-assisted pedicle screw placement. An in vivo computed tomography analysis / Spine 22:452~458

Belmont PJ Jr / 2001 / In vivo accuracy of thoracic pedicle screws / Spine 26:2340~2346

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