Objective To explore the clinical effect of PSIS-A robot-assisted percutaneous screw in the treatment of thoracolumbar fracture. Methods Patients with thoracolumbar fracture who were hospitalized in Mianyang Orthopedic Hospital between August 2022 and January 2024 and required percutaneous pedicle screw f ixation were selected. Patients were divided into robot group and free hand group by random number table. Operative time, intraoperative bleeding, intraoperative radiation dose and time, implant accuracy rate, small joint invasion rate, Visual Analogue Scale score for pain and other indexes were compared between the two groups. Results A total of 60 patients were included. Among them, there were 28 cases in the robot group and 32 cases in the free hand group. On the third day after surgery, the Visual Analogue Scale score of the robot group was better than that of the free hand group (P=0.003). Except for intraoperative bleeding and radiation frequency (P>0.05), the surgical time, average nail implantation time, and intraoperative radiation dose in the robot group were all lower than those in the free hand group (P<0.05). The accuracy and excellence rate of nail planting in the robot group were higher than those in the free hand group (94.6% vs. 84.9%; χ2=7.806, P=0.005). There was no statistically significant difference in the acceptable accuracy rate (96.4% vs. 91.1%; χ2=3.240, P=0.072) and the incidence of screw facet joint invasion (7.2% vs.14.1%; χ2=3.608, P=0.058) between the two groups. Conclusion The application of PSIS-A type robot assisted percutaneous minimally invasive pedicle screw fixation in the treatment of thoracolumbar fr actures is promising.
Objective To observe the effect of platelet-rich plasma (PRP) gel combined with local decompression bone grafting on lumbar fusion. Methods A total of 80 patients with lumbar degenerative diseases who needed posterior lumbar fusion surgery at Mianyang Orthopedic Hospital between January and June 2024 were selected and randomly divided into groups A and B using the random number method. For patients in group A (n=40), decompression bone graft combined with PRP gel was implanted intraoperatively, while those in group B (n=40) received only decompression bone graft. The Visual Analogue Scale (VAS) pain scores before surgery and 3 days, 1 month and 3 months after surgery, the Oswestry Disability Index (ODI) and the Activities of Daily Living (ADL) scores before surgery and 1 month and 3 months after surgery, the intervertebral space height before surgery and 1 month and 3, 6, and 12 months after surgery, and the intervertebral fusion rate 3, 6, and 12 months after surgery were observed between the two groups. Results The VAS, ODI and ADL scores of group A were significantly better than those of group B 3 months after surgery (P<0.05). Regarding the intervertebral space height, the interaction effect of time and group was statistically significant 6 and 12 months after surgery (P<0.05), and the intervertebral space height of group A was better than that of group B at these time points (P<0.05). The difference in fusion time survival curves between the two groups was statistically significant (P=0.008), group A was better than group B. Conclusion Intervertebral bone grafting with PRP gel mixed with local decompression bone can significantly increase the intervertebral fusion rate, reduce the degree of intervertebral space subsidence, and significantly improve the postoperative pain and quality of life of patients, providing an effective and feasible new strategy for improving the intervertebral fusion rate after lumbar fusion surgery.