ArticleJournal of orthopaedic surgery and research2025
Clinical efficacy and safety of modified tracer fixation technique in robot-assisted percutaneous pedicle screw fixation for thoracolumbar fractures.
Article in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis study aims to compare the clinical efficacy and safety of the modified skin-fixed tracer with spinous process-fixed tracer in robot-assisted percutaneous pedicle screw (PPS) fixation for thoracolumbar fractures.
methodsA total of 98 patients with thoracolumbar fractures undergoing robot-assisted PPS fixation were retrospectively recruited from April 2023 to June 2024 in the Second Affiliated Hospital of Xuzhou Medical University, including 46 in skin-fixed tracer group and 52 in spinous process-fixed tracer group. In skin-fixed group, there were 20 males and 26 females, with an average age of 44.0 ± 8.7 years (range 19-59 years); In spinous process-fixed group, there were 30 males and 22 females, with an average age of 42.7 ± 8.9 years (range 19-58 years). Clinical outcomes were assessed by preoperative and postoperative (day 7, 3-month and 6-month) Visual Analogue Scale (VAS), anterior vertebral height ratio (AVHR), Cobb angle, and Oswestry Disability Index (ODI). Surgical indicators included tracer fixation time, total duration of surgery, intraoperative blood loss, number of intraoperative fluoroscopy, and length of incision. Besides, Gertzbein-Robbins classification was used to evaluate the accuracy of PPS fixation.
resultsAll surgeries were successfully completed under intraoperative neurophysiologic monitoring (IONM) without complications of spinal cord injuries. Patients were followed up for 6 to 14 months, with an average follow-up time of 10.2 ± 2.8 months. Two groups showed markedly improvements (P < 0.05) in postoperative VAS, AVHR, Cobb angle, and ODI, but no statistical intergroup differences were found (P > 0.05). Compared with spinous process-fixed group, skin-fixed group had significantly shorter tracer fixation and surgical duration, less intraoperative blood loss and lower length of incision, with all P values less than 0.05. However, the two groups had similar numbers of intraoperative fluoroscopy and accuracy rates of PPS fixation, with both P values greater than 0.05.
conclusionIn robot-assisted PPS fixation for thoracolumbar fractures, the modified skin-fixed tracer has the same safety and accuracy as spinous process-fixed tracer, but can shorten tracer fixation and surgical duration, reduce length of incision, decrease intraoperative blood loss, as well as promote pain relief and functional recovery. Thus, skin-fixed tracer is a safe and feasible method that is worthy of promotion and application.
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