The purpose of this study was to compare the clinical and radiological differences among three advanced guided technologies in adult degenerative scoliosis. A total of 1012 pedicle screws were inserted in 83 patients using a spine robot (group A), 886 screws were implanted in 75 patients using a drill guide template (group B), and 1276 screws were inserted in 109 patients using CT-based navigation (group C). Screw positions were evaluated using postoperative CT scans according to the Gertzbein and Robbins classification. Other relevant data were also collected. Perfect pedicle screw insertion (Grade A) accuracy in groups A, B, and C was 91.3%, 81.3%, and 84.1%, respectively. Clinically acceptable accuracy of screw implantation (Grades A + B) respectively was 96.0%, 90.6%, and 93.0%. Statistical analysis showed the perfect and clinically acceptable accuracy in group A was significant different compared with groups B and C. Group A exhibited the lowest intra-op radiation dose and group B showed the shortest surgical time compared with the other two groups. Robotic-assisted technology demonstrated significantly higher accuracy than the drill guide template or CT-based navigation systems for difficult screw implantations in adult degenerative scoliosis and reduced the intra-op radiation dose, although it failed to reduce surgery time.

中文翻译：

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成人退变性脊柱侧凸椎弓根螺钉固定三种辅助技术的放射学和临床差异。


本研究的目的是比较三种先进引导技术治疗成人退行性脊柱侧凸的临床和放射学差异。使用脊柱机器人为 83 名患者植入了 1012 个椎弓根螺钉（A 组），使用导钻模板为 75 名患者植入了 886 个螺钉（B 组），使用基于 CT 的导航为 109 名患者植入了 1276 个螺钉（C组）。根据 Gertzbein 和 Robbins 分类，使用术后 CT 扫描评估螺钉位置。还收集了其他相关数据。 A、B、C 组的完美椎弓根螺钉置入（A 级）准确度分别为 91.3%、81.3% 和 84.1%。临床可接受的螺钉植入准确度（A + B 级）分别为 96.0%、90.6% 和 93.0%。统计分析显示，A组的完美且临床可接受的准确性与B和C组相比有显着差异。与其他两组相比，A组术中辐射剂量最低，B组手术时间最短。对于成人退行性脊柱侧凸的困难螺钉植入，机器人辅助技术表现出比钻导模板或基于 CT 的导航系统更高的准确性，并减少了术中辐射剂量，尽管它未能缩短手术时间。