机器人在骨质疏松性压缩性骨折经皮穿刺球囊扩张椎体成形术中的应用-《中国医学物理学杂志》

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Title:: Application of surgical robot in percutaneous balloon kyphoplasty for osteoporotic vertebral compression fractures

文章编号:: 1005-202X（2026）09-1252-07

作者:: 阿海; 韩翔; 贺元; 关炳瑜; 西宁市第一人民医院骨科，青海西宁 810001

Author(s):: Ahai; HAN Xiang; HE Yuan; GUAN Bingyu; Department of Orthopedics, Xining First Peoples Hospital, Xining 810001, China

关键词:: 骨质疏松性椎体压缩骨折; 骨科手术机器人; 经皮球囊扩张椎体成形术; 精准外科; 空间定位; 手术智能化

Keywords:: Keywords: osteoporotic vertebral compression fracture orthopedic surgical robot percutaneous balloon kyphoplasty precise surgery spatial positioning surgical intelligence

分类号:: R318；R683.2

DOI:: DOI:10.3969/j.issn.1005-202X.2026.09.013

文献标志码:: A

摘要:: 目的：探讨骨科手术机器人智能辅助系统在骨质疏松性椎体压缩性骨折（OVCF）经皮穿刺球囊扩张椎体成形术（PKP）中的应用价值，重点剖析机器人三维配准、空间精准定位、动态轨迹校正等智能化技术对手术精准性、安全性的赋能机制，量化对比机器人辅助术式与传统透视徒手术式的手术指标、临床疗效及并发症差异，为机器人精准微创治疗OVCF的标准化、规范化临床推广提供循证依据与技术参考。方法：采用回顾性对照研究，纳入2024年6月至2025年10月西宁市第一人民医院收治的83例OVCF患者，按手术方式分为观察组（骨科手术机器人辅助PKP，32例）与对照组（传统C臂透视徒手PKP，51例）。以机器人手术技术体系为研究重点，系统比较两组术中精准性指标（穿刺调整次数、术中透视次数、穿刺轨迹偏差）、常规手术指标、围手术期VAS疼痛评分、椎体前缘高度恢复率、ODI功能障碍指数，统计术后6个月并发症发生情况并分析机器人技术的风险规避机制。结果：观察组依托机器人多模态影像融合、微米级空间定位、实时动态误差校正的核心技术优势，术中透视次数、穿刺调整次数、穿刺轨迹偏差均显著低于对照组（P<0.05），手术精准性显著提升；观察组椎体前缘高度恢复质量、术后疼痛缓解程度、脊柱功能恢复效果均优于对照组（P<0.05），且骨水泥渗漏、远期再骨折等并发症发生率显著低于对照组（P<0.05）。机器人系统存在短暂的配准与机械臂校准耗时，故整体手术时长大于对照组。结论：骨科手术机器人通过智能化、量化、标准化的手术技术体系，解决传统PKP依赖术者经验、主观误差大、放射暴露高、并发症可控性差的技术短板，可显著提升OVCF PKP的穿刺精准度与操作规范性，优化术后临床疗效，降低手术风险，是实现OVCF微创治疗精准化、智能化升级的核心技术手段。

Abstract:: Abstract: Objective To explore the value of the intelligent orthopedic surgical robot system applied in percutaneous balloon kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCF). This study focuses on the enabling effects of the intelligent techniques of surgical robot, including three-dimensional registration, precise spatial positioning, and dynamic trajectory correction on surgical accuracy and safety, quantitatively compares intraoperative parameters, clinical outcomes and postoperative complications between robot-assisted surgery and conventional fluoroscopy-guided manual surgery. It is expected to provide evidence-based evidence and technical reference for standardized popularization of robotic minimally invasive therapy for OVCF. Methods A retrospective controlled trial was carried out. A total of 83 patients with OVCF admitted to the Xining First Peoples Hospital from June 2024 to October 2025 were enrolled and divided into two groups according to surgical protocols: observation group (orthopedic surgical robot-assisted PKP, n=32) and control group (conventional C-arm fluoroscopy-guided manual PKP, n=51). Focusing on the robotic operating system, intraoperative precision indicators (puncture adjustment frequency, fluoroscopy times and puncture trajectory deviation), routine surgical parameters, perioperative VAS scores, anterior vertebral height restoration rate and ODI were compared between the two groups. The incidence of complications within 6 months postoperatively was counted, and the risk prevention mechanism of robotic technology was analyzed. Results Benefiting from multi-modal image fusion, micron-level spatial positioning and real-time dynamic error correction, the observation group had markedly fewer fluoroscopy times and puncture adjustments as well as smaller trajectory deviations (P<0.05), demonstrating significantly improved surgical accuracy. Compared with the control group, the observation group exhibited better recovery of anterior vertebral height, more satisfactory pain relief and superior spinal functional recovery (P<0.05), and significantly reduced the incidence of bone cement leakage and long-term vertebral refracture (P<0.05). Owing to the time required for image registration and robotic arm calibration, the total operative duration was slightly longer than the control group. Conclusion The orthopedic surgical robot establishes an intelligent, quantitative and standardized operation system. It overcomes the drawbacks of traditional PKP, including heavy dependence on operator experience, large subjective deviations, excessive radiation exposure, and poor control of complications. For OVCF PKP, the robotic technique greatly improves puncture precision and surgical standardization, optimizes postoperative efficacy and lowers surgical risks, serving as a core technical means to realize the precision?riented and intelligent upgrading of minimally invasive treatment for OVCF.

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

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