Multidimensional Efficacy Evaluation of Tianji Orthopedic Robot-Assisted Screw Placement Surgery and Traditional Open Surgery in the Treatment of Thoracic Fractures
Objective: To compare the clinical efficacy of Tianji orthopedic robot-assisted surgery and traditional open surgery in the treatment of thoracic fractures. Methods: 30 patients in the robot group and 25 patients in the open group were included. Baseline data such as age, BMI, and gender of the two groups were compared. The ODI scores, Cobb angles, anterior and posterior vertebral height ratios before and after surgery, as well as intraoperative blood loss, vertebral fracture healing time, postoperative hospital stay, screw accuracy rate and scores of the two groups were compared. Results: There was no significant difference in baseline data between the two groups of patients (P > 0.05). Before surgery, the ODI scores, Cobb angles, and anterior and posterior vertebral height ratios of the two groups were similar (P > 0.05). After surgery, the robot group was superior to the open group in terms of Cobb angle improvement (1-week postoperative review: t = 2.4880, P = 0.0080; last review: t = 3.3921, P = 0.0007). The intraoperative blood loss in the robot group was significantly less than that in the open group (t = 4.0903, P = 0.0001), and the vertebral fracture healing time was shorter (t = 4.4702, P = 0.0000). In terms of screw accuracy, the number of Grade A screws in the robot group was more than that in the open group (χ2 = 10.9506, P = 0.0009), the number of Grade B screws was less than that in the open group (χ2 = 9.9740, P = 0.0016), but the accuracy score was lower than that in the open group (t = 1.7832, P = 0.0401). Conclusion: Tianji orthopedic robot-assisted surgery has advantages over traditional open surgery in reducing intraoperative bleeding, shortening fracture healing time and improving some imaging indicators in the treatment of thoracic fractures, but there are differences in screw accuracy scores, providing a new reference for the clinical treatment of thoracic fractures.
References
[1]
Zygogiannis, K., Manolakos, K., Kalampokis, A., Thivaios, G.C. and Moschos, S. (2022) Traumatic Fracture of the Thoracic Spine with Severe Posterolateral Dislocation: A Case Report. Cureus, 14, e23830. https://doi.org/10.7759/cureus.23830
[2]
Ge, J., Chen, K., Xu, P., Zhang, Z., Wang, K., Zhang, T., et al. (2025) Percutaneous Vertebroplasty by Two-Step Fluoroscopy: A Treatment for Osteoporotic Compression Fractures of Thoracic Vertebrae in Older Adults. BMCMusculoskeletalDisorders, 26, Article No. 135. https://doi.org/10.1186/s12891-025-08403-7
[3]
Lin, S., Hu, J., Wan, L., et al. (2020) Short-Term Effectiveness Comparison between Robotic-Guided Percutaneous Minimally Invasive Pedicle Screw Internal Fixation and Traditional Open Internal Fixation in Treatment of Thoracolumbar Fractures. Chinese Journal of Reparative and Reconstructive Surgery, 34, 76-82.
[4]
Yang, Y., Hu, Q.Q., Cai, J.B., et al. (2024) A Prospective Controlled Study on the Treatment of Thoracolumbar Burst Fractures Using Precise Quantitative Method of Transpedicular Bone Grafting Combined with Short Segment Fixation of Injured Vertebrae with CT Three-Dimensional Reconstruction Assistance. Journal of Practical Medical Techniques, 31, 399-403.
[5]
Xiong, C., Huang, B., Wei, T., Kang, H. and Xu, F. (2020) Effect of the Short-Segment Internal Fixation with Intermediate Inclined-Angle Polyaxial Screw at the Fractured Vertebra on the Treatment of Denis Type B Thoracolumbar Fracture. JournalofOrthopaedicSurgeryandResearch, 15, Article No. 182. https://doi.org/10.1186/s13018-020-01686-7
[6]
Li, J.J., Li, X.J. and Yu, J.L. (2024) Comparison of Therapeutic Effects between Robot-Assisted and Pedicle Boundary Method Screw Placement for Thoracolumbar Fractures. Journal of Spinal Surgery, 22, 152-157.
[7]
Zheng, C., Chai, J. and Lu, W.J. (2024) Clinical Effect of Robot-Assisted Percutaneous Pedicle Screw Fixation in the Treatment of Patients with Single Segmental Thoracolumbar Compression Fracture. Chinese Journal of Robotic Surgery, 5, 818-824, 830.
[8]
Peters, D.R., Owen, T., Tariq, H., Pfortmiller, D., Holland, C., Coric, D., et al. (2024) Open versus Percutaneous Stabilization of Thoracolumbar Fractures: A Large Retrospective Analysis of Safety and Reoperation Rates. Cureus, 16, e61369. https://doi.org/10.7759/cureus.61369
[9]
Jiang, Z.W., Li, Z.H., Jin, H.L., et al. (2024) 3D Printed Guide Assisted versus Freehand Pedicle Screw Fixation of Upper and Middle Thoracic Spine Fractures. Orthopedic Journal of China, 32, 397-402.
[10]
Zhang, T.T., Wang, Z.P., Wang, Z.H., et al. (2022) Accuracy and Safety of Robot Assisted Pedicle Screw Placement. China Journal of Orthopaedics and Traumatology, 35, 108-112.
[11]
Motov, S., Butenschoen, V.M., Krauss, P.E., Veeravagu, A., Yoo, K.H., Stengel, F.C., et al. (2025) Current State and Future Perspectives of Spinal Navigation and Robotics—An AO Spine Survey. BrainandSpine, 5, Article ID: 104165. https://doi.org/10.1016/j.bas.2024.104165
[12]
Zhao, J., Zhang, Y., Fan, M., Han, X., Liu, B., He, D., et al. (2024) The Positional Consistency between Guidewire and Cannulated or Solid Screw in Robot-Assisted Spinal Internal Fixation Surgery. JournalofOrthopaedicSurgeryandResearch, 18, Article No. 708. https://doi.org/10.1186/s13018-023-04053-4
[13]
Villeneuve, L.M., Lee, B., Cornwell, B., Nagarajan, M. and Smith, Z.A. (2022) Robot-Assisted Thoracolumbar Fixation after Acute Spinal Trauma: A Case Series. Cureus, 14, e31832. https://doi.org/10.7759/cureus.31832
[14]
Ozono, K., Son, K., Momii, K., Morifuji, Y., Ikenaga, N. and Nakamura, M. (2024) Severe Hemothorax Due to Traumatic Fracture of Thoracic Vertebra. SurgicalCaseReports, 10, Article No. 26. https://doi.org/10.1186/s40792-024-01819-8
[15]
Sun, Y. (2023) Percutaneous Kyphoplasty to Relieve the Rib Region Pain in Osteoporotic Thoracic Vertebral Fracture Patients without Local Pain of Fractured Vertebra. PainPhysicianJournal, 26, 53-59. https://doi.org/10.36076/ppj.2023.26.53